Galen Centre calls for reforms, increased investments in 4 critical health areas in Budget 2025

THE Galen Centre for Health and Social Policy has called on the government to make reforms and increase investments in four critical areas, namely in healthcare financing, dialysis care, dermatology and access to innovative medicines.

“We know what changes are needed, how much money is available, and potential solutions to address issues such as recruitment and retention of healthcare workers, modernisation of key medical infrastructure, and strengthening health security,” said its CEO Azrul Mohd Khalib.

On healthcare financing, Azrul said the government should remove the RM1 and RM5 charges for outpatient and specialist care respectively in Health Ministry (MOH) facilities.

“People should not need to pay anything at the point of accessing care. These charges also keep alive the fiction that the cost of healthcare in Malaysia is cheaper in government facilities, and mislead the public,” he pointed out.

“Removing these charges will open the way to meaningful discussion and serious consideration of future reforms in healthcare financing.”

He said the government not only need to identify new and sustainable funding for health but also ensure that aged care will be properly supported.

“We recommend introducing national health and social insurance. The pooling of funds will go towards investing in two separate areas: health and aged care. It will complement the existing annual budgetary allocation, and not replace it,” Azrul remarked.

In terms of dialysis care, Azrul went on to note that each year, more than 10,000 people are newly diagnosed with kidney failure and needing dialysis, and this annual number is steadily increasing.

(Image: B. Braun Malaysia)

Worryingly, as the number of people with diabetes increases, MOH has projected that more than 106,000 Malaysians could be on dialysis by 2040, with most likely to be on haemodialysis.

“However, automated peritoneal dialysis (APD) should be prioritised and supported, both in the public and private sector,” he added.

“Patients on peritoneal dialysis (PD) have the potential to live longer, healthier, with more mobility, and without the need for major medical equipment. They are more productive and have a better quality of life. Having just the government to prioritise PD is insufficient.

“We recommend that the Government introduce tax rebates for private dialysis centres to switch their patients to peritoneal dialysis as a form of financial incentive and encouragement, and to support the National PD First policy.”

Meanwhile, Azrul noted that dermatology is under-prioritised and underfunded, with dermatology patients in advanced stages of their conditions such as for generalised pustular psoriasis and atopic dermatitis being forced to resort to seeking innovative treatment with out-of-the-pocket payments.

 

“Investing in immunotherapy and biologics offers significant long-term cost benefits and improved health outcomes,” he disclosed.

“Although such medication and treatments may have higher upfront costs compared to traditional therapies, they are often more effective at controlling symptoms, preventing further disease progression, and have an overall favourable safety profile.”

He said this leads to fewer hospitalisations, reduced need for ongoing treatments, and less time lost to disability, all of which have been proven to lower overall healthcare expenditure.

“We recommend that the government increase the medicines allocation for the dermatology services,” he said.

“Many dermatology patients depend on this essential service to improve their quality of life, address stigma and discrimination, and reduce pain and suffering due to their condition.”

On access to innovative medicines, Azrul shared that the annual drug budget in public hospitals under both MOH and the Higher Education Ministry struggle to sufficiently accommodate innovative therapies despite their increasingly critical role in treatment, improve health outcomes and save lives.

“Providing efficacious and safe immunotherapy or biologic agents to patients is a challenge under existing budgetary limitations and priorities,” he acknowledged.

For this area, Azrul recommends the government allocate and earmark 5% of annual revenue from excise duty imposed on the sale of tobacco, vape, e-cigarettes, and alcohol products (estimated to be more than RM5.5 bil per annum) to provide funding of an estimated RM290 mil annually for the procurement of innovative medicines.

“This will be a focused, sustainable and targeted fund to ensure the availability of lifesaving therapies for those who need it. This move will save lives and prolong life,” he stressed. – Oct 11, 2024

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