Pharmacy Zoning & Ownershp:
95 percents of the population are within 5 kilometers of a government healthcare facility in this country. Kuala Lumpur, Selangor and Johor are the three most densely populated states, accommodating 35 percents of the national population estimated at 7.81 million persons (in year 2000 Population Census), and are being served by 49% of private doctors, 54% private pharmacists, 55% of private hospitals and nursing/maternity homes, in addition to 19 government hospitals and 20 public health clinics. An unequal distribution of healthcare professionals and services in Malaysia is clearly shown by these statistics. This type of scenario is common in all the developing countries across the globe.
Zooming into the pharmacy sector, there were 2,828 practising pharmacists in Malaysia, in year 2002, according to Pharmacy Board Annual Report. 2,311 pharmacists (82%) and 517 pharmacists (18%) work in the private and public sector, respectively. Detailed breakdown of the pharmacists distribution, in 14 States in Public and Private Sectors, are shown below:
States |
Public Sector |
Private Sector |
Public + Private |
Johor |
44 |
146 |
190 |
Kedah |
28 |
109 |
137 |
Kelantan |
46 |
75 |
121 |
Melaka |
20 |
40 |
60 |
Negeri Sembilan |
14 |
72 |
86 |
Pahang |
31 |
44 |
75 |
Perak |
48 |
183 |
231 |
Perlis |
9 |
10 |
19 |
Puala Pinang |
58 |
221 |
279 |
Selangor |
63 |
805 |
868 |
Terengganu |
27 |
22 |
49 |
Kuala Lumpur |
67 |
366 |
433 |
Sabah |
35 |
87 |
122 |
Sarawak |
27 |
131 |
158 |
MALAYSIA |
517 |
2,311 |
2,828 |
Overseas |
|
|
96 |
Ideally speaking, it is always a good thing to have an even distribution of pharmacists and healthcare facility such as community pharmacy throughout a country. In reality, the ideal situation is not even found in the developed nations.
Nonetheless, there are about 30 rural districts in Malaysia where there was no private community pharmacy; about one-third of these districts also did not have a private clinic, in year 2002. Some of these districts do have good potential for the setting up of one or two private community pharmacies. Most of these rural districts are presently served only by the government health facilities.
About 450 newly qualified pharmacists will join the profession each year; giving an average of 32 new pharmacists per State. If these new pharmacists decide to set up their own community pharmacies, where should their premise be? What happen if a new pharmacy open next door to an existing pharmacy which belongs to you? Should the new pharmacy be legislated at a certain distance, says 1 Km, from an existing one? This is one way to ensure more even distribution.
In Australia, they have the Australian Community Pharmacy Authority (a body authorized under their National Health Act 1953) to consider and make recommendation on (1) new pharmacy set-up, and (2) relocation of existing pharmacy. A set of Rules was established for the purpose. Their Health Department makes the final decision, based on the recommendation. A pharmacy can be relocated to a less than 1.5 Km distance from the present address provided that there is no other pharmacy within 500 meters zone.
What about other countries nearer to us in Asia? Anybody wants to comment? South Korea or Taiwan?
The important question on Pharmacy Distribution or Zoning has come up once again when the Dispensing Separation is approaching. What are your views? What should be the most ideal solution?
The other related issue is the Pharmacy Ownership? Should the pharmacies’ ownership be restricted to the pharmacists only? If so, what do we do with those existing ones that are owned by non-pharmacists? What happen to the pharmacy when the pharmacist-owners die and their children are not pharmacists?
Only a few countries, such as Australia, have restricted pharmacies’ ownership to the pharmacists. Britain and America did not have control over the pharmacies’ ownership. Rather they exercise control, similar to Malaysia, over the management control of the pharmacies by the pharmacists, including the Board of Directors’ control structure.
Under the Registration of Pharmacists Act 1951, each community pharmacy should be bona fide conducted by a registered pharmacist. Is this condition been complied by all the pharmacies? If you are working for a non-pharmacist owned pharmacy and have problems to abide by this regulation, can you let us know the details? MCPA is established to protect your rightful interests.
Assuming that it is not possible to practise 100% pharmacy ownership in Malaysia. What percentage of pharmacy ownership shall we, as a profession, target at? 51% to 99%? Do all the pharmacists have financial constraint to come up with the required capital? Maybe, you can contact some senior pharmacists for ‘financial advice when you plan to set up a pharmacy?
Health Ministry, working through Pharmacy Division, has been exercising some measures of control over pharmacy ownership when one applies to register a company with the word pharmacy. Pharmacist’s control and more than 51% ownership are essential criteria to obtain approval.