A new policy has sparked debate across the healthcare sector. Here’s why it matters for both pharmacists and the people they serve.
In recent months, a long-overdue policy introducing drug price transparency has stirred conversations across the healthcare landscape. While it’s largely seen as a step toward clarity and accountability, responses have been far from one-note.
Some believe it’s a win for consumer rights, making healthcare more transparent, accessible and affordable. Others, however, raise concerns about how the policy is being rolled out, especially in more complex or sensitive healthcare settings.
With much of the conversation centring on implementation and impact, we spoke to Encik Amrahi bin Buang, who has served as President of the Malaysian Pharmacist Society (MPS) for the past eight years, to unpack his perspective on the intent behind the policy, its impact on independent pharmacies, and why transparency is ultimately a win for the rakyat.
1Twenty80: After the government introduced the drug price transparency policy, what was your initial opinion?
Amrahi Buang: This isn’t something new, the idea has been around since KJ’s (Khairy Jamaluddin) time as Health Minister. It was even mentioned in Parliament back then. What we’re seeing now is simply the continuation of that discussion.
The recent announcement came from the Prime Minister, who also chairs the National Action Council on Cost of Living (NACCOL). Because the decision was made at that level, both the Ministry of Health and the Ministry of Domestic Trade and Cost of Living are involved in implementing it. So you need to understand that this isn’t just a MOH issue—it’s a cross-ministry initiative driven by concerns about affordability.
In fact, the whole concept of making medicine prices more transparent is already embedded in the Malaysian National Medicines Policy (MNMP). If you look into who manages the policy and the stakeholders involved, you’ll get the full picture of why pharmacists, like those of us in MPS, are not against it. We’ve been involved from the start, so for us, there’s no issue.
People often forget the role of community pharmacies today. We’re not retailers or drug sellers. We’re a part of the healthcare system. That’s why when we partnered with online shopping platforms, we ensured all storefronts meet three conditions: the pharmacist is registered, has a Type A Poison Licence, and is a member of MPS. That way, consumers know they’re buying from a trusted source.
1Twenty80: Did you know of any challenges faced in complying with this policy as a pharmacist?
Amrahi Buang: From what we’ve seen, there aren’t major issues when it comes to compliance, but it really depends on the type of pharmacy.
We usually group them into three categories:
#1 Big chain pharmacies
First, the big chains like BIG Pharmacy, Caring, Healthlane Pharmacy, and Alpro. These pharmacies already have established systems in place, so implementing drug price transparency isn’t a problem for them.
#2 Smaller chains
Then, there are the small chains—independent owners with a few outlets. They’re not as large, but generally still can comply.
#3 Independent pharmacies
The group I focus on the most is the independent single-outlet pharmacies, especially those outside urban areas like Sabah and Sarawak. Some of them might still use manual systems and may not have a proper POS (Point-of-Sale) system, which makes generating itemised receipts and displaying medicine prices a bit more challenging. But I’ve spoken directly to some of them and asked, “Can you comply with the drug price transparency display?” And they’ve said, “Yes, no issue.”
At MPS, we’ve taken extra steps to support them. We have organised nationwide webinars and town halls specifically for independent community pharmacies, and about 150 of them joined. We also invited MOH representatives to explain the policy and clarify any concerns.
This opened up communication channels that didn’t exist before. Independents tend to operate on their own, so getting them all in one space was an achievement.
Now, we’re much better connected, and I can confidently say, compliance isn’t an issue.
1Twenty80: As drug price increases and fluctuates, does this policy bring up additional workload to pharmacists?
Amrahi Buang: Drug prices fluctuate because we operate in a free market. Medicines are treated like commodities—except they’re inelastic. People only buy them when they’re sick, but when they need them, they can’t delay or avoid the purchase. So no matter how the price changes, the demand stays. That’s the issue.
You can’t compare prices between pharmacies in different areas (one in a shop lot in the city vs. another in a rural district). These price differences exist because there’s no control in the private sector. That’s the challenge.
Stepping back, this all ties into our two-tier healthcare system: public and private. In the public system (like MOH facilities), healthcare is heavily subsidised. You pay RM1 to see a doctor, or RM5 to see a specialist. Sounds great, but someone has to bear the cost. The reality is, only 15% of Malaysians pay tax. So how can 15% support the rest? It’s not sustainable, especially since we don’t have a national health insurance system.
The private sector, on the other hand, isn’t connected to the public sector (there’s little integration). So while drug pricing in public facilities can be controlled, it’s not the same in private pharmacies, where we work. That’s why pharmacists feel the strain—not just from changing prices, but from a system where the public and private sectors aren’t working together. We’ve talked about improving this for years, but nothing has changed.
We’ve been talking about reforming the healthcare system for decades, but there’s been little progress. Finally, on 15 June 2023, the Health White Paper was passed in Parliament, and it includes a framework to address these issues, including national healthcare financing and access to medicine. But since then, implementation has been slow. We haven’t been invited to contribute or consult further, even though pharmacists are key players in this.
So yes, price fluctuations add pressure. But the real issue isn’t workload. It’s the lack of system integration and sustainable healthcare financing. If we don’t address that, nothing changes.
1Twenty80: Do you think pharmacists find this policy effective or efficient?
Amrahi Buang: There is no issue. You have to understand that our profession exists because of patients and consumers. Some people try to separate the two and say patients aren’t consumers, which to me, that’s nonsense. We are all consumers, whether you’re a stakeholder, patient, or member of the public. So of course we have the right to information and transparency.
Pharmacists are part of a noble profession. Our role is to serve the community ethically and responsibly, and that includes being transparent about prices. Because we believe in doing what’s right, and upholding our code of ethics. The first principle is to put patients first, and that’s exactly what we’re doing. Don’t forget. We’re doing our part.
1Twenty80: What are some of the advantages and disadvantages of this new policy?
Amrahi Buang: As I mentioned earlier, the objective of this policy is very clear: price display. I don’t think it’s rocket science. If we can’t even do something this basic, and yet we receive so much criticism, how do we move forward? How do we even begin talking about things like price control?
I’ve told my pharmacists, we understand there’s a price war. We know the competition is there between independent community pharmacies and chains. But I told them, “Just display the prices.” Because at the end of the day, it makes sense: pharmacies must be able to earn a profit.
The issue is, the Ministry talks about profiteering, not profit. And there’s a difference. Profiteering is when the margin is excessive. You take your base price and multiply it by a huge factor. That’s when people start to feel the pressure, especially from the other group (e.g. doctors). As for us, our position is clear. If you look at the MPS logo, it says, “Berkhidmat Untuk Kesihatan Rakyat”, so that is our focus.
We care about health, not just sick care (there’s a big difference between healthcare and sick care). A lot of the time, what we’re discussing is sick care, treatment, rehabilitation, and palliative care. But we should be looking at promotive and preventive care. That’s where community pharmacies have a huge role to play.
If you refer to the Health White Paper, it’s already mentioned that our non-communicable disease (NCD) numbers are alarming. Diabetes, for example. So we need to invest in keeping people healthy, not just treating them when they fall sick.
Of course, when it comes to the role of community pharmacies, there’s still the issue of overlap with general practitioners (GPs). Whether or not the government addresses this is up to them. But I told our pharmacists that it’s not wrong to just do what you’re supposed to do, even without a formal separation of roles.
In many systems, the roles are already clear. In public hospitals, the doctor sees the patient, gives a prescription, and the pharmacist handles the medicine. Even in private hospitals or ambulatory care, there’s a clear separation. But in the private sector between GPs and community pharmacies, it still doesn’t exist.
1Twenty80: Do you think complying with this policy achieves its intended goal of promoting transparency and price competition?
Amrahi Buang: I think it’s as clear as daylight, isn’t it?
This is something we should support. If you ask the 34 million people in this country, I believe most would give a thumbs up, or even double thumbs up, for drug price transparency.
How can you walk into a place and not know the price? How can you have a sector where someone says, “Oh, I cannot tell you the price”? That doesn’t make sense. So yes, they have to comply.
So I reiterate, as far as pharmacists are concerned, we have no issue with this.
1Twenty80: As the policy has just been implemented, have you observed any changes in consumer behaviour since the prices of the drug have been visible to consumers?
Amrahi Buang: There are two sides to this—both from pharmacists and consumers.
From the pharmacists’ perspective, at MPS, we ensure pharmacists carry out their duties responsibly and professionally. We offer support to help them uphold this standard. On the consumer side, it might not be entirely fair for me to comment, as it’s their experience to share. Maybe you’ve noticed changes better than I have.
What I can say is that with the new policy, when you go to a pharmacy, you now receive an itemised bill listing each drug. This lets you compare prices, whether you visit a big chain or a smaller pharmacy. Ultimately, the choice is yours.
However, I feel the public needs to better understand the pharmacist’s role. Pharmacists are not merely drug sellers. For example, if you want to buy something simple like paracetamol, it shouldn’t just be a quick pay-and-go. At the point of payment, pharmacy staff should ask if you want to speak to the pharmacist. There’s a reason for this, because pharmacists can offer professional advice to help you. It’s your choice to accept or decline.
If you choose to speak with the pharmacist—say it’s me—I’ll ask questions like, “Who is this medication for?”, “What is your temperature?”, or “How long have you had it?” These questions show that I’m concerned about your health, which helps build trust.
We’ve been encouraging the public to seek the pharmacist’s advice when they visit pharmacies. When people ask for pharmacists, it helps pharmacists gain more confidence. If we don’t initiate this interaction, pharmacists miss the chance to gain experience, and the public misses out on the best possible service. Sometimes, I may need to refer you to a doctor—say if I suspect dengue. Even something like a headache can have many causes—different types of headaches need different treatments, and paracetamol might not always be appropriate. That’s why professional advice matters.
I hope the younger generation helps promote this for the benefit of society. Trust is very important.
1Twenty80: After the policy, do consumers find it beneficial in terms of being able to make informed choices as well as make comparisons of the prices?
Amrahi Buang: As a consumer, what do you want? You want to know. Just like a menu that shows the price of each item, the prices of drugs are now clearly displayed. It’s all there for you to see.
This is your right. A universal right. If you want to understand more, you can refer to the Consumer Protection Act. From there, you’ll learn more about your rights as a consumer. Other ministries also support this approach. In fact, you can even approach SUHAKAM, the Human Rights Commission of Malaysia, because this issue goes beyond just pricing. It’s about your basic human rights.
1Twenty80: In your opinion, what do you think the aim of this policy is for both the pharmacy and consumers?
Amrahi Buang: I think I explained this earlier. From the very beginning, it’s important to understand why MOH made this decision. Nothing more than that—because you can’t move forward if you don’t clear this first step.
This step is essential. Only with this transparency can you get a clear picture of what is really happening in the market. I’m sure after this, there will be surveys and checks. In fact, consumer associations should play a big role here.
That means you, as consumers, should report any issues—not to us directly, but to consumer groups who can raise these concerns properly. I don’t believe there is any other agenda behind this policy. I know who’s involved, especially the Ministry of Health, because under the National Medicines Policy (Dasar Ubat Nasional), we are part of this effort. This policy is about improving access to medicine and making it more affordable.
The time frame given is three months for education and advocacy about the policy. MPS will remind our members regularly—maybe by the end of this month, then again after two more months. We’ll keep pushing this through our channels. After that, there will be a follow-up, and that’s it. I don’t foresee any problems.
1Twenty80: Has this policy had any financial impact on pharmacy operations so far?
Amrahi Buang: Maybe slightly. For example, the big pharmacy chains have no issue because they’ve already been doing this. Even the small chains, so far, haven’t raised major concerns.
What I’m more worried about are the independent pharmacies. As I mentioned before, these pharmacies are especially important in rural and suburban areas. Don’t look at KL. If you go to the outskirts of Sabah or Sarawak, then you’ll see how challenging it is over there.
1Twenty80: What could be improved in the implementation or enforcement of this policy?
Amrahi Buang: I think the most important thing is this: when the government implements a policy, it’s ultimately for the rakyat—for the people. If it’s good, then we should just follow through with it. Once we’re able to meet that initial goal, then we can start to move forward. I’m talking about future improvements, but even that depends on whether we can get through this first step.
We must pass this stage of drug price transparency first. Even with something as small as this, you can already see a big commotion. For the first time in Malaysia’s history, you see doctors protesting—that’s never happened before. It shows something’s not right somewhere. But it’s not my place to comment on that. Mind you, I have a doctor as a daughter and a pharmacist as a son.
At the end of the day, patients need both good doctors and good pharmacists. We’re playing different roles. Pharmacists don’t want to be doctors. If a pharmacist wants to be a doctor, they need to study medicine—it’s a whole different field. Doctors focus more on diseases and treatment. We, on the other hand, are medicine experts. Sometimes that gets misunderstood.
Here’s a simple example: when you go to a pharmacy, you’ll find many types of paracetamol. Why? It’s all about the formulation and the technology behind it—how the drug is absorbed, how long it lasts in your system, whether it’s for regular or more intense pain. That’s all under the pharmacist’s domain. Each formulation is different, and we adjust based on the patient’s needs.
1Twenty80: Any last words?
Amrahi Buang: I think in the end, it all goes back to society and the community. Don’t take things too personally. If anyone objects to this policy, just remind them that it’s about people’s rights—and we’re simply here to uphold those rights. That’s important, because we’re talking about the majority. We’re talking about millions of people.
How many pharmacies are there? Around 23,000. Maybe there are 50,000 to 100,000 doctors. But at the end of the day, it’s just numbers. When you compare that to a population of 34 million, you can see how big the issue actually is.
Like I said earlier, if you look at the bigger picture and speak from your own experience and perspective, I think we’ve already won—because now the society and the community trust us.
