A publication of the PHARMACEUTICAL SERVICES DIVISION AND THE CLINICAL RESEARCH CENTRE MINISTRY OF HEALTH MALAYSIA MALAYSIAN STATISTICS ON MEDICINES 2008 Edited by: Lian L.M., Kamarudin A., Siti Fauziah A., Nik Nor Aklima N.O., Norazida A.R. With contributions from: Hafizh A.A., Lim J.Y., Hoo L.P., Faridah Aryani M.Y., Sheamini S., Rosliza L., Fatimah A.R., Nour Hanah O., Rosaida M.S., Muhammad Radzi A.H., Raman M., Tee H.P., Ooi B.P., Shamsiah S., Tan H.P.M., Jayaram M., Masni M., Sri Wahyu T., Muhammad Yazid J., Norafidah I., Nurkhodrulnada M.L., Letchumanan G.R.R., Mastura I., Yong S.L., Mohamed Noor R., Daphne G., Kamarudin A., Chang K.M., Goh A.S., Sinari S., Bee P.C., Lim Y.S., Wong S.P., Chang K.M., Goh A.S., Sinari S., Bee P.C., Lim Y.S., Wong S.P., Omar I., Zoriah A., Fong Y.Y.A., Nusaibah A.R., Feisul Idzwan M., Ghazali A.K., Hooi L.S., Khoo E.M., Sunita B., Nurul Suhaida B.,Wan Azman W.A., Liew H.B., Kong S.H., Haarathi C., Nirmala J., Sim K.H., Azura M.A., Asmah J., Chan L.C., Choon S.E., Chang S.Y., Roshidah B., Ravindran J., Nik Mohd Nasri N.I., Ghazali I., Wan Abu Bakar Y., Wan Hamilton W.H., Ravichandran J., Zaridah S., Wan Zahanim W.Y., Kannappan P., Intan Shafina S., Tan A.L., Rohan Malek J., Selvalingam S., Lei C.M.C., Ching S.L., Zanariah H., Lim P.C., Hong Y.H.J., Tan T.B.A., Sim L.H.B, Long K.N., Sameerah S.A.R., Lai M.L.J., Rahela A.K., Azura D., Ibtisam M.N., Voon F.K., Nor Saleha I.T., Tajunisah M.E., Wan Nazuha W.R., Wong H.S., Rosnawati Y., Ong S.G., Syazzana D., Puteri Juanita Z., Mohd. Shahrir M.S., Low Y.L., Husni H., Liew L.F.E., Muhaini O., Mary S.C., Choy Y.C., Marzida M., Nur Irnawaty Z., Choo Y. M., Sapiah S., Mohd. Sufian A., Norsima Nazifah S., Nurul Faezah M.Y., Khutrun Nada Z., Md. Hanip M.R., Toh C.L., Nor Hayati A., Azizul A., Mazni M.J., Umi Adzlin S., Wong C.W.V., Noor Ratna N., Shamini R., Ang W.N., Roslina A.M., Sabrina M.S., Laila Nadrah M.Z., Valuyeetham K.A., Saraiza A.B., Suliyana Y., Aswani Yanti B., Primuharsa Putra S.H.A., Thayanithi.S., S Anusiah S., Manimegahlai S., Hana Radhiah M.D., Chuah J.L, Shamala R., Elias H., Ho B.K., Chan P.L., Saraiza A.B.,Tan K.K., Nor Saleha I.T., Rohani J., Saidatul Norbaya B., Najwa A.H. A publication of the PHARMACEUTICAL SERVICES DIVISION AND THE CLINICAL RESEARCH CENTRE MINISTRY OF HEALTH MALAYSIA MALAYSIAN STATISTICS ON MEDICINES 2008 April 2013 © Ministry of Health Malaysia Published jointly by: The National Medicines Use Survey Pharmaceutical Services Division Ministry of Health Lot 36, Jalan Universiti 46350 Petaling Jaya Malaysia Tel. : (603) 7841 3200 Fax : (603) 7968 2222 Website : http://www.pharmacy.gov.my Website : http://www.crc.gov.my AND The National Medicines Use Survey Clinical Research Centre Ministry of Health 3rd Floor, MMA House 124, Jalan Pahang 50286 Kuala Lumpur Malaysia Tel. : (603) 4043 9300 Fax : (603) 4043 9400 e-mail : [email protected] Website : http://www.crc.gov.my This report is copyrighted. Reproduction and dissemination of this report in part or in whole for research, educational or other non-commercial purposes are authorized without any prior written permission from the copyright holders provided the source is fully acknowledged. Suggested citation is: Pharmaceutical Services Division and Clinical Research Centre, Ministry of Health Malaysia. Malaysian Statistics on Medicine 2008. Kuala Lumpur 2013 This report is also published electronically on website of the Pharmaceutical Services Division at: http://www.pharmacy.gov.my and the website of the Clinical Research Centre at: http://www.crc.gov.my Funding: The National Medicines Use Survey is funded by Operational Budget from Pharmaceutical Services Division, Ministry of Health. Please note that there is potential for revision of the data in this report. Please check the latest edition of Malaysian Statistics on Medicines report for any amendments at www.pharmacy.gov.my or www.crc.gov.my i MALAYSIAN STATISTICS ON MEDICINES 2008 PREFACE Ensuring access to quality and affordable medicines is an important objective of Malaysia’s National Medicines Policy. The National Medicines Use Survey (NMUS) was conducted with the intention to continuously and systematically collect data on medicines with the hope that the findings will help promote rational use as well as provide a tool for better decision making in the allocation of healthcare resources for the Malaysian population. The NMUS is into its eighth year and this report, the Malaysian Statistics on Medicines (MSOM) 2008, is its fifth publication. From the first publication of MSOM 2004, we have progressively improved and enhanced the data processing and statistical analysis methodologies. For this report, the 2007 data was reanalysed using the updated statistical methodology, taking into consideration also changes in WHO Guidelines for ATC and DDD Assignment, thus allowing comparison with the 2008 data. The drug utilisation data in this report is tabulated in such a way as to allow this comparison. The scope of NMUS and the MSOM reports are limited by data collection logistics and availability of defined daily doses (DDD) for a drug in the WHO Guidelines for ATC Classification and DDD Assignment. Nonetheless, for MSOM 2008 we are able to add two new chapters i.e. Chapter 26: Use of Drugs for Cough and Cold and Chapter 27: Use of Vaccines, using locally established DDDs based on WHO general guidelines. We are optimistic that as NMUS matures, more chapters will be added to deliberate on more classes of drugs, and future MSOM reports will continue to produce accurate and reliable statistics on Malaysian medicines consumption. The NMUS faces many challenges, not the least the varied and non-standardised form of source data and its volume. This has made data- processing and data quality assurance an almost insurmountable task. However, with perseverance, we have managed to come out with data which reflect the general quantum and pattern of medicines consumption in this country. Continued efforts will be made to improve all aspects of the survey and report, and to ensure timely publication of the data in future. We sincerely hope that this MSOM 2008 report will be useful to relevant healthcare professionals, serving as a source of reference and baseline for embarking in future research or clinical audits towards promoting rational prescribing and effective medicines use. The author(s) would like to thank the Director General Of Health Malaysia for permission to publish this report. We also would like to thank all staff, past and present, who had worked very hard in ensuring the success of the NMUS, all agencies and institutions that had helped in providing data, all expert panel members and everyone who has in one way or another contributed enthusiastically to the success of the NMUS and the writing of this report. Pharmaceutical Services Division Clinical Research Centre Ministry of Health Malaysia i MALAYSIAN STATISTICS ON MEDICINES 2008 ACKNOWLEDGEMENTS The National Medicines Use Survey would like to thank the following for their participation, assistance, support or contributions: • Director General of Health, Malaysia • Deputy Director General of Health (Research and Technical Support), Ministry of Health (MOH) • Deputy Director General of Health (Medical Services), MOH • Deputy Director General of Health (Public Health), MOH • Senior Director of Pharmaceutical Services Division, MOH • Senior Director of Oral Health Division, MOH • Director, National Pharmaceutical Control Bureau, MOH • Director, Clinical Research Centre, MOH • Heads of Clinical Services, MOH • Procurement and Privatisation Division, MOH • All medical doctors, pharmacists and support personnel who participated in the NMUS surveys • All participating public and private hospitals which provided or allowed access to their medicines procurement data • University of Malaya Medical Centre, Hospital Universiti Kebangsaan Malaysia, Hospital Universiti Sains Malaysia, Lumut Armed Forces Hospital, Terendak Armed Forces Hospital • Members of the NMUS Expert Panels who contributed to writing this report • Association of Private Hospitals Malaysia, Malaysian Organisation of Pharmaceutical Industries (MOPI) and Pharmaceutical Association of Malaysia (PhAMA) • Pharmaniaga Logistics Sdn Bhd. and Forte Tech Solutions Sdn. Bhd. • Dr. Lim Teck Onn, former Director, Clinical Research Centre, who played a pivotal role in the initiation and development of the NMUS project • All who have in one way or another supported and/or contributed to the success of the NMUS and this report Dr. Salmah binti Bahri Chairman Dr. Goh Pik Pin Co-Chairman National Medicines Use Survey, Ministry of Health Malaysia ii MALAYSIAN STATISTICS ON MEDICINES 2008 ABOUT THE NATIONAL MEDICINES USE SURVEY The National Medicines Use Survey (NMUS) is a project initiated and supported by the MOH to collect information on the supply, procurement, prescription, dispensing and use of drugs in Malaysia. The NMUS is designed to support the implementation of our National Medicines Policy (NMP). The objectives of NMP are to ensure only safe, efficacious and good quality medicines are available for use in Malaysia, as well as to promote equitable access to, and rational and cost-effective use of these medicines, ultimately leading to improved health for all Malaysians. In supporting this, the NMUS provides the functional capacity for the collection, analysis, reporting and dissemination of data on drug utilization in Malaysia. The NMUS is jointly sponsored by: • Pharmaceutical Services Division, Ministry of Health • Clinical Research Centre, National Institutes of Health, Ministry of Health Purpose of the NMUS The availability of high quality, reliable and timely information on medicines use is crucial for any discussion on improving the use of medicines in Malaysia.