MALAYSIAN STATISTICS ON MEDICINES 2009 & 2010 Edited by: Siti Fauziah A., Kamarudin A., Nik Nor Aklima N.O. With contributions from: Faridah Aryani MY., Fatimah AR., Sivasampu S., Rosliza L., Rosaida M.S., Kiew K.K., Tee H.P., Ooi B.P., Ooi E.T., Ghan S.L., Sugendiren S., Ang S.Y., Muhammad Radzi A.H. , Masni M., Muhammad Yazid J., Nurkhodrulnada M.L., Letchumanan G.R.R., Fuziah M.Z., Yong S.L., Mohamed Noor R., Daphne G., Chang K.M., Tan S.M., Sinari S., Lim Y.S., Tan H.J., Goh A.S., Wong S.P., Fong AYY., Zoriah A, Omar I., Amin AN., Lim CTY, Feisul Idzwan M., Azahari R., Khoo E.M., Bavanandan S., Sani Y., Wan Azman W.A., Yusoff M.R., Kasim S., Kong S.H., Haarathi C., Nirmala J., Sim K.H., Azura M.A., Suganthi T., Chan L.C., Choon S.E., Chang S.Y., Roshidah B., Ravindran J., Nik Mohd Nasri N.I, Wan Hamilton W.H., Zaridah S., Maisarah A.H., Rohan Malek J., Selvalingam S., Lei C.M., Hazimah H., Zanariah H., Hong Y.H.J., Chan Y.Y., Lin S.N., Sim L.H., Leong K.N., Norhayati N.H.S, Sameerah S.A.R, Rahela A.K., Yuzlina M.Y., Hafizah ZA ., Myat SK., Wan Nazuha W.R, Lim YS,Wong H.S., Rosnawati Y., Ong S.G., Mohd. Shahrir M.S., Hussein H., Mary S.C., Marzida M., Choo Y. M., Nadia A.R., Sapiah S., Mohd. Sufian A., Tan R.Y.L., Norsima Nazifah S., Nurul Faezah M.Y., Raymond A.A., Md. Hanip M.R., Toh C.L., Nor Hayati A., Azizul A., Mazni M.J., Umi Adzlin S., Noor Ratna N., Shamini R., Roslina A.M., Pang Y.K., Nurhayati M.M., Suhadah A., Pang S.F., Valuyeetham K.A., Leow W.L., Aswani Yanti B., Elias H., Bethel L., Shamala R., Manimegahlai S., Nur Izzura M.S., Valuyeetham K.A., Leow W.L., Aswani Yanti B., Primuharsa Putra S.H.A., Ho B.K., Husni H., Chan P.L., Norazida A.R., Saraiza A.B., Tan K.K., Rohani J., Nor Saleha I.T., Saidatul Norbaya B., Najwa A.H. A publication of the PHARMACEUTICAL SERVICES DIVISION AND THE CLINICAL RESEARCH CENTRE MINISTRY OF HEALTH MALAYSIAN STATISTICS ON MEDICINES 2009 & 2010 December 2014 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 AND The National Medicine Use Survey Clincial 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 purpose 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 Statistcs on Medicine 2009 & 2010. Kuala Lumpur 2014 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 Cenre at: http://www.crc.gov. my Funding: The National Medicines Use Survey is funded by Operational Budget from Pharamceutical Services Division, Ministry of Health. 2 MALAYSIAN STATISTICS ON MEDICINES 2009 & 2010 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 intent to continuously and systematically collect data on medicines in the hope to further improve their use as well as to provide a tool for better decision making in the allocation of healthcare resources for the Malaysian population. The NMUS is into its ninth year and we are about to publish the sixth report of the Malaysian Statistics on Medicines (MSOM) 2009-2010. Initially from the first publication of MSOM 2004, we have progressively enhancing the data processing by scaling up the survey to a large sample size that requires time to compute and modify data processor to cater for the immense data. MSOM 2009 & 2010, the drug utilization data is tabulated in such a way as to allow comparison of utilization between 2009 and 2010 as both data were analysed using the same statistical methods. The data was not compared to MSOM 2008 in order to expedite the most current data that is possible to publish at given time and resources. We are optimistic that as NMUS matures, there will be more chapters deliberated and the data processing methodologies will constantly refined, future MSOM reports will continue to produce accurate and reliable statistics on Malaysian medicines consumption at all time. We sincerely hope that this MSOM 2009-2010 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. We would like to thank all staff 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. No matter how much we can do by ourselves on the national level, whether it be research or development, it is never enough. In a spirit of true cooperation, we must join in an action-oriented effort to uphold the rational use of medicine and healthcare of our nation. Pharmaceutical Services Division Ministry of Health Malaysia 3 MALAYSIAN STATISTICS ON MEDICINES 2009 & 2010 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) • Malaysian Medical Council, Malaysian Medical Association, Malaysian Pharmaceutical Society, The Academy of Family Physicians, Primary Care Doctors Association Malaysia, Malaysian Dental Association, Malaysian Private Dental Practitioners Association • Pharmaniaga Logistics Sdn Bhd. and Forte Tech Solutions Sdn. Bhd. • 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 4 MALAYSIAN STATISTICS ON MEDICINES 2009 & 2010 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. The objective of the NMUS is therefore to quantify the present state and time trends of medicines utilization at various levels of our health care system, whether national, regional, local or institutional. Routinely compiled statistics on medicines utilization have many uses, such as: 1. Estimate the consumption of medicines and describe pattern of medicines use through assessing which alternative drugs are being used for particular conditions and to what extent. 2. Estimate the number of medicine users overall, by age, sex and geography and over time. 3. Estimate on the basis of known disease epidemiology to what extent medicines are under or over-used. 4. Relate the number of adverse drug reactions reported to our pharmacovigilance system to the number of people exposed to the drug in order to assess the magnitude of the problem, or to estimate the degree of under-reporting of adverse events 5. Provide a crude estimate of disease prevalence based on its utilization rate. 6. Estimate expenditure on pharmaceuticals, which constitutes a significant proportion of our healthcare expenditure. Monitor and evaluate the effects of interventions to improve the use of medicines. These interventions may be educational effort, promotional campaign, formulary restriction, medicines reimbursement scheme or regulatory measures 5 MALAYSIAN STATISTICS ON MEDICINES 2009 & 2010 NMUS STEERING COMMITTEE Chairman Dr.