MMA president Dr R Thirunavukarasu said in a statement today that the government had failed to regulate TPAs, despite warnings from the association since 1998.
He said the recent circular was a direct result of the government’s neglect and risked damaging the doctor-patient relationship.
“The government must stop sidestepping the long-overdue regulation of TPAs and managed care organisations, as mandated under the Private Healthcare Facilities and Services Act (Act 586) and in line with the Malaysian Medical Council standards, instead of piling more restrictions on doctors who are already bound by strict ethical codes,” he said.
“For years, TPAs have been directly involved in the healthcare ecosystem, yet they have continued to operate without any regulation – a situation that is both shocking and inexcusable.”
Health news portal CodeBlue recently reported that MiCare Sdn Bhd, a TPA owned by Hong Kong-based Zuellig Group, had directed panel healthcare providers to limit Hong Leong bank employees to generic versions of medicines for chronic conditions.
Thirunavukarasu said while MMA strongly supports the wider use of quality-assured generic medicine, a blanket mandate was unacceptable as it risked undermining professional ethics and patient rights.
He said laws like Act 586, health ministry guidelines and professional codes made it clear that a doctor’s judgment must never be overridden by corporate policy.
“While generics may be suitable in most cases, there are situations such as narrow therapeutic index medicines or where intolerance has occurred, where a specific brand is clinically necessary.
“In such circumstances, it is the doctor’s responsibility to prescribe what is safest and most effective for the patient. Any substitution must be explained and consented to,” he said.
Thirunavukarasu warned that requiring prescriptions by active ingredient would shift control of treatment choices from doctors to corporate payers, opening the door to pre-selection based on commercial arrangements rather than medical judgment.
“Such policies may appear minor at first, but slowly and surely, commercial interests will override clinical judgment,” he added.