title: Separation of prescribing and dispensing in Malaysia: the history and challenges.
abstract: This article serves as an update to the work by Shafie et al. (2012) which previously reviewed the benefits of policies separating prescribing and dispensing in various countries to advocate its implementation in Malaysia. This article seeks to strengthen the argument by highlighting not only the weaknesses of the Malaysian health care system from the historical, professional and economic viewpoints but also the shortcomings of both medical and pharmacy professions in the absence of separation of dispensing. It also provides a detailed insight into the ongoing initiatives taken to consolidate the role of pharmacists in the health care system in the advent of separation of dispensing. Under the two tier system in Malaysia at present, the separation of prescribing and dispensing is implemented only in government hospitals. The absence of this separation in the private practices has led to possible profit-oriented medical and pharmacy practices which hinder safe and cost-effective delivery of health services. The call for separation of dispensing has gained traction over the years despite various hurdles ranging from the formidable resistance from the medical fraternity to the public's scepticism towards the new policy. With historical testament and present evidence pointing towards the merits of a system in which doctors prescribe and pharmacists dispense, the implementation of this health care model is justified.
authors.affiliation: School of Pharmacy, Taylor's University, Subang Jaya, Selangor, Malaysia.
authors.forename: John Jeh Lung
authors.initials: JJ
authors.lastname: Tiong
authors.affiliation: School of Pharmacy, International Medical University, Kuala Lumpur, Malaysia.
authors.forename: Chun Wai
authors.initials: CW
authors.lastname: Mai
authors.affiliation: School of Pharmacy, International Medical University, Kuala Lumpur, Malaysia.
authors.forename: Pou Wee
authors.initials: PW
authors.lastname: Gan
authors.affiliation: Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, UK.
authors.forename: James
authors.initials: J
authors.lastname: Johnson
authors.affiliation: School of Pharmacy, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia.
authors.forename: Vivienne Sook Li
authors.initials: VS
authors.lastname: Mak
mesh_terms: D003362:Cost-Benefit Analysis; D003695:Delivery of Health Care / Q000191:economics / Q000331:legislation & jurisprudence / Q000458:organization & administration*; D006291:Health Policy; D006801:Humans; D008296:Malaysia; D010593:Pharmaceutical Services / Q000191:economics / Q000331:legislation & jurisprudence / Q000458:organization & administration*; D010595:Pharmacists / Q000331:legislation & jurisprudence / Q000458:organization & administration*; D010819:Physician's Role; D010820:Physicians / Q000191:economics / Q000331:legislation & jurisprudence / Q000458:organization & administration*; D010818:Practice Patterns, Physicians'; D024382:Professional Role
keywords: dispensing separation; health care reform; medicine; pharmacy