Challenges for accessing and financing high-cost medicines in multipayer systems: case studies of multiple sclerosis in Malaysia

Vijayasingham, Lavanya, Jogulu, Uma and Allotey, Pascale, (2017). Challenges for accessing and financing high-cost medicines in multipayer systems: case studies of multiple sclerosis in Malaysia. Critical Public Health, 193-202

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  • Sub-type Journal article
    Author Vijayasingham, Lavanya
    Jogulu, Uma
    Allotey, Pascale
    Title Challenges for accessing and financing high-cost medicines in multipayer systems: case studies of multiple sclerosis in Malaysia
    Appearing in Critical Public Health
    Publication Date 2017-11-20
    Place of Publication London
    Publisher Taylor & Francis Online
    Start page 193
    End page 202
    Language eng
    Abstract Timely and continued access to high-cost medicines for the management of chronic illnesses such as multiple sclerosis, are often constricted by its affordability for patients. Health systems also face challenges in arranging sustainable financing for populations with chronic illness in need of equitable and long-term access to high-cost medicines. In many low-to-middle income countries, pluralistic health payers within and beyond the public system contribute to health financing. The structures, processes and dynamics of access through these payers however, may have limitations and negative consequences for patients. In this paper, we present vignettes of case experiences from working individuals with multiple sclerosis in Malaysia, on their experiences and encounters when seeking access through public and private health payers. The Malaysian case and experience is an example of the public–private health care system challenges in providing sufficient access and financing to high-cost medicines. Themes include limited and interrupted hospital access, requirements to prove individual socio-economic deservingness for reimbursement, and confronting discrimination from employers as discretionary payers of medical care. These discussions reinforce the value of universal health access, pooled systems of financing and risk sharing to provide comprehensive health care access and reduce economic and health vulnerabilities in patients.
    Keyword Access to high-cost medicine
    Patient experience
    Multiple sclerosis
    Pluralistic health payers
    Copyright Holder Informa UK Limited
    Copyright Year 2017
    Copyright type All rights reserved
    DOI 10.1080/09581596.2017.1403011
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    Created: Wed, 28 Mar 2018, 17:39:24 JST by Cheah, Swee Neo on behalf of UNU IIGH