The Taiwan Health Reform Foundation yesterday sounded a note of worry about the possibility of higher drug misuse, after patients are required to buy over-the-counter drugs at the beginning of July.
Given the low level of public awareness of the over-the-counter drugs and substandard medical services at community clinics and drugstores, health experts are concerned that ill-informed patients will be at risk of drug misuse.
"The Department of Health failed to educate the public on the subject of over-the-counter drugs," said the foundation's president Chang Ly-yun (張笠雲) at a press conference yesterday. "Nor did the health authority succeed in bettering primary care at the community level."
Without ample information on medicine usage and consultation services, Chang cautioned, patients could become victims of the new policy.
Chang's warning came after the Bureau of National Health Insurance announced last month that 1,200 kinds of over-the-counter drugs will be excluded from insurance coverage at the beginning of July. Currently, patients can get free over-the-counter drugs when they visit their doctors.
Once the policy is implemented in July, patients themselves will have to go to a pharmacist and pay for non-prescription drugs like painkillers or cold medication.
The policy is expected to bring temporary relief to the cash-strapped bureau, which borrowed NT$77.5 billion to fill its yawning financial deficit this year.
"By excluding the over-the-counter drugs from insurance coverage, we can save NT$2.3 billion," Liu Chien-hsiang (劉見祥) the president of the Bureau of National Health Insurance, said when he announced the new policy last month.
Apart from economizing the use of medicine expenses, the bigger goal of this policy is to transfer the responsibility of health care from the state to the individual. "What's more important, we hope the policy will motivate people to learn how to take care of themselves," Liu explained.
The foundation praised the policy, yet they also voiced doubts as to whether the government has equipped patients with adequate knowledge of how to take drugs.
Even though drug packaging at medical centers or regional hospitals is labeled, almost all of the nation's clinics and drugstores failed to meet the official standards for drug labeling, the foundation said.
The foundation's survey on drug labeling showed that over 98 percent of clinics and 99 percent of drugstores do not provide the required 13 pieces of information on drug packaging, including the name of the drug, its clinical indication, potential side effects and appropriate dosage.
"Patients don't even know what they are swallowing," Chang said.
Another hidden risk is the lack of medical professionalism at community clinics and drugstores. Even though about 89 percent of pharmacists in hospitals are licensed practitioners, that figure drops to an alarming 53 percent at community clinics and drugstores, according to the foundation's statistics.
An accident at the Chong Ai Hospital (崇愛醫院) in Pingtung County in 2002 was a dire lesson, A nine-month-old baby died because pharmacists mistook anti-diabetes tablets for antihistamine to allay cold and allergies.
"How could the health authority ask the public to have confidence in primary care? Who and where can the public turn for medical help in the community?" Chang said.
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