THE government in numerous instances has indicated that the ceiling price of various Covid-19 tests have been set and that the public can have the comfort of knowing the maximum rate that one would have to pay for those tests. This was gazetted through an order signed by the prime minister on May 17 through the emergency ordinance.
However, the signed order and subsequent statements made by the Health Ministry (MoH) about this has brought about much confusion rather than clarity on the matter.
1) What licence does the order refer to?
The order signed by the prime minister was addressed to the “licence holders” of 24 laboratories listed in the appendix that came with that order. In Malaysia, private laboratories currently operate using a business licence and adhere to certain requirements to obtain Standard Malaysia and MoH accreditation, on top of ISO certification.
It is worth noting that although the Pathology Laboratory Act 2007 was gazetted many years ago, it has yet to be enforced. What this means is that, as of today, no laboratory is in possession of an operating licence issued under this act and neither would there have been a call for them to apply for the same. So, what kind of licence is the order signed by the prime minister referring to? And since the order specifically applies to the 24 laboratories listed in the appendix, does this mean that any new laboratory set-up after that date is not bound by the order until a revised one is released?
2) Does the ceiling price only apply to the laboratory testing component of the Covid-19 screening?
The Covid-19 screening process has two components. First is the process of collecting a sample from the patient and following that, laboratory processing of that sample. It must be stressed that laboratories are only allowed to process Covid-19 samples received from registered or licenced private healthcare facilities. The MoH has clearly stated that in the private sector, only certain qualified and trained personnel from either a medical clinic, ambulatory care centre or hospital can take a Covid-19 screening sample from a patient.
Clearly there are significant costs involved in both components. The private healthcare facility would have to factor in consultation costs, prices of the test kits, operation overheads and the cost of consumables such as gloves, aprons, and other personal protective gear (PPE). The laboratories in turn would also incur various costs to undertake the processing of specimens. Both components are equally important and would need to be done following stringent standard operating procedures to yield high quality results.
Conducting this procedure at off-site locations and additional logistical arrangements for collection of samples from remote areas are examples of some miscellaneous costs. Urgent samples would also incur a premium. Besides that, the price of procuring test kits and consumables also vary markedly as suppliers are often only keen to lower their price for large orders or those made by their preferred customers. This certainly puts smaller healthcare facility operators at a disadvantage.
The signed order has set the ceiling price for the RT-PCR test at RM150, RTK-Ag test at RM60 and RTK antibody tests at RM50 in Peninsular Malaysia and RM 200, RM80 and RM70 respectively in Sabah and Sarawak. Clearly these rates are too low to represent a fair value that compensates the total cost and effort involved during both components of this procedure. It needs to be stressed that there are many factors that contribute to the overall cost of the procedure.
Any attempt to set a lower ceiling price just to make it affordable to the public would have disastrous consequences. The last thing we need is for any party to be forced to compromise on safety or quality just to rationalise the cost of the procedure to be within a predetermined cap.
Therefore, MMA hopes that MoH will be able to make it clear once and for all that the set ceiling price for the Covid-19 screenings only applies to the cost of the laboratory testing component of said procedure. The public should not be misled to believe that those rates are reflective of the maximum price they would be paying for the whole procedure when they visit a private healthcare facility. – The Vibes, June 20, 2021
Datuk Dr. Subramaniam Muniandy is president of the Malaysian Medical Association
