Unfavourable guidelines and price hikes tied hinders development in dialysis treatments, says association

SHAH ALAM - Although the private sector has been known to provide quality treatments and better care for dialysis patients, the reimbursements from the government have yet to change for three decades now.

Malaysian Dialysis Professionals Association chairman Datuk Dr Zulkifli Abdul Aziz said naturally, higher-quality treatment calls for higher costs for medicine, equipment, transportation, as well as operations.

He said due to unchanging policies when it comes to reimbursements for the private dialysis sector, treatments offered cannot move forward with developments in the field.

“The dialysis industry has been struggling to cope with this issue and this raises the risk in providing good dialysis treatments to patients.

“It is not only a matter of the cost of supplies increasing, but other elements that the industry must comply with, which are infrastructure, professional fees, and even manpower,” he told Sinar Daily in an interview in conjunction World Kidney Day today.

Dr Zulkifli said that the industry has complied with all requirements set and implemented by the Health Ministry, but with price hikes abound, the reimbursement schemes have remained static.

He said there were already some industry players cutting corners to ensure that their patients were treated at “affordable” prices.

This, he said, would merely increase the overall cost in the long run for patients should complications arise and they have to end up in the hospital again.

Asked what solutions were best suited to mitigate this pressing concern, Dr Zulkifli said that the association was currently urging the government to look into the current reimbursement scheme in place.

“There should be a long term plan for dialysis services,” he added.

For now, the private sector could only provide basic treatment modalities, haemodialysis and peritoneal dialysis such as Hemodiafiltration and Home Dialysis.

“We are way behind on treatment modalities compared to other countries,” he confessed.

He did, however, state that there was an eagerness within the private sector to provide more peritoneal dialysis in their units but due to unfavourable guidelines and reimbursements, such plans are not possible at the moment.

He also said that funders and insurance companies should look into all the new modalities available not just in the country, but overseas as well.

There was a potential to bring the private dialysis sector to the next level, he said, stating that Hemodiafiltration and peritoneal dialysis should be options in the near future.

He said this includes continuous ambulatory peritoneal dialysis and automated peritoneal dialysis.

“We already have local manufacturing companies providing such services nationwide and this will give us much more to work with.

“Furthermore, we do see potential in bringing back haemodialysis into every patients’ home. All private haemodialysis centres can explore this possibility, especially when it comes to patients who need less supervision,” he said.

Dr Zulkifli also highlighted the increasing costs of dialysis treatments for patients diagnosed with Covid-19, an issue he wishes to bring up with the Health Ministry.

These patients, he said, would have to go to private centres to undergo dialysis treatments, which is burdensome to them.

He said more than 800 dialysis treatment centres had to bear the losses of Covid-10 transmission.

“A lot of money had been spent on PPE, sanitisation efforts, and even quarantine of employees should they be infected with Covid-19.

“It is unfair that the Health Ministry does not assist the private sector with this matter when they have the ability to alleviate these burdens,” he said.