Hendro D Situmorang, Jakarta – A pharmacists' advocacy group has pinpointed corruption and gratuity payments by certain doctors as key factors driving up medication costs in Indonesia. While this issue is widely recognized in the industry, discussing it has remained somewhat taboo, possibly due to fear of repercussions.
Merry Patrilinilla Chresna, Coordinator of the Alliance for the Advancement of the Pharmacists' Profession (KAMPAK), emphasized that these doctors have the authority to prescribe and select medications, which adds to consumer costs.
"Forms of gratuity can include cash, goods, travel tickets which are often disguised as seminars abroad, and other incentives," she told Beritasatu.com, a sister publication of the Jakarta Globe, on Sunday.
Merry noted that drug prices in Indonesia can be five to six times higher than in other Asian countries, largely due to advertising and promotional expenses that are passed on to consumers.
She mentioned that while the high cost of medications is a longstanding issue within the pharmaceutical and healthcare communities, discussing the core problem has been avoided.
"Health Minister Budi Gunadi Sadikin previously addressed this issue publicly, but it seems to have received little attention, likely due to pressure, as he now appears hesitant to discuss it further," Merry said.
She argued that resolving this persistent issue requires eliminating the chain of corruption involving doctors' gratuities. The individuals involved often occupy significant roles in therapy and have received substantial benefits from pharmaceutical companies through sales representatives.
"I hope someone has the courage to start exposing this longstanding issue," she urged.
Merry acknowledged that Indonesia possesses sufficient human and natural resources but noted that the sector remains heavily reliant on imports.
"If the government is genuinely committed to achieving self-sufficiency in local raw material production, it should be wary of rent-seeking importers who may continue to profit from the import process through bribery to those in authority over drugs," Merry advised.
Earlier this month, Budi Gunadi Sadikin met with President Joko "Jokowi" Widodo to address concerns over drug and medical equipment prices in Indonesia, which are reportedly five times higher than in neighboring Malaysia.
Factors contributing to the high price, according to Budi, include inefficient trade routes, governance, and high taxes.
A 2024 survey by Indonesia's National Institute of Health Research and Development found that generic drugs in both the public and private sectors are priced about 2.5 times higher than the lowest-priced alternatives. Many essential medications are considered unaffordable, requiring up to 17 days' salary for the lowest-paid government workers.
The availability of the lowest-priced generics was just 47 percent in the public sector and 62 percent in the private sector, indicating limited accessibility. Additionally, local government procurement prices for these generics often exceeded international reference prices by 74 percent, exacerbating affordability issues.