Easing Malaysia’s NCD economic burden: The case for generics and biosimilars

THE information in your report, "Healthcare crisis hitting all income groups" (Sept 8), is consistent with the feedback we receive first-hand from healthcare providers (HCPs), our own teams on the ground, and even friends during social occasions.

To me, the message is clear: Malaysia is facing a healthcare affordability crisis – and has been for some time. At the centre of this strain is the growing burden of non-communicable diseases (NCD) such as diabetes, heart disease and cancer. These conditions not only claim lives but also carry enormous financial cost for households, businesses and the nation’s economy.

The numbers are sobering. In 2021 alone, NCDs cost Malaysia an estimated RM64.2bil, equivalent to 4.2% of GDP. For families, especially those in the B40 category, these diseases often mean catastrophic health payments, increasing their risk of falling deeper into poverty.

But more than the economic burden, the patient impact is equally significant. Diabetes affects about 16% of Malaysian adults, hypertension is present in 29%, high cholesterol in 33%, and obesity in 22%. Together, cardiovascular diseases, cancer, diabetes and chronic respiratory illnesses account for nearly three-quarters of premature deaths in the country.

Malaysia’s NCD crisis is as much about sustainability as it is about health. The question is: How do we make every healthcare ringgit work harder so patients get the care they need without overwhelming households or the system itself?

One part of the solution lies in making better use of generics and biosimilars, which are affordable, proven medicines that deliver the same outcomes as originators but at a fraction of the cost.

Generics and biosimilars represent about 80% of medicines used worldwide by volume at under a third of total cost. If used more widely and systematically, they could become one of Malaysia’s strongest levers in easing its NCD burden.

Generics and biosimilars reduce treatment expenditure without compromising quality. They stretch every healthcare ringgit further, turning cost pressure into system resilience by freeing up resources for prevention, workforce training and hospital infrastructure.

The economics are simple. Globally, the introduction of biosimilars consistently drives down the cost of biologics, creating opportunities for wider access. In the United Kingdom, savings from just 10 biosimilar and generic medicines were enough to fully fund initiatives like the UK Cancer Drugs Fund.

Malaysia is already seeing a similar benefit: the entry of biosimilars for treatments such as insulin and trastuzumab has led to meaningful price reductions and improved access. Meanwhile, a review by the National Heart Institute estimated potential savings of nearly RM130mil if adoption were scaled up.

These savings are not abstract numbers. They represent the possibility of funding nationwide screening programmes, more specialist training or upgrading of hospitals to better serve rural Malaysians.

Malaysia’s healthcare transformation agenda, from the Health White Paper to the 13th Malaysia Plan, recognises the urgent need for equitable access and financial sustainability to go hand in hand. Generics and biosimilars are a natural policy lever to achieve these goals, ensuring universal coverage without overwhelming public hospitals.

By aligning procurement and treatment guidelines more closely with these affordable options while building on recent progress like NPRA’s (National Pharmaceutical Regulatory Agency) new screening package to accelerate regulatory pathways, Malaysia can unlock both fiscal and social dividends.

But no single stakeholder can do this alone. The task requires collaboration across the health ecosystem. Policymakers, regulators, insurers, providers and patient groups must work together to create an environment that supports the adoption of generics and biosimilars. This is no longer a matter of choice but of necessity. Malaysia cannot afford to treat NCDs lightly. Generics and biosimilars must become the cornerstone of our national response.

Having spent years looking at healthcare through an economic lens, I sincerely believe this is one of the smartest investments Malaysia can make. Ultimately, generics and biosimilars are not just medicines, they are economic multipliers that make every healthcare ringgit stretch farther and reach more patients.

This is how Malaysia can safeguard both the health of its people and the sustainability of its healthcare system for the long term.

CARLOS PATARRANA

Country Head

Sandoz Malaysia-Singapore-Brunei