This is an open letter to both the health minister and the director-general of health who were both once practicing doctors. Recently, it was announced that creams used in the treatment of skin conditions will only be packed in tubes of 15 grammes and no longer in 450gm or 500gm jars as is now being practiced

The logic is that it is more hygienic and easier for dispensing. But what about the phenomenal increase in cost to the poor patient? If he is only going to use 15 gm for his condition, then it's fine.

But there are literally hundreds of thousands of patients in Malaysia with chronic skin conditions like psoriasis, eczema, and other chronic dermatoses who need up to 30 gms a day for generalised skin problems which are often lifelong conditions. We can't be dispensing 50 tubes at every visit can we? Where is he going to find the money to pay?

To give you an example, a 500 gm jar of hydrocotisone cream is at the most RM30 and the cost for 15 gm from the jar is only 90 sen when dispensed in an ointment box. The same cream is now going to be RM5 for a 15 gm tube which means 450 gm of the cream will cost RM150.

Atopic dermatitis is so prevalent here. In hospitals, we actually dispense in jars so that the patient need not come so often for his or her medication. Children with this condition have to be on their creams until they are 12 to 15 years old. The patient is going to pay through his nose if the MOH goes ahead with this distressing idea.

And how are doctors in private practice going to explain the six-fold increase in price to their patients? A patient who needs 100 gm of cream for a week will have to fork out six times the price for the same medication that he has been on for years. The rich and famous can afford it but what about the 'kampung folk' and the poor in the rural areas? They too suffer from skin problems, probably more than urbanites.

This is the same thing that happened when gallon packs of cough mixtures were axed and replaced by pre-packed bottles. The cost of a bottle of cough mixture went up three to four times. Doctors could dispense100 ml of mixture for 90 sen at one time. Now it is RM3.60!

The people are already suffering from the ever increasing prices for everything, please don't burden them further. I am surprised the consumer associations let this one by them without even a whimper.

As I see it, the only beneficiary of this entire exercise is going to be the politically-connected company that is supplying the so-called registered product logo (silver logo) which has become mandatory under the present administration while it was not when Dr Mahathir Mohamad was around.

Why do we need this logo when all pharmaceutical products are already registered with the Drug Control Authority. Previously, only one label was required for a 500 gm jar or a gallon pack of mixture. Break it down into smaller packs, and now you will need 36 logos for every 100 ml of mixture.

Can you imagine the millions this politically-linked company is going to rake in just for importing the logos from France and forcing it down the throats of manufacturers and importers of medicine? Why is the Malaysian Medical Association silent on all this?

This is supposed to be a caring government, so please show us that you care. Please have a heart. If you had a family member with a chronic skin problem you will know what agony the patient and his family go through. Don't add increased cost to their misery as well.