Disinvestment initiatives in Malaysia healthcare system: the journey from possibility to reality

Disinvestment in healthcare allows for strategic reallocation of resources from low-value care to higher-value areas, particularly in promoting clinical effectiveness, improving patient outcomes, and long-term cost savings. The Malaysian Health Technology Assessment Section (MaHTAS) is investigating the incorporation of a disinvestment framework into the health technology life cycle, in accordance with the Ministry of Health Malaysia's recent healthcare transformation strategy. Several health technology assessment (HTA) reports by MaHTAS have integrated concepts of health technology reassessment, with an emphasis on effectiveness and adverse effects. However, the need for additional funds and implementation strategies has impeded the impactful and timely execution of HTA recommendations. This article highlights ongoing efforts to promote disinvestment activities in the Malaysian healthcare system by raising early awareness and engaging with healthcare stakeholders during the planning phase. The journey from the possibility to the reality of implementing healthcare disinvestment initiatives in Malaysia requires addressing both facilitators and challenges. Facilitators identified include strong political will and the presence of global support for collaboration and knowledge sharing, among others. Some of the recognized challenges are getting the trust of the stakeholders, the need for additional funding to support disinvestment programs, and the lack of expertise as well as guideline to carry out the disinvestment process. By highlighting the steps taken and the strategic planning required, this article sheds light on the potential for disinvestment to enhance the efficiency and effectiveness of healthcare delivery in Malaysia, ultimately contributing to a more sustainable healthcare system.