Stakeholders’ perspectives on the contemporary landscape of pharmaceutical market competition in Malaysia’s public sector: exploring the key influences of economic, regulatory, and public procurement policies and practices

Abstract Background Effectively managing market competition is critical in an unregulated pharmaceutical pricing system to maintain public healthcare sustainability. Previous studies, limited in variables and results, leave gaps in understanding the factors shaping market competition in Malaysia’s public healthcare sector. This study explores stakeholders’ perceptions of market competition within Malaysia’s public healthcare pharmaceutical sector, focusing on their views of the current landscape and its key influencing factors. Methods The qualitative semi-structured interviews were conducted with purchasers from the Ministry of Health (MOH) and suppliers from the pharmaceutical industry in Malaysia between November 2023 and February 2024. Purposive sampling was used to select stakeholders with extensive experience in the public procurement system. Each interview was audio-recorded and transcribed verbatim. Coding and data organisation was done using ATLAS.ti version 9.1.3 and analysed using thematic analysis. Results A total of 26 participants with four to 40 years of experience in pharmaceutical purchasing were interviewed. There were 18 participants from the public sectors who were from the Pharmacy Services Programme MOH, state pharmacy’s central stores, hospitals, and health clinics, and eight multinational and local pharmaceutical companies’ suppliers and tendering agents. Stakeholders perceived that the competition landscape in Malaysia’s public procurement system may be influenced by factors such as product marketability, product competitiveness, and market competitiveness. These factors include supply and demand, pricing strategies, intraclass and therapeutic competition, as well as product and non-product criteria. Additionally, stakeholders emphasized that market power, regulatory frameworks, procurement policies, and efficiency may influence market dynamics and how firms engage in the public healthcare sector. Conclusions The pharmaceutical market competition landscape within the public procurement system is complex, dynamic, and potentially influenced by various factors. The findings indicate that governments could benefit from considering policies and processes aimed at optimizing and promoting healthy competition while balancing sustainability objectives and ensuring firm viability to safeguard public interests.