The Jakarta Post
As the government calls for developing the herbal medicine sector, officials and scientists have both highlighted the need to gain the support of the medical community and to standardize certification for herbal medicines derived from Indonesia’s wide variety of endemic plant species.
Research and Technology Minister Bambang Brodjonegoro said that the government had declared the development of Indonesian modern medicine (OMAI) as a national research priority in its pursuit of a self-sufficient health system, which rose to the forefront with the emergence of the coronavirus pandemic. However, he said, more needed to be done to expand product adoption.
“We have realized that, indeed, we need the support of doctors and hospital heads. This is a major [issue] because the [primary] users, in this case, doctors, are not yet confident or accustomed to prescribing these medicines to their patients,” Bambang said during a webinar hosted by tempo.co last Friday.
The minister explained that the healthcare system was currently dominated by pharmaceutical medicines that were the major focus of large drug manufacturers, while herbal medicines created from natural ingredients had yet to receive the same level of research and investment.
“This is a vicious cycle that must be broken,” he said.
Bambang said that companies generally thought twice about investing in research and development of OMAI because they were uncertain whether there was a market for the products. On the other hand, Indonesia possessed the high biodiversity that was necessary to support a herbal medicine sector.
Indonesia has long relied on imports to support its pharmaceutical industry, importing up to 90 percent of medicines and raw materials from other countries, including China and India. Government officials and industry players have highlighted Indonesia’s import dependency as a major problem, particularly after the global supply chain was disrupted as an impact of the pandemic.
President Joko “Jokowi” Widodo recently called for complete reform of the national health system, stressing that self-sufficiency in the pharmaceutical and medical equipment industries was a shared priority for all stakeholders amid the public health crisis.
“We know that around 90 percent of medicines and [pharmaceutical] raw materials still rely on imports, even though our country has rich biodiversity both on land and in the ocean,” the President said last Thursday in a national meeting with the Indonesian Pharmacists Association.
“Indonesia’s abundant natural resources must serve as basic capital for reviving the domestic pharmaceutical industry. Biodiversity can be used to strengthen community resilience in the health sector,” Jokowi said.
The President also urged clinical trials and standardization for the use of phytopharmaceuticals as alternative medicines and therapies.
Phytopharmaceuticals are manufactured drugs that contain pure active substances extracted from plants and parts of plants.
To address the lack of confidence in Indonesian herbal medicines, experts have called for OMAI to be listed among the approved drugs of the national health insurance (JKN). This would not only accelerate the development of OMAI, but would also position OMAI on a par with pharmaceuticals.
Dita Novianti Sugandi Argadiredja, the pharmaceutical services director at the Health Ministry, said that existing regulations permitted this approach, but that the inclusion of OMAI on the national formulary would require recommendations from medical professionals.
The national formulary lists the medicines that have been approved for prescribing under the national health insurance program.
“There is already a platform that facilitates this. It is up to the doctors to use it, and the requirements are not [stringent],” Dita said at Friday’s webinar. “How do medicines enter the national formulary? It starts with a suggestion from hospitals, professional organizations, backed by supporting data,” she said.
According to the founder of the Indonesian Herbal Medicine Doctors Society (PDHMI), Hardhi Pranata, the lack of a medication competency certificate for herbal medicines was one reason why doctors shied away from prescribing OMAI.
“In medical education, there is no certification for competency [in prescribing OMAI],” Hardhi said. Offering this certification would help increase awareness of medicinal alternatives among doctors and therefore increase their interest in using herbal medicines.
Executive director Raymond R. Tjandrawinata of the Dexa Laboratories of Biomolecular Sciences, a subsidiary of PT Dexa Medica that specializes in the research and development of medicines derived from locally sourced ingredients, also stressed that wider adoption of OMAI among Indonesian doctors was necessary to develop the herbal medicine sector.
“We need to recruit more doctors [to using OMAI] so these herbal medicines gain the same recognition as [pharmaceutical] ones,” Raymond said.
He added that Indonesia trailed behind South Korea, China and Germany, where 25 percent to 50 percent of doctors actively prescribed herbal medicines for therapeutic treatment.