The Senate and House versions of the bill on affordable medicines were finally married last 29 April 2008. It brings excitement to this cashcow’s heart. Will the “Universally Accessible Cheaper and Quality Medicines Act of 2008” finally give birth to cheap and quality drugs for us? I still believe it will. The only question now is when? As expected, the ‘generics only’ and ‘price regulatory board’ clauses in the House version were scrapped. Critics of the bill like Senate President Manuel Villar, say these two provisions could have made a bigger impact in drug price reduction. Rudy Coronel of Batangas City, commenting in the Philippine Daily Inquirer about the removal of the ‘generics only’ clause believes that the passing of this “puede na [good enough]” bill is “a triumph of vested interests.” For him, the giant multinational pharmaceuticals and greedy physicians were still able to preserve the “detailman-doctor unholy alliance”.
Come to think of it, the good man has a strong point. I am a bit ashamed—being a registered pharmacist myself—to have accepted this slap from doctors who do not want to let go of their source of “perks!!!” On the contrary, knowing these market savvy drug firms, what guarantee would we have that the “generics only” clause, in case it was included in the signed bill, would not cause a shift to a “detailman-pharmacist unholy alliance?” Perhaps that is why doctors were against it in the first place. They do not want to transfer or share the pharma booty with their supposed partners in healthcare.
Doctors also argued that it is wrong to require them to write generic names only because it is their ethical obligation to prescribe which drug they think is best for the patient. This sort of medical professionals continue to get around the ‘Generics Law of 1988′ by preaching their “branded-is-best” mindset. This is another reason why the growth of local generic manufacturers is hampered. Now I ask, can they really ensure their patient’s welfare by writing down the name of a branded product in a piece of paper? The bill does not make it illegal to verbally advise a patient to buy a certain brand, does it? Will this matter to a poor person who can’t even afford rice to feed his/her family? Is writing the brand name in the prescription a sort of documentary evidence needed by their big time pharmaceutical sponsors? Alas, I wish I was a doctor so that I would know the answers to these questions.
Ricelander’s remarks on my previous post “Quality Affordable Medicines; Now!” were also true. The country needs a working local pharmaceutical industry. We are mere compounders of IMPORTED raw materials and repackers of IMPORTED finished bulk drug products! India and China, like western countries, have long been producing their own active ingredients and excipients. In fact, the Philippines currently sources a significant amount of its pharmaceutical raw material requirements from these two countries. How come we can’t even manufacture pharmaceutical grade sodium chloride when the Philippines, being an archipelagic nation, has vast supplies of salt? We can also obtain dextrose from the ubiquitous cassava but no one is interested in exploring that on an industrial scale. Something is amiss. Government support in creating an environment suitable for the development of real local pharmaceutical businesses is next to nil.
Thus, in the long run, despite gains from this venerable bill, the local generic drug industry in the country could still be facing tremendous difficulties. Yes, drug prices will have gone down but what about the ‘new competition’? Some Indian companies, for example, have found a new “goldmine of opportunities” with the passing of the cheaper medicines act. We can expect more and more cheaper India-made drugs flooding the Philippine market soon. Now, where are the local generic manufacturers in that picture? The effects of parallel importation will be beneficial for now. But, when the playing field with the western multinationals is finally leveled, how will we fare in the generics game with great India, not to mention humongous China? We see mainland China products all over the Philippines nowadays, from food to clothing to mobile phones to plastic toys. Will cheaper priced China-made generic drugs make it to Philippine soil as well? Will the raw-material-importing Philippine drug industry survive the battle for the local markets against India and China?
I have so many questions and doubts… Oh well, with the type of leaders in our country right now, we can’t really have it all. Let’s just celebrate with the passage of this important bill… for the time being.