Are Filipinos Dying Because of Expensive Medicines?

The Philippines has the second highest drug prices in Asia
(From Newsbreak, December 4, 2006)

Wigberto E. Tañada, FTA Lead Convenor

Many Filipinos today are dying because they cannot afford expensive medicines prescribed by their doctors. In many cases, what seems to be a simple ailment becomes a serious threat to one’s health due to complications arising from inadequate medicines or failure to see a doctor regularly. Around 40 percent of Filipinos have never seen a doctor in their lives.

The prices of medicines in the country today are higher by 40 to 70 percent than in neighboring countries. The Philippines ranks second to Japan as the country with the highest prices of medicines in Asia. Our country’s medicines are 18 times more expensive than India’s or Canada’s.

Some of the country’s policies need reexamination. These include the laws on intellectual property rights such as patents and trademarks.

Certain provisions of the Intellectual Property Code (IPC) under Republic Act 8293 make it difficult for local drug manufacturers to secure compulsory licensing from research-based multinational companies. They are mired in litigation before they could even start negotiations.

Another difficulty is the inability to make parallel importation of cheaper drugs from India and Pakistan without being threatened with damage suits for supposedly infringing on patents secured by multinational companies in the Philippines.

On March 1 this year, one of the biggest pharmaceutical companies in the Philippines, Pfizer Ltd (UK), filed a suit against the Bureau of Food and Drugs (BFAD) and the Philippine International Trading Corp. (PITC). Pfizer claimed that PITC infringed on the Pfizer patent by importing an amlodipine besylate product and submitting it to BFAD for product registration.

The drug is marketed by Pfizer in the Philippines as Norvasc, which is normally used by patients as daily maintenance for the treatment of hypertension, angina, and myocardial ischemia. It is marketed in two dosage formats: 5mg tablet at P44.75 and 10mg tablet at P74.57. The same product under the brand name Amlogard is being sold by Pfizer in India at only P5.98 per 5mg tablet and P8.96 per 10mg tablet.

Pfizer Ltd. (UK) is the registered owner of Philippine Letters Patent 24348 on amlodipine besylate, which will expire on June 13, 2007. Pfizer Inc. is the exclusive licensee of Pfizer Ltd in the Philippines. It is asking the court to issue a temporary restraining order (TRO) to prevent PITC from making, using, or offering the sale or distribution of any Pfizer patent product while enjoining BFAD from entertaining applications for registration of amlodipine besylate by generic companies.

PFIZER CASE

What Pfizer wants is to extend its monopoly over the product by at least 18 months after its patent has expired. It may be noted that it takes 18 months for BFAD to evaluate an application for drug registration filed by a generic company. Essentially, this is the kind of “prejudice” that Pfizer accused PITC and BFAD of inflicting upon it. BFAD and PITC invoked Administrative Order 2005-001 issued by the Department of Health (DOH) dated Jan. 3, 2005, which states that “the DOH through BFAD is mandated only to ensure the safety, efficacy, and good quality of pharmaceutical products for registration. It has no mandate at all to pass upon intellectual property matters since it does not have the legal authority, resources, and competency to do so.”

PITC has not marketed or sold a single amlodipine besylate product in the country. It has no intention to do so until after the Pfizer patent expires in June 2007. Hence, the only issue is whether importing samples of a patented product such as Pfizer’s and submitting the same to BFAD for product registration constitutes infringement under IPC.

The case is still pending at the Makati Regional Trial Court under Judge Cesar Untalan, who favored a compromise agreement supporting Pfizer’s demand for PITC to stop any Pfizer product importation.

To many social development practitioners, the case is a clear example of harassment against government officials committed to do public service.

CURE TO MONOPOLY?

At present, the Philippine drug market is being controlled and dominated by multinational corporations, with more than 70 percent share of the market. The annual sales of drugs and medicines in the country total P93 billion.

In this context, President Arroyo pledged to lower the prices of medicines bought by the poor by 50 percent through project GMA 50.

GMA 50 aims to ensure that affordable, high-quality, safe, and effective drugs and medicines are always available through the use of generic drugs and medicines and the operation of the Botika ng Barangay, and National Food Authority (NFA) Rolling Stores to sell over-the-counter herbal medicines.

But the impact of these health programs because of the low budget for public health and services, which is only 3.3 percent of the country’s Gross Domestic Product, is minimal.

It is commonly observed that generic drugs in the country have very low acceptability to medical practitioners and the general public as reflected in the sales and use of these products. It is estimated that 97 percent of the medicines sold in the market are “branded,” prescribed by doctors and from direct counter sales. True generics account for a measly 3 percent of medicines sold in the Philippines.

It is imperative to correct the wrong perceptions and beliefs against generic drugs.

Reducing the prices of drugs and medicines requires the concerted efforts of the different stakeholders. The major players in the public sector are DOH, BFAD, the Department of Trade and Industry, PITC, Philippine Health Insurance Corp. (PhilHealth), Philippine Charity Sweepstakes, NFA, and local government units.

The private sector is composed of the Association of Drug Industries in the Philippines, Pharmaceutical and Healthcare Association of the Philippines, Chamber of Filipino Pharmaceutical Manufacturers and Distributors, Filipino Drug Association, Generics Association of the Philippines, United Laboratories Inc., and Drugstore Association of the Philippines. It also includes a loose coalition called Ayos na Gamot sa Abot-Kayang Presyo (AGAP).

AGAP members, supported by the Fair Trade Alliance, are committed to campaign for:

  1. An enabling environment where the general public can have access to quality, affordable, and life-saving drugs and medicines.
  2. Amendments to the IPC, taking into account the flexibilities provided by the Trade Related Aspects of Intellectual Property Rights (TRIPs) Agreement, as reiterated in the Doha Declaration on TRIPs and Public Health.
  3. Enactment of Senate Bill 2139 sponsored by Sen. Manuel Roxas II and cosponsored by Sen. Juan Flavier promoting parallel importation and healthy competition in the Philippine drug market.
  4. PhilHealth to use its resources as leverage to reduce medicine prices.
  5. Serious implementation of Republic Act 6675, or the Generics Act of 1988, and the adoption of therapeutically proven indigenous and community health care products and practices.

We cannot afford to compromise the nation’s public health.

—————————

(A former senator, the author is the lead convenor of the multisectoral Fair Trade Alliance (FairTrade) and convenor of Ayos na Gamot sa Abot-Kayang Presyo (AGAP) coalition, which aims to change policies that will bring down the cost of drug prices.)

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