Bu-lat-lat (boo-lat-lat) verb: to search, probe, investigate, inquire; to unearth facts Volume 2, Number 23 July 14 - 20, 2002 Quezon City, Philippines |
Commentary A
health NGO comments on the failure of the government’s drug importation
program to provide a long-term solution to the problem of exorbitantly priced
medicines in the Philippines. By
REYNALDO LESACA JR., MD / HEALTH ALLIANCE FOR
DEMOCRACY President
Gloria Macapagal-Arroyo’s solution to the high prices of medicines in the
Philippines -- 40 to 60 percent more than in other Asian countries -- has been
“Pharma 50: Mabisang Gamot sa Presyong Abot-kaya (Effective and Low-Priced
Medicines),” a program under the Department of Health (DOH) which involves
mainly parallel importation of drugs. Also tagged by the DOH as GMA 50 or Gamot
na Mabisa at Abot Kaya, it
aims to cut down the prices of drugs by 50 percent. To
date, the DOH and the Department of Trade and Industry (DTI) have imported under
this program some P120 million worth of medicines from India. Some of these
branded medicines include Ventolin/Ventorlin (generic name salbutamol),
Becloforte/Becoride (generic name Beclomethasone), Tenormin (generic name
Atenolol), Adalat Retard (generic name Nifedipine), Bactrim and Septrin/Septran
(generic name Cotrimoxazole) and Daonil (generic name Glibenclamide).
The price discount ranges from 49 percent, as in the case of Ventolin, to
a high 451 per cent for Adalat Retard. A
price discount through parallel importation is attractive and buffers the
shrinking pocket of Filipinos. At the onset, no one will argue against bringing
down the exorbitant prices of medicines. However, does parallel drug importation
address the root cause of expensive medicines? Are there no instant solutions
that somehow go in the strategic direction of addressing this problem? We
believe that parallel drug importation is a poor symptomatic and palliative
measure to ease the price of costly medicines and cannot be expected to
significantly alter the situation. Pharma 50 or parallel drug importation is but
a temporary relief to the ailing Filipino. The Arroyo government needs political
will to decisively solve the problem of expensive medicines in the Philippines. Medicines
are expensive because successive governments have never been interested in
developing a truly independent and people-oriented health care policy, including
the development of a Filipino drug industry.
Ownership and manufacture of drugs are controlled by transnational
oligopolies entrenching import-dependence, “their brand” mentality and sheer
commodification of a vital health and life support. Distribution is likewise
cornered by a handful of Filipino businessmen.
Access to medicines has always been under the mercy of market economics
dominated by foreign interests, never in the interest of the Filipino. In
the absence of a Filipino drug industry, the government should review its
current parallel drug importation policy. Parallel drug importation to be
successful should be able to reach out to majority of the Filipinos.
To be effective and significant, it should take in consideration the
following: First,
government allocation for parallel importation should be increased to at least
P5 billion to be able to make a dent in the drug market competition and reach
majority of the Filipinos. The current P75 million-drug importation accounts for
a measly 0.16 percent of the total medicines purchased in 1999. Pharma 50 has
thus reached only a very small percentage of the population. Second,
parallel imports should not be branded but generic, in keeping with the Generic
Law of 1988. This would help in prompting Filipinos to use generic medicines
that are cheap and effective. The millions poured into the parallel drug
importation could have been used for massive health education on the use of
generics and other tenets of rational drug use. Third,
branded parallel imports should only be of those that do not have cheaper and
equally effective locally produced generic equivalents. For example, the India
imported Bactrim (generic is co-trimoxazole) was advertised by DOH at P5.10
while a local drug manufacturer sells a generic co-trimoxazole at P5. Insiders
in the industry said they could even offer it at a much lower cost. Pharma 50 in
essence competes and virtually kills whatever is left of the Filipino drug
industry. Fourth,
parallel imports should be of medicines not yet manufactured in the Philippines.
These include insulin, anti-cancer drugs, HIV/AIDS medicines and vaccines. These
incidentally are some of the most expensive drugs because of strict patent
regulations. One only has to learn from the South African experience when they
lobbied for parallel drug importation and compulsory licensing for these sets of
medicines to put up competition with their existing high-priced medicines.
Fifth,
the government should ensure that there is a qualified health professional to
properly diagnose the illness and prescribe these prescription medicines. Making
antibiotics available over the counter or, worse, in Gloria Labandera’s
rolling stores, only invites massive irrational drug use leading to antibiotic
resistance. On
a final note, the GMA administration can learn a lesson or two from this
parallel drug importation. Why is India, a poor country, able to make its drugs
cost so low and affordable even if the same transnational companies produce
them? The answer is glaring; the Indian government still has a political will
and wrestles with its foreign investors in order to keep them from punishing its
citizens with prohibitive costs. And this we ask: when can GMA do this? The GMA government should take steps toward developing a drug industry that is self reliant and not dependent on the vagaries of the market economy or the control of transnational oligopolies. Without this move, GMA 50 or Pharma 50 is nothing but PORMA 50, a cheap political gimmick to pacify a restless and sick citizenry. Bulatlat.com We want to know what you think of this article.
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