Commentary
An Assessment of Pharma 50, A GMA SONA Promise

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
Bulatlat.com

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

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