DOH Fails to Implement the Cheaper Medicines Act

In a rally on June 6, 2012, the four years after then Pres. Gloria Macapagal Arroyo signed the Cheaper Medicines Act, The Consumers’ Action for Empowerment gave the Department of Health a failed mark for its inability to bring down the prices of medicines.

Consumers’ Action for Empowerment scored the Department of Health based on its failure of four major provisions of the Cheaper Medicines Act. These provisions are:

1. Regulate prices of medicines. Prices of medicines have gone up. As per monitoring of the Senate committee of Trade and Commerce on five medicines, prices of medicines monitored in 2008 when the law was implemented and the current prices June 2012 have gone up, except for Norvasc. These medicines are: Plendil 5mg for hypertension was P23.76 and is now P30; Ventolin inhaler for asthma was P352 and is now P 430.50; Ponstan 500mg for pain was P26 and is now P29.75; Bactrim which is an antibiotic was P17 and is now P33.75. Only the anti-hypertensive Norvasc, has gone down then P44 is now P22.85. Is it because of Cheaper Medicines that the price of Norvasc has gone down or because it went off-patent in 2009?
   
   In addition, the Department of Health claims to regulate and monitor the prices of about 200 medicines. What is the basis for the selection of these medicines which is nowhere near the 600 essential medicines needed in the country. It uses an electonic data monitoring system which is hard to access; thus making it virutally ineffective.
2. Increase parallel importation. Importation of patented medicines from abroad competes with the medicines manufactured in the Philippines, thus threatening the very existence of the fledgling drug industry in the country.
3. Promote and educate the Generic Laws. After more than two decades of the existence of the Generics Law, sales of generics medicines is only four percent. Though generic medicines are cheaper, still patients could not complete the required dosage or take their medicines on a maintenance level because of lack of money. Those aware of savings incurred through use of generic medicines use branded medicines because there is no generic equivalent available in the country. These medicines include eye and ear preparations, dermatological or skin infections, medicines for kidney, heart, anti-depresssion and cancer.
4. Widen availabity by allowing the sale of over-the-counter medicines to non-pharmacy outlets. Sales personnel are not knowledgeable of the rational use of these medicines, which may create adverse side effects and damage vital organis like the kidney and liver.

The Consumers’ Action for Empowerment calls for affordability and availability of medicines vis-à-vis quality and rational use of the medicines and the development of a comprehensive health care. The government through the Department of Health, as well as other government institutions, has a central role in this. Patients need free essential medicines in government hospitals and the exemption of medicines from the 12 percent VAT. These may bring the temporary relief while government still has to seriously define steps in developing a genuine national drug industry that is free from transnational control.

A position paper submitted to the Quality and Accessible Medicines Oversight Committee (QAMOC) on the Universally Accessible Cheaper and Quality Medicines Act of 2008
(19 March 2012)

CONSUMERS' ACTION FOR EMPOWERMENT works on the premise that health is a basic human right and it includes the right to accessible, safe and affordable essential medicines.

We believe that the key to improving people's access to affordable and safe essential medicines and other goods and services can only be achieved when people are provided full economic and social opportunities in a democratic society.

From the start, the Cheaper Medicines Act had its inherent flaws and was not expected to effectively bring down the prices of medicines. The act failed to address exorbitant drug prices and failed to promote and ensure access of majority of the people to quality affordable medicines mainly because:

First, the law while avowed to help generic firms to develop quality and affordable generic medicines does not truly support the development of a local drug industry. The law favours parallel importation of branded medicines from countries where these are more affordable even if their generic drug equivalents are available in the Philippines. Parallel importation promotes dependence and virtually kills whatever is left of the Filipino drug industry.

Second, the law does not address the monopoly control of transnational corporations on patents. Though 80 to 90 percent of essential drugs sold in the Philippines is already off-patent, their generic equivalents still cannot be manufactured and made available to the people. To date, local drug manufacturers produce only 200 of 600 essential medicines. The government fails to fully support local drug manufacturers.

Third, the price of medicines has been left to unregulated free-market forces. The President of the Philippines was given the power to set price ceilings of medicine but transnational drug corporations in the marketing, distributing and pricing of medicines still maintain the control of drug prices.

Consumers’ Action for Empowerment believes that the problem of unabated high prices of medicines can be abated through the implementation of national policies and programs that will:

Establish a self-reliant nationalist drug industry that is responsive to the health needs of the people;

Develop technology that will extract and refine raw materials and chemicals for medicine production;

Improve the potentials of herbal medicine and natural components that are locally available as complementary forms in health management;

Create a temporary drug price regulatory board with representation of stakeholders from people's organizations, consumers, academe, health and industry professionals, etc.

Support the genuine development of the local drug industry and provide incentives to local drug manufacturers in the manufacture of essential medicines;

Facilitate selective importation of essential medicines t not locally produced and available and have gone through extensive testing for safety and efficacy;

Implement the National Drugs Policy and Generics Law of 1988.

The need of Filipinos for efficacious and affordable medicines can only be met when a strong national health care system is in place and under a government whose policies are in the best interest of the people.##

CONSUMERS' ACTION FOR EMPOWERMENT works on the premise that health is a basic human right and it includes the right to accessible, safe and affordable essential medicines.

We believe that the key to improving people's access to affordable and safe essential medicines and other goods and services can only be achieved when people are provided full economic and social opportunities in a democratic society.

From the start, the Cheaper Medicines Act had its inherent flaws and was not expected to effectively bring down the prices of medicines. The act failed to address exorbitant drug prices and failed to promote and ensure access of majority of the people to quality affordable medicines mainly because:

First, the law while avowed to help generic firms to develop quality and affordable generic medicines does not truly support the development of a local drug industry. The law favours parallel importation of branded medicines from countries where these are more affordable even if their generic drug equivalents are available in the Philippines. Parallel importation promotes dependence and virtually kills whatever is left of the Filipino drug industry.

Second, the law does not address the monopoly control of transnational corporations on patents. Though 80 to 90 percent of essential drugs sold in the Philippines is already off-patent, their generic equivalents still cannot be manufactured and made available to the people. To date, local drug manufacturers produce only 200 of 600 essential medicines. The government fails to fully support local drug manufacturers.

Third, the price of medicines has been left to unregulated free-market forces. The President of the Philippines was given the power to set price ceilings of medicine but transnational drug corporations in the marketing, distributing and pricing of medicines still maintain the control of drug prices.

Consumers’ Action for Empowerment believes that the problem of unabated high prices of medicines can be abated through the implementation of national policies and programs that will:

Establish a self-reliant nationalist drug industry that is responsive to the health needs of the people;

Develop technology that will extract and refine raw materials and chemicals for medicine production;

Improve the potentials of herbal medicine and natural components that are locally available as complementary forms in health management;

Create a temporary drug price regulatory board with representation of stakeholders from people's organizations, consumers, academe, health and industry professionals, etc.

Support the genuine development of the local drug industry and provide incentives to local drug manufacturers in the manufacture of essential medicines;

Facilitate selective importation of essential medicines t not locally produced and available and have gone through extensive testing for safety and efficacy;

Implement the National Drugs Policy and Generics Law of 1988.

The need of Filipinos for efficacious and affordable medicines can only be met when a strong national health care system is in place and under a government whose policies are in the best interest of the people.##

Cheaper Medicines Act not properly implemented — Villar

A study conducted by the Senate committee on trade and commerce has shown that four years after the ratification of Republic Act No. 9502 or the "Universally Accessible Cheaper and Quality Medicines Act of 2008," prices of some medicines have yet to go down.

At the bicameral hearing of the quality affordable medicine oversight committee on Monday, it was revealed that of the five drugs included in the study, only the price of one has decreased since 2008 — and it was not even because of the law.

“Norvasc lang ang bumaba. Nabanggit kanina na kaya bumaba ito [ay] dahil naalis na ‘yung patent protection at talagang normally bababa na ‘yun. Walang kinalaman ang batas sa pagbaba nun,” Sen. Manny Villar, chairman of the Senate committee on trade and commerce, told reporters in an interview after the hearing.

Other drugs that were part of the study were Plendil, which cost P23.76 before the passage of the Cheaper Medicine Law but is now P32.25; Ventolin (inhaler), which used to be P352 but is now P432.50; Ponstan, which used to be P26 but is now P29.75; and Bactrim, which used to be P17 but is now P33.75.

70-percent decrease

But according to Reinier Gloor, executive director of Pharmaceutical & Healthcare Association of the Philippines, prices of some medicines have gone down by as much as 70 percent since the law was passed. He said most of these medicines were those sourced from abroad.

“There are lots of Filipino companies… 125 local firms, some competing with multinational products. In certain products sourced from India or China and so forth, the reduction is 60 to 70 percent. For products made in Europe and the United States, the product price reduction goes down to 60 percent,” Gloor said.

Still, Villar said he would further study the implementation of the Cheaper Medicines Act.
“Hindi ako titigil hanggang hindi nakakagawa ng rekomendasyn ang aking komite dito sa implementasyon ng batas na ito. Mahalaga na bumaba ang presyo ng gamot, ito ang objective ng batas na ito at ‘yan ang dapat mangyari,” he said.

“Lobbied”?

Villar said it is “possible” that pharmaceutical companies had a hand — through intensive lobbying — in drafting the Implementing Rules and Regulations (IRR) of the law.

“Possibleng nagkaron ng lobbying sa IRR pero wala akong inaakusahan. Ang sinasabi ko lang ay posible… Masyadong maaga para malaman kung sino pero definitely sa ating pagre-review may mga kumpanya na nagva-violate nito,” he said.

Villar said his committee would invite health officials who drafted the IRR to the third bicameral hearing.

Out with VAT

To further lower the prices of medicines, Villar proposed to remove the value-added tax on medicines.

“Pino-propose ko rin na tanggalin ang VAT sa gamot. Hindi naman talaga dapat na papatungan pa ng VAT ang mga gamot [dahil] talaga namang napakahalaga ito sa ating buhay, kaya hindi ko naiintindihan kung bakit naipasama yan sa VAT natin noon,” he said.

He said his son, Las Piñas Rep. Mar Villar, has already filed a bill for this, noting that tax measures must originate from the House of Representatives.

Free medicines for cancer patients

Meanwhile, Villar also proposed to provide free medicines specifically to cancer patients.

“Ako’y talagang nag-propose noon pa na dapat itong mga gamot sa cancer ay ibigay ng gobyerno na libre. Naniniwala akong kaya ng budget 'yan,” he said.

The senator claimed that the government may opt to buy in bulk to avail of discounts.

“Ang isang Pilipino ay hindi dapat mamatay dahil sa cancer na hindi lamang nagkakaroon ng pagkakataon [makatikim ng gamot],” he said. – KBK, GMA News


Cheaper Medicines Act not properly implemented — Villar