By ALECKS P. PABICO
Philippine Center for Investigative Journalism

Conclusion

BFAD’s Ramos also says there is "no real threat" as the agency, together with law enforcement agencies, can easily detect counterfeit drugs. Besides, medicines that will be subject of parallel importation will have to be registered with BFAD. The agency is also tasked to conduct the necessary post-market surveillance.

"The counterfeit medicines issue is not a real issue," says Elpidio Peria, an associate of the Third World Network that is among the various nongovernmental organizations supporting the Senate bill, Peria explains that most, if not a large majority, of the pharmaceutical products that will be brought in through parallel imports are the same products produced by the same pharmaceutical firms already operating in the country.

"It is a fact," he adds, "that these same companies imported from their mother units or manufacturing bases and made money out of the price differentials between the Philippines and the countries from where these products were sourced."

But a healthcare professional who was once part of the Department of Health (DOH) says that while the parallel importation provision in the House bill is "relevant," it is nevertheless "too simplistic." He says there are no protocols to ensure checks and balance; neither are there provisions to ensure that imported drugs would come from firms complying with current good manufacturing practice and from legitimate wholesalers and consolidators. He also notes the lack of punitive clauses for those who would import or manufacture substandard generic drugs.

The healthcare professional adds that the provision on compulsory licensing (which the World Trade Organization says happens "when a government allows someone else to produce the patented product or process without the consent of the patent owner") practically means nothing since Philippine drug manufacturers have no technical capacity to make drugs in the true sense of the term. "What we do have," he says, "is secondary manufacturing which is compounding, tableting, and capsuling."

For sure, given its total dependence on imported raw materials and chemicals, the Philippine pharmaceutical industry cannot be considered a true drug industry. Although almost 90 percent of drugs sold are locally produced, Philippine drug companies are mainly compounders, formulators, and packagers. The big pharmaceutical firms either import their products or have them toll manufactured at the foreign-owned Inter-Phil Laboratories.

Yet while the Philippine drug industry remains far from having India’s economies of scale and the heavy investments in science and technology, there are now a few local companies like United Laboratories, Elin Pharmaceuticals, and Pascual Laboratories that are engaged in the manufacture of active substances. Besides, says BFAD’s Ramos, if the country invokes the Doha Declaration on the TRIPS flexibilities, compulsory licensing can be extended to countries with manufacturing capability to cover the needs of those without such capability.

Still, for all the hopes being pinned on the passage of the affordable medicines law to either usher in amendments to the Intellectual Property Code, or a drug price regulation scheme, or both, there are those who acknowledge it is not going to be a magic pill.

"No bill filed in the 14th Congress could single-handedly lower the price of medicines," admits Akbayan party-list Rep. Ana Theresia Hontiveros-Baraquel. She says that to bring down the exorbitant price of medicines in the country, a more comprehensive legislation is necessary.

Such a situation is rooted in a complex mix of problems involving dynamic forces that affect the market, the industry, doctors and health professionals, and patients, plus the reality of national poverty. What future legislations will have to provide are solutions to the issues that observers say the current bills failed to address. Among these are the fundamental problems of market failure in pharmaceuticals, the need for true quality generics competing fairly in the Philippine market, the need for monitoring and limiting unethical promotions, advertising, and marketing practices that influence prescribing and add to the cost of drugs.

In the meantime, doctors like Rosan Badon who deal with impoverished patients have become innovative. Badon says she has even resorted to prescribing traditional Chinese medicine to some of her very poor patients, reasoning that it would be useless anyway to prescribe a modern drug that they will not be able to afford.

For hypertensive patients, for example, Badon recommends tiny pechay seeds that are stuck to a piece of bandage and are then placed at the back of one’s head. "This is actually part of acupuncture," says the doctor, who is also an acupuncturist. She also explains that the treatment is part of a holistic approach. "We also advocate a low-salt diet and a healthy lifestyle," she says.

But Badon says extremely poor patients see a doctor only when they already feel very ill, which makes it more difficult to treat them. Ironically, that is almost always because they feared they would not be able to afford the medicine they needed to get better in the first place.