Tuesday, May 05, 2020

BWorld 433, Rushing new treatments and vaccines

* My article in BusinessWorld, April 30, 2020.

On April 24, President Rodrigo Duterte announced in his address to the nation, “…the bright Filipinos who are there working day and night trying to find out how to combat COVID, I’m raising the bounty to 50 million… Baka ‘pag sa ligaya ko, another 50 million… So kung kailangan nila ng additional funding… kung hindi masyado malaki, I will readily give it to them.”

The good news about this statement is that the President recognizes the importance of medicines and vaccines innovation and by extension, government should reward, not harass innovators.

The bad news is that developing just one new successful and effective vaccine will cost not just $1 million (P50 million) but around $1 billion or more. And upon the prodding of the Department of Health (DoH), he signed Executive Order (EO) 104 on Feb. 17 that precisely harasses innovators via drug price control.

There are two types of vaccines to deal with diseases: 1.) Preventive vaccines, help the body develop immunity to a disease by imitating an infection and teach the immune system how to identify and target viruses and bacteria without actually causing an infection; and, 2.) Therapeutic vaccines which treat pathogens by provoking a targeted immune response against an existing disease.

Vaccine development by innovator pharma and biotech companies against COVID-19 was progressing fast. As of mid-March, more than 20 vaccines and antiviral medicines were being developed and undergoing nearly 80 clinical trials in various phases in various countries, data from the International Federation of Pharmaceutical Manufacturers Association (IFPMA) showed.

By mid-April, there were already 70+ candidate vaccines from many innovator companies worldwide. Other diseases were also getting new candidate vaccines on top of existing ones, according to data from the Pharmaceutical Research and Manufacturers of America (PhRMA) showed (see Table 1).

Humanity is being assured of better healthcare in the future via new and evolving treatment and vaccines. But politics of envy interfere in the distribution and sale of these new treatments. Recall how the DoH was focused on drug price control (DPC) lobbying and defending mainland Chinese travellers even when COVID-19 was already wreaking havoc in China and other countries since January (see Table 2).

So when those successful vaccines and treatments vs COVID-19 become available worldwide a few months from now, there is the danger that the Philippines may not get them because of existing political dangers.

One, the old DPC under EO 821 (July 2009) issued by former President Gloria Macapagal Arroyo remains in place until now and was never pulled out.

Two, IPR- and patent-confiscation provision via compulsory licensing against newly invented, patented successful medicines and vaccines may be issued under RA 9502 (Cheaper Medicines Act of 2008).

Three, with EO 104 is already waiting for them, price controls at the manufacturers and wholesale level can be imposed at any time. Criteria No. 4 of EO 104 says that if medicines are most prescribed by physicians and it is not priced “fairly” based on DoH’s subjective judgment, then it can be placed under price control.

It will be unfair for Philippine patients and the public if effective treatments and vaccines against the virus are available in Hong Kong, Malaysia, Singapore, etc. but not in the Philippines because of these dangers.

While the DoH and the President may not have the time to amend dangers 1 and 2, they have the time and power to rethink EO 104 as its timing is very bad at the moment. They should pull out this order without fanfare.

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