The
Generics Act of 1988, RA 6675, turned 25 years old last month. The Department
of Health organized the "Generic Medicines Summit 2013" at the DOH
Convention Hall, DOH Compound, Manila last Monday, September 30, 2013. It was a
whole day activity, I was not able to attend the morning session, I went to the
afternoon sessions.
Panel Session No. I, 1-2:30pm, the theme was “The Impact of Generics
Policies in Improving Access to Medicines and Health Outcomes”. The
speakers were:
Presentation No. 1:
Global Achievements in
Implementing Generic Policies
Presentation No. 2:Local
Market Trends
Presentation No. 3:
Analysis of the Prescribing and
Dispensing of Generic Medicines as Prescribed by Generics Act of 1988
Panelists: PCPI, PHAP, PPhA
|
Dr.
Brian Godman
Mr.
Romeo Castro,
GM, IMS Health Phils., Inc.
Dr.
John Q. Wong,
Consultant,
PIDS
|
Panel Session No. II, 2:30-5pm, the theme was “Progress of
Pharmaceutical Reforms and Continuing
Efforts of Government in Assuring
Availability and Affordability of
Quality Generic Medicines”. The speakers were:
Presentation No. 4:
Impact Evaluation and Monitoring
of the Cheaper Medicines Act of 2008
Presentation No. 5:
The Impact of the Cheaper
Medicines Act on Households in Metro Manila:
A Quarterly Study”
Presentation No. 6:
Philhealth’s Initiatives in
Promoting and Using Generic Medicines
Presentation No.7:
FDA Efforts to Assure the Quality
of Generics in the Market
|
Dr.
Jesus N. Sarol, Jr.
Consultant, PCHARD
Dr.
Eleanor De Guzman
Research Consultant, PIDS
Dr.
Poch Soria
Vice
President, PHIC
Dr.
Kenneth Hartigan Go
Director
General, FDA
|
The panel of
reactors were Dr. Delen de la Paz of HAIN and UP College of Medicine, Dr.
Isidro Sia of the National Formula Board, also of UPCM, and Atty. Pau Tanguieng
of AGAP. Pau was not around, Before panel 1 ended, Dr. Melissa Guerrero of
NCPAM asked me if I can be a reactor, speak as representative from civil
society. It’s not a difficult task, I quickly said Yes.
So I was
seated in the front table beside Docs Dela Paz and Sia, have a good view of the
speakers and their presentations. Nice.
Dr. Sarol and Dr. de Guzman spoke about their respective assessment reports about drug price regulation of the Cheaper Medicines Act (CMA) of 2008, FDA Director KHGo spoke about the reforms that FDA is doing, and Doc Soria spoke about new thrusts of PhilHealth.
My comments
to the four presentations:
1. Dr.
Jesus Sarol presentation...
Their study covering 2009-2011 simply confirms what we already know, that medicine prices are just following the law of gravity, they are coming down. In fact even before CMA became a law, ave medicine prices have been declining slowly, thanks to that good old reliable law of competition.
I added that CMA is more than drug price regulation or control. The law is mainly revising the Intellectual Property Code (IPC) of the country to accommodate compulsory licensing (CL) and other IPR concerns.
Their study covering 2009-2011 simply confirms what we already know, that medicine prices are just following the law of gravity, they are coming down. In fact even before CMA became a law, ave medicine prices have been declining slowly, thanks to that good old reliable law of competition.
I added that CMA is more than drug price regulation or control. The law is mainly revising the Intellectual Property Code (IPC) of the country to accommodate compulsory licensing (CL) and other IPR concerns.
2. Dr.
Elanora de Guzman paper:
Good findings in their study, confirms that the main beneficiaries of the drug price control policy were the upper middle class and the rich, class AB and C, not the poor, class DE. Before price control was imposed, many cheaper generic drugs were available, so when Pfizer's Norvasc (anti-hypertension) price was forced down from P44 to P22 a tablet, there were several generics already selling at P7.50 or lower. The poor will find the P22 still expensive and won't buy it, they'll go for the P7 or P5 other branded generics.
Good findings in their study, confirms that the main beneficiaries of the drug price control policy were the upper middle class and the rich, class AB and C, not the poor, class DE. Before price control was imposed, many cheaper generic drugs were available, so when Pfizer's Norvasc (anti-hypertension) price was forced down from P44 to P22 a tablet, there were several generics already selling at P7.50 or lower. The poor will find the P22 still expensive and won't buy it, they'll go for the P7 or P5 other branded generics.
3. FDA Director,
Doc KHGo:
Happy that
FDA is promoting the rule of law in ensuring the safety of food, medicines,
drinks, other consumer (chemical, biological) products, law based on science.
Congratulations.
But it is
simply impossible for FDA to monitor all such products, from anti-cancer
medicines to barbeque sauce or new energy drinks or skin whitening soap, etc.
Commiserations. The number of products to be monitored and approved is directly
proportional to their misery.
One option is to partner with private or civil society accreditation bodies, also industry associations, that will police their own ranks and disallow unsafe products from being manufactured and sold. This way, FDA can focus its resources and manpower on firms and products that are not covered by those private or civil society accreditation bodies and industry associations. Spot checks by FDA to these bodies, so that repeated cases of unsafe food and drugs being allowed will mean revocation or blacklisting of such bodies, and firms will have to go through the usual, stringent FDA approval process.
One option is to partner with private or civil society accreditation bodies, also industry associations, that will police their own ranks and disallow unsafe products from being manufactured and sold. This way, FDA can focus its resources and manpower on firms and products that are not covered by those private or civil society accreditation bodies and industry associations. Spot checks by FDA to these bodies, so that repeated cases of unsafe food and drugs being allowed will mean revocation or blacklisting of such bodies, and firms will have to go through the usual, stringent FDA approval process.
4. Dr. Poch Soria:
PhilHealth
is somehow a victim of its huge and monster existence, there is also monster
expectations, monster disappointment by the public. The more they promise to do
something or correct past inadequacies, the more expectations and even more
loopholes that will be introduced.
Their data that of the 315 govt hospitals they surveyed (42 DOH hospitals + PGH, and 273 LGU hospitals), only 7% complied with the no balance billing (NBB) for indigent patients. 93% of them required out of pocket (OOP) spending by the poor. This shows that often, government is a big violator of its own rules.
PhilHealth then should learn to step back on certain promises, reduce the expectations. One area is on NCDs (non communicable diseases) patients. Someone with communicable disease like dengue is easy to treat, after the disease is killed, a patient won't go back to the hospital for several/many years. Compare that to a hypertension or other adult NCD patient, who will be patient for the next 10, 20 years or more. Can drain the reserves.
Their data that of the 315 govt hospitals they surveyed (42 DOH hospitals + PGH, and 273 LGU hospitals), only 7% complied with the no balance billing (NBB) for indigent patients. 93% of them required out of pocket (OOP) spending by the poor. This shows that often, government is a big violator of its own rules.
PhilHealth then should learn to step back on certain promises, reduce the expectations. One area is on NCDs (non communicable diseases) patients. Someone with communicable disease like dengue is easy to treat, after the disease is killed, a patient won't go back to the hospital for several/many years. Compare that to a hypertension or other adult NCD patient, who will be patient for the next 10, 20 years or more. Can drain the reserves.
