The cost of medicines in the Philippines is among the highest in the world. A study shows that it would take a full six days of wages for an average worker to purchase basic medicines in the country. There are more than 17,000 registered drugs in the local market, but a majority of the population can barely afford these expensive essential drugs.
Lawmakers are bewildered why Norvasc, a medicine for hypertension, is sold in the Philippines by a multinational pharmaceutical company for 41.41 pesos (US$1) per 5-mg tablet; while in India and Pakistan, the same drug manufactured by the same company is priced at around 5.77 pesos (US$.14).
Plendil, also for hypertension, is priced in the Philippines at 21.82 pesos (US$.54) per tablet while it costs only 2.69 pesos (US$.07) in India. A Ventolin inhaler for asthma patients is sold for 315.00 pesos (nearly US$8) in the local market while in India it costs only 126.78 pesos (US$3).
Other medicines also show the same disparity. Ponstan, a common painkiller, costs only 3.22 pesos (US$.08) in India but costs 24.92 pesos (US$.60) per pill in the Philippines. Bactrim 400, priced at 17.75 pesos (US$.40) per tablet in the Philippines, can be bought for only 1 peso (US$.02) in Pakistan and 0.69 centavos in India (less than US$.01).
Why are medicines so expensive in a poor country like the Philippines?
A few big foreign pharmaceutical companies control the local drug market. More than 70 percent of local drug trading is dominated by transnational corporations. Since there is no competition, drug firms are dictating the prices of medicines for as much as the market can bear. The Intellectual Property Code is used by the dominant pharmaceutical companies to block efforts of local companies and even by the government to manufacture and import patented drugs.
Wholesale drug distribution in the country is dominated by one company. The people are helpless if the company decides to raise drug prices in its more than 600 outlets throughout the country. Government-subsidized drug kiosks are very few and remain inaccessible in most provinces.
The Generics Law of 1988 is a big disappointment. Only 5 percent of drugs sold in the country are generic. Doctors continue to prescribe branded drugs. The Philippine has to study why generics laws have worked so well for other countries in bringing down the cost of medicines.
The local drug industry can only manufacture less than 200 drugs. Most of the raw materials used to produce drugs are imported. There is also no sustained research or government program to develop the medicinal and commercial potential of the country’s herbal products.
The issue of costly medicines has been recognized by the government and steps have been taken to reduce drug prices. The government announced its plan to sell affordable drugs in public universities and health centers. The first legislative proposal filed in Congress last July was the Cheaper Medicines Bill.
Senator Mar Roxas explained the urgency of approving this measure:
"The bill seeks to amend the Intellectual Property Code in order to allow the parallel importation of more affordable medicines from abroad; support the generics industry by adopting the ‘early working’ principle and to disallow the grant of new patents on grounds of ‘new use;’ and give ample muscle to the government through a framework for government use and compulsory licensing. The substitute bill also reiterates the president’s power, patterned after the Price Act, to impose drug price ceilings in times of calamity, public health emergencies, illegal price manipulation and other instances of unreasonable drug price hikes."
Most political parties have vowed to support this bill. The president has also certified it as a priority measure. So far, Congress has not yet approved the final draft of this measure. Is the lobby fund of big drug companies working already?
Perhaps the Cheaper Medicines Bill will finally become law next month. But the two chambers of Congress must first resolve their differences over what regulatory measures to include in the law. There are lawmakers who believe that parallel importation of cheaper drugs cannot substantially lower drug prices in the country. They want to create a drug price regulation board which will be given absolute powers to fix a maximum retail price for medicines. However, senators are worried that a drug price regulation board which is composed of only seven individuals could be influenced by big pharmaceutical companies.
Some activist groups are also not very optimistic that the people will have access to low-cost essential drugs through the Cheaper Medicines Bill. They are frustrated that the proposed bills in Congress do not make any single mention about the need to develop a self-reliant national drug industry that is responsive to the medical and health needs of the people. The Cheaper Medicines Bill is also silent about the control of multinational corporations in the marketing, distribution, and pricing of medicines in the country.
Health advocacy groups are urging the government to tap the medicinal potential of indigenous and herbal plants in the Philippines. They propose that prices of medicines should be regulated based on the production cost and reasonable profit of companies. Tax incentives can be given to local drug manufacturers to ensure production of medicines. A drug price regulatory board is also being proposed; but it should be represented by health stakeholders and the selection process for membership in the board should be independent and transparent.
Many Filipinos are dying because they lack the means to buy the drugs prescribed by doctors. The government is right to prioritize the passage of the Cheaper Medicines Bill. Congress should improve this measure and incorporate the criticisms of various organizations.