By Alberto Romualdez, M.D.
Tuesday, 6 May 2008

Last week, the Philippine Congress, after what seemed like an eternity of agonizing debate, finally passed the first piece of legislation since the 1988 Generics Law aimed at rationalizing the pharmaceutical industry in this country. The approval came almost four years since a bill to amend the Intellectual Property Code of the Philippines to unburden the Intellectual Property Office of decades of pro-foreign business rulings and precedents that tied up local companies in knots whenever they attempted to take advantage of lapsing patents to produce cheaper medicines for Filipinos.

With the new legislation, it will no longer be possible for pharmaceutical giants (particularly those who are American-based) to prolong for long periods of time their monopolies on drugs that they had long before introduced into the Philippine market. Interestingly, the long debates highlighted the great differences in style, mind-set, and attitudes of the two houses of the Philippine Congress.

To begin with, there was considerable wrangling between the two chambers regarding what to call the Bill. The final agreed short name of the Bill is “Universally Accessible Cheaper and Quality Medicines Act of 2008”. On this score, it appears that the more populist-leaning House won over the upper crust pretensions of the Senate that preferred the word “affordable” over “cheaper”.
There were other more critical differences that delayed quick agreement in the bicameral conference committee. A thorough reading of the final bill reveals some serious omissions and changes in language that could critically hamper the intended effects of the bill.

The obviously pro-business Senate panel blocked all House attempts to include any provisions that would allow the possibility of a strong price regulatory regime. Even the compromise agreement that gave authority to the Executive Branch to impose price controls based on certain conditions was significantly diluted by allowing price controls only in case of “health emergency”. In very early discussions, it had been suggested that mere certification of a “public health need” would have been sufficient to trigger a price regulation process as well as compulsory licensing by patent-holders. This is in fact the wording of the Doha Declaration that allows countries to lift intellectual property restrictions on the production of medicines that are important to their public health programs.

The other deletion that effectively diluted the effects of the bill was the dropping of the “generics only” provision of the sections amending the Generics Law of 1988. This provision would have prohibited physicians to write brand names of drugs on prescriptions and would have required drug companies to completely revise their marketing practices. Again, in this instance, the House contingent, whose members included some very ardently pro-poor congresspersons including physicians, had to buckle under to their insistently pro-business Senate colleagues.

What was even more curious was the role played by the Executive Branch of Government in the discussions of the Bill. The “generics only” provision was actually included upon the suggestion of the Department of Health in the Technical Working Group of the House Committee deliberations. When the medical profession and the pharmaceutical industry loudly protested this feature, Malacanang stepped in to order the DOH to withdraw support for the provision. Eventually, when some administration congressmen persisted in supporting “generics only” prescribing, the Palace used its clout with the House leadership to quell a budding mini-revolt. Thus it was that another “pro-poor” feature of the legislation finally bit the dust.

In summary, what the advocates for reform in the pharmaceutical industry got was a little bit less than half a loaf of legislation to put pressure on prices of medicines to come down. The provisions revising parts of the Intellectual Property Code will help local firms with established capacities to provide better competition to the multinationals. However, the mechanisms necessary to ensure that this enhanced competitiveness translates into a better deal for the Filipino have been weakened to near impotency.
When the Lower House debated their version in the Thirteenth Congress, there were loud accusations of a multi-million peso lobby fund against its enactment. To be sure, there is absolutely no evidence that any blatant lobbying, least of all by multinational companies, ever took place – at least in this Fourteenth Congress. Nevertheless, there is no question that this watered down bill is much more favorable to the business sector (both local and foreign) than had been anticipated. Since most members of the delegation from the Lower House appeared to be fully supportive of strong anti-business measures, the question now is who was lobbied by whom?

Unfortunately, the enthusiastic media coverage of the arguments in Congress simply served to heighten expectations of people that prices of medicines will drop dramatically soon. Because Congress has passed to the Executive Branch the responsibility for ensuring that this happens, the ball is now in Malacanang’s court. Considering this administration’s tendency to indecision on issues, especially when business is affected, people should not be too disappointed if the “cheaper medicines law” turns out to be a dud…

3 Responses to “Cheaper Medicines: Less than Half a Loaf”

  1. everlasting Says:

    sabi ko na wala rin kahihinatnan ito dahil papogipoints lang yun minadali na cheaper (kuno) medicines act. the MNCs will do its damnest to block any laws that will lessen their profits.

  2. Don Kishote Says:

    it takes political will and grit to realy make a responsible law. but will and grit our lawmakers have NONE.

  3. nj Says:

    i think its not a matter of cutting down prices of those leading brands(leading brands because its what doctors prescribe) but i think its the matter of EDUCATING THESE DOCTORS and THE people the efficacy of other affordable brands or even their respective generic equivalence…DOCTORS SHOULD PRESCRIBE THESE MEDICINE BECAUSE THEY BELIEVE THAT IT IS EFFECTIVE AND NOT BECAUSE THESE BRANDS ARE FROM THE MAJOR COMPANIES WHO SPONSOR THEM…talking about health commercialization

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