Cheap talk about medicines
AS I WRECK THIS CHAIR By William M. Esposo
The Philippine Star 2008-01-22
With Elections 2010 in the air, Filipinos now witness how the political wannabes and factors of the GMA regime in Congress and in the DOH are rabidly competing for public favor in seeking passage of bills that they believe will make a big impression on voters.

Surveys show that health is a major concern of Filipinos and making voters think that you offer a solution is one way of winning their vote. The sad reality about our so-called health system is that even those who are better off here tend to find it difficult to meet the expenses required from major surgical procedures.

I know of people who are relatively better off but had to pretend to be indigent just so they can have a child treated for a major heart operation at the Philippine General Hospital. They just could not afford the expense.

I know one family running a profitable business here who had just decided to take their children (all honor graduates of prestigious schools here) to migrate to Canada. A quadruple bypass on one of the couple almost wiped out their savings and another one such procedure would surely set them back significantly. Canada is known to have the best health care system in the world. Canada’s health care makes a big difference in keeping its citizens happy and attracting quality migrants to help build Canada’s future.

An important component of health care is making medicines accessible to poorer citizens. Yet, the opposite is the case, says Dr. Eduardo Gonzalez, Professor at the UP’s Asian Center.

Gonzalez wrote in a 2007 global report of the Montevideo, Uruguay-based nonprofit group Social Watch: “The reality for the vast majority of poor people is that social services are unavailable, or are skewed towards the needs of the rich, or are dauntingly expensive — and this drives up social inequality.”

In Canada, drugs are dispensed at “no cost” to indigents while those who have jobs are adequately covered by their employers’ health care plans. This provides great leverage for government and insurance companies to negotiate with drug companies for reasonable pricing.

The Canadian generic industry enjoys government incentives and medicines in Canada are of the same quality as the original patents. Hence, Canadians do not hesitate to choose generic substitutes when the brand name is out of supply.

In Canada, pharmaceutical companies are not regarded as enemies but partners. The Canadian government does not need to look for scapegoats because their health system works.

Around 92% of Filipinos who do not belong to the economic elite live in varying degrees of need and relative poverty. This group certainly cannot afford regular health care services offered in this country.

Health care is one of the top issues in the ongoing US Presidential campaigns. Democracies like the US, Great Britain, Scandinavian countries and Canada are among the countries where health care is a national concern. Through the health care system, even the poor can have access to quality medicines.

In this country, health care is a serious issue during elections. Don’t you remember the 2004 presidential campaign when they were distributing Philhealth cards indiscriminately?

I’m afraid that most of the authors and advocates of the many versions of cheaper medicines bills are motivated by political ambition, rather than real concern for the poor. Since popularity is an issue here, we can expect them to lambast big pharmaceutical companies as ‘evil’ and generic drugs and parallel imported medicines as ‘good’.

I have nothing against generics but I need to trust them as effective and of equal quality as the branded ones. It is a big question of credibility. How can we be sure these generic medicines are effective?

Government’s PITC has been authorized to coordinate with the Department of Health to import and sell generics and cheap drugs that enter as parallel imports from countries where they are supposedly sold at lower prices. This sounds good but who will check if government is not only concerned about getting their hands on revenues that can be earned from selling cheaper medicines? If the medicines are A-1, then we have no problem. But can we really trust this government?

Another question is: Does the Bureau of Food and Drugs have the capability to test each generic drug or those that come from parallel importation to make sure they are not fakes, expired or ineffective?

I do not see any strategic, holistic approach in any of the bills or position papers that advocate cheap medicines. They have even antagonized physicians and have cast doubts on their integrity, as though they are the thugs and the government lackeys behind the cheap medicines proposals are the heroes of the day.

Medicines take several trials and tests before they are made available. One must never be hasty and careless when it comes to the health and wellbeing of people.

But in their haste to create brownie points for 2010, it is the very poor they are luring to their corner and they happen to be the ones who stand to suffer most.

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