Cheaper Medicine Bill Part II: Not cheap at all!

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The dizzying melee over the Lower House version of the Cheaper Medicine bill has brought out some disconcerting and ironically “costly” issues to the medical community and the current Philippine healthcare industry. And these almost intangible yet paralyzing and costly “side effects” are beginning to wreck havoc and are not cheap at all!

Even before the passage of the bill by the congress and senate bicameral committee, the Quality and Affordable Medicine Bill (which is supposed to lower the high cost of medicines in the Philippines) already took its toll on the very parties it primarily aimed to help- the Filipino patients and their MDs. Imagine these:

  1. The discussions and bickering had succeeded, in some way, of polarizing two of the primary parties to the bill. The doctors has been “demonized” ( to use Prudence’ term) as anti-poor and greedy because of their allegedincentive” driven practice of prescribing “branded” drugs . The PMA loudly declares “MDs are for the patient’s welfare” not some drug companies! The patients on the other hand, thought to be less informed and knowledgeable about their sickness, is deluded by unscrupulous politicians of the promise that a cheaper generic drug will heal all their illness. Imagine the mistrust (between these two parties) that emanates from this polarization! I am totally scared to even think of a doctor patient-relationship that is based on mistrust.
  2. A landmark study about the therapeutic equivalence and safety profile of generic drugs in the Philippines (compared to its branded counterpart) has yet to be heralded by someone. This is perhaps the gist of The Physicians’ arguments against some (generics only prescriptions) provisions of the cheaper medicine bill, and remains a major stumbling block towards MD’s accepting some generics drugs as a good alternative. But such studies is costly, and not even BFAD (who wallows in its funding mediocrity) nor some low cost generics drug company, will willingly spare any cent at all.
  3. That the general perception of doctors receiving “incentives” from the pharmaceutical companies (in any form) and that these incentives influences his prescribing objectivity, is a costly blow to the medical profession. Even the PMA President acknowledges that a few MDs practice such “incentive driven drug prescribing habits”, but this form of “bribery” is not unique to the medical profession. Nevertheless, such practice is totally unacceptable and is a shame to medical community. The noblest profession on earth couldn’t afford such stain to its integrity.
  4. BFAD accepted its inadequacies in implementing stringent rules on the testing, approval, monitoring and policing all (not just the generic but also branded) drugs in the market. This confession made us wonder how on the earth did the current drugs went into market after all? Are we having less or subpar medicines in the market?If BFAD is inutile, then the doctors were left with their expertise and preferences in prescribing their drugs after all! BFAD therefore needs some sort of “medicine” to take care of its ailing “status” of de facto licensing and drug regulatory agency. And in this government, where health is of lesser priority, surely it has a long way to go.
  5. The “BFAD inadequacy” thus lead to another costly move for some of exhibitionist politicians to jump gun on the MDs directly. “Screw the BFAD rehab for now (we need more of our pork barrels instead), lets police the doctors and coerce them to give only the cheapest generic drugs! More ever, lets allow the hapless pharmacist (if your lucky to face one in the drug stores) to guide the patient in choosing one of the 3 or so generics in the drug store“! Anyway, it is the doctor who will be held liable if this drug wouldn’t get its desired effects. Tell me I am all wrong but this is another costly pursuit for any parties involved, the patient or the doctor-litigation for a malpractice suit!

Nobody wants an expensive medicine, not even the doctors. In fact, everyone is for lowering the cost of medicines here in the Philippines. Even the pharmaceutical companies themselves wants their medicines be affordable to the masses. If nobody can afford their medicines, how can they reap their profits?And if the doctors prescribe exorbitant drugs and the patients didn’t get well because he/she can afford it, will the doctors make a living?

As Prudence has said, “lets not loose our guard in this discussion”. Because after all the hullabaloos in the race for “enacting the Cheaper Medicine Bill”, we might have been deceived at seeing the real cost of our incessant political exhibitionism.

Dr. Remo-tito Aguilar co-founded #HealthXPh. A board certified orthopedic surgeon, he is previously Chief of Clinics at St. Louis Hospital in Tacurong City and a consultant in Orthopedics at the Southern Philippines Medical Center in Davao City. Dr. Aguilar is a healthcare social media evangelist and writes his medical musings at The Cast & Curious (www.remomd.com).

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