Where in heaven’s name are the cheaper drugs?

Q. We are spending over P200 a day buying medicines for my dad who had a stroke two years ago. (Here, she lists down seven drugs.) This is very painful for us. Is there a way for you to help us reduce our budget for medicines? — Jennylyn

A. Dear Jennylyn, our readers can surely empathize with your situation. I remember a headline, “80 percent of Filipinos can’t afford to buy drugs.” In your dad’s case, I believe we can replace his current medicines with less expensive drugs, which have almost the same quality and potency. But I need to know your budget limitations. Let me give you two options to choose from:

• Option 1: Middle-class budget. For this option, we can lower your daily budget for drugs by 50-60 percent. There are several Filipino drug companies that offer more affordable alternatives. The biggest one out there is United Laboratories (Unilab).

Being a cardiologist, I mostly prescribe drugs by Therapharma, a division of Unilab, which has a wide range of affordable drugs for heart disease, high blood pressure, and diabetes. Their medicines range from P17 to 20 only. Their product line includes the very popular Amlodipine 5 mg, which, for me, is hands down the best drug for high blood pressure. My lola who is 97 years old and all my relatives take it. Amlodipine is so powerful that one tablet will control your blood pressure for two days. You can miss a day and still be protected!

My second favorite drug for high blood pressure is hydrochlorothiazide, which has recently been revived. Yey! For those who don’t know, hydrochlorothiazide is the number one drug in the US for many decades now. It’s the most recommended by studies, committees, and associations, but recently they have listed other expensive drugs to be at par with it (I leave it to astute and cynical readers to figure out why.) Hydrocholorothiazide (brand name Hytaz) 12.5 mg and 25 mg cost only P4 pesos and P6 per tablet respectively. The low-dose 12.5 mg is perfect for most patients, especially the elderly, because it has less side effects. My dad is taking it. It’s perfect for him because hydrochlorothiazide is a mild diuretic, which compensates for his salty Chinese restaurant diet.

According to Dr. Mariano Lopez, Therapharma medical director and past president of the Philippine Heart Association, their drugs are priced 50 percent lower than other brands. “But why only 50 percent lower?” I bargained. “Sir, can’t we make it 60 percent lower? Every peso counts for our patients.” To which Dr. Lopez just smiled.

John Dumpit, Therapharma’s general manager, pitched in and enumerated the many community projects they have helped all these years, including Gawad Kalinga. “We put a high premium on corporate responsibility and helping doctors’ worthy causes. We believe in giving back to the community the blessings we have received.”

There are, of course, other Filipino drug companies with good quality drugs. One of the more popular is metoprolol 50 mg (brand name Neobloc), a beta-blocker from Gx International used for mild high blood pressure. It’s still priced at around P4 per tablet.

Now, please do not confuse these drugs with generics. The above drugs are branded drugs from Filipino drug companies. So does this mean that buying their drugs would help the Philippine economy? I don’t know the answer except that they employ thousands of Filipino workers.

• Option 2: Poor man’s budget. For those who find a maintenance drug at P17-20 still too high, the last option is to go for generic drugs. These drugs are harder to find and I know are not sold in drugstores. In our experience at the Pasay Filipino Chinese Charity Center (our free medical mission for 16 years founded by my father, Co Tec Tai), we have utilized generic drugs from Filipino companies. They’re advertised in the major broadsheets. These drugs are very cheap, sometimes costing only P1-2 per tablet. But the problem is, you have to buy them wholesale, in boxes of 100. You can’t buy only 10 tablets.

Do generic drugs work? I believe they do, but maybe not with the 100-percent efficacy of the expensive drugs. But consider this: For very poor patients, getting a drug which works 80 percent of the time at six times lower the cost is not a bad deal, right? In our Charity Clinic, where we see an average of 400 indigent patients per medical mission, these people really have no money at all. They don’t even have P20 in their pockets. It’s a sad reality the government should look into.

But what about the Botica ng Bayan? Well, where, oh where, are the Boticas ng Bayan? I went to Jose Reyes once and tried buying their Indian-made nifedipine for our charity patients. Instead, I found that each 20 mg tablet of nifedipine (with a funny-looking package) already costs P18, which is just 30 percent lower than imported brands. Not much of a discount, if you ask me.

Also, the Botica’s line of drugs is so limited. And the packaging of the drugs and the packaging of the project itself is off tangent, if you ask me. (If I get to meet the hardworking Secretary Obet Pagdanganan, I would just respectfully pitch one advice, “Get competent doctors to endorse Botica ng Bayan for it to work.” Sorry, Secretary, but doctors won’t take your word for it.) For now, I think I’ll put my trust in our Filipino drug companies first.

These are our options, Jennylyn. I hope it helps. It pains me so much to see so many poor Filipinos dying because they have no access to these expensive drugs. Sick patients need immediate help. And as a doctor, I swear to do what I can, with whatever opportunities God has given me, to help poor people find some semblance of healthcare. Hopefully, our collective efforts can make them live a bit longer and enjoy the company of their loved ones a bit more.

* * *

For your comments or questions, send e-mail to willietong@gmail.com.