Drugs beyond our reach

Viagra, the drug for erectile dysfunction, must be doing wonders – in terms of efficacy and Pfizer’s sales. After enjoying a few years’ lead, Viagra will soon face stiff competition from the Bayer group. This September Bayer is launching in the United States its version of Viagra. The drug, vardenafil, will be marketed as Nuviva, and it will be introduced in the Philippines in September next year.

Why should men buy Nuviva instead of Viagra? If you want an unbiased opinion, perhaps you’d like to volunteer for clinical trials in the Philippines. Alok Kanti, general manager of Bayer Philippines Inc.’s Pharmaceuticals Business Group, said that to develop such a drug, you need to conduct "rigidity tests" and determine the duration of an erection. Too brief and your drug is a flop; too long and the consumer could end up in a hospital and the drug company gets a lawsuit. Kanti said patients put on Nuviva were measured for erectile function, intercourse satisfaction, orgasmic function and overall sexual satisfaction.

Volunteers naturally need to get it up first for their tests. To help them along, Kanti said they’re given VCDs or videotapes to watch. I couldn’t resist asking Kanti how you measure rigidity. You put weights, someone told me helpfully; I couldn’t get a serious answer from all the laughter in the room.

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Erectile dysfunction, however, is no laughing matter. Kanti said the Massachusetts Male Aging Study showed that 52 percent of men between 40 and 70 years old suffer from mild, moderate or severe erectile dysfunction. The problem afflicts between 35 to 60 percent of diabetic men and from 14 to 58 percent of hypertensive men. Kanti said Nuviva improved erections in up to 72 percent of diabetic men who were tested. Erections were achieved within as early as 24 minutes.

So Nuviva probably takes effect faster and performs better. Will it be more affordable? Viagra isn’t cheap. Then again, do we care if such drugs are beyond the reach of a majority of Filipinos? After all, failure to get it up is not a life-threatening problem, and we could use slower population growth.

But it’s not entirely a joke that erectile dysfunction can cause psychological problems and put a strain on marriages. And the cure, like many drugs in this country, is beyond the reach of most Filipinos.

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This brought me to a more important question: Why is medicine more expensive in the Philippines than in other countries? Even vitamins are cheaper in the United States.

It’s easy to blame the multinationals for this and accuse them of greed, especially companies as big as Bayer. Meeting with Bayer executives, our talk ranged from cockroaches (easily zapped by their best-selling Baygon) to polyurethane and synthetic rubber for tires, to needle-free injection systems, Cipro the antidote to anthrax, and of course to their most famous product, Aspirin. Even the material used for CDs is made by Bayer. A company as huge as this is easily demonized.

Bayer, however, is projecting an image of "expertise with responsibility." Kanti’s counterpart in Bayer’s Consumer Care group, Reinhard Schellner, said drug pricing cannot simply be blamed on multinationals. Other countries have developed a strong local generic drug manufacturing sector to compete with the multinationals, forcing prices down, Schellner pointed out. He also said the Philippines’ budget allocation for public health care is way below the minimum set by the World Health Organization, thus putting many drugs beyond the reach of millions of Filipinos.

Schellner also has an interesting question: Shouldn’t the value-added tax on pharmaceutical products, which he believes is a substantial amount, go to public health care? And speaking of VAT, he suggests tax breaks if the government wants to bring down the cost of branded medicine.

The government has stepped in, importing a handful of generic drugs from countries such as India. Kanti said they don’t mind as long as the drugs are not patented. And they’re hoping the drugs’ efficacy is guaranteed.

Drug research is costly, Kanti pointed out. It takes an average of 11 years to develop a drug, and the cost has risen from $50 million per drug in the 1970s to a staggering $500 million. You need money for research, and you get the money from sales. Pharmaceutical companies are discussing socialized pricing, Kanti said, but they can’t give away everything at a loss.

If Viagra and Nuviva don’t come cheap and power failure hits you, go natural and try durian instead.