For low-priced medicines

We don’t have the figures right now, but it is safe to assume that a lot of people die from not being able to buy medicines needed for them to survive. I have the names of long-suffering patients who eventually died because they could not afford the drugs prescribed for diabetes, hepatitis, hypertension and leukemia. Some of my colleagues skip taking expensive anti-diabetes maintenance pills for days because they have to pay for their children’s and household expenses first, and their health only second. Even pain killers – for toothache and stomach ache – can be painfully costly.

There may be hope for the poor – and even middle-class – consumers once a bill calling for the lowering of the costs of medicines is passed. Worth watching is how legislators will act on H.B. 3830, authored by Reps. Rolex T. Suplico, Ferjenel G. Biron, Rodolfo Plaza and Janette L. Garin. The bill which was filed early last month in the 13th Congress, has now gotten the signatures of 57 congressmen as of this writing. It had been originally filed in the last 12th Congress by Rep. Suplico, but had not reached the committee levels, whereas H.B. 3830 is about to be tackled by the committees on health, trade and industry, and appropriations, with trade and industry taking the lead.

Rep. Biron (KAMPI, 4th District, Iloilo), introduced the bill, and showed how international pharmaceutical and drug retailer companies rake in so much money by selling medicines at deadly prices. Here are prices he quoted:

• Biogesic, 500 mg., or Tempra (brand names of Paracetamol), is priced in drug stores at P2.65, when their actual production cost is less than P0.50 per tablet.

• A tablet of Bactrim Forte (a brand name of cotrimoxazole), is sold at P28.75, when its production cost is less than P3.

• A 500- mg. tablet of Ponstan (a brand name of mefenamic acid), sells for P23 per tablet, when its production cost is only P1.50.

• A 500. mg. tablet of Dolfenal, a pain reliever, is sold at drug stores at P15, but its production cost is only P1.50 per tablet.

Your blood level shoots up when you find out that it costs little to produce drugs that you can hardly afford to buy, especially during these difficult times.

Biron blames the existence of a drug cartel for the astronomically high-priced medicines. This cartel he calls the "silent monster that is insidiously ravaging our lives with each passing moment." That silent monster is no other than the unconscionable, ruthless overpricing of medicines in this country, putting us on top of the list in terms of the prices of medicines in Asia and one among the highest in the world, a dubious distinction that we could all do without."

Only one word describes the root of our predicament, Rep. Biron told the House of Representatives in a session assembled on March 12, 2005 – greed. "It is the greed of the giant multinational pharmaceutical companies and that of a drugstore chain in the Philippines that has driven the prices of medicines to uncontrollable, unexplainable proportions."

He described the operation of the cartel. The giant multinational pharmaceutical firms impose on their Philippine subsidiaries a mark-up profit which the latter must ensure as a condition to their continued presence in the country. In the absence of government regulatory control in the market prices of their products, these local subsidiaries in turn, ensure their own profitability and viability by imposing their own unrestrained mark-up, including a huge allowance for intensive marketing and promotional efforts.

The retailers of these medicines are allowed a 10 percent mark-up. But what is "utterly shocking," said Biron, is that the giant multinational pharmaceutical firms are being pressured by a drugstore chain – which demands an automatic 20-30 percent discount (in the form of either straight discount or free goods, or a combination of both) as a precondition for the latter to carry the former’s products in its nationwide retail branch network.

The 20-30 percent discount extracted from the giant pharmaceutical firms, is on top of the usual trade volume discounts plus the 10 percent retail mark-up enjoyed by this drugstore chain, Biron said.

This compels the giant multinational pharmaceutical firms to jack up their transfer prices to compensate for the 20-30 percent discount they give as "tribute" to the drugstore chain.

Accordingly, the small drug stores could not give the 20 percent discount to senior citizens as mandated by RA 9257 – or the Senior Citizens Act – which the big drugstore chain could easily grant.

"Simply stated, the cost the ordinary Filipinos pay for otherwise affordable medicines - in the big retail drugstore chain - is already overpriced by 20 to 30 per cent, if we go by the rule that a 10 percent retail mark-up is par for the course," Biron said.

Under a deregulated, free-wheeling pharmaceutical industry such as that characterizes the industry at present, said Biron, the mark-up for each product varies from one firm to another – "they range, however, from the substantial to the scandalous."

H.B. 3839 seeks to impose price controls on medicines "in order to bring down the anomalous costing of medicines to reasonable and affordable levels and save the lives of millions of Filipinos in our generation and beyond."

The imposition of price controls in drugs is not a strange idea born of thin air, said Biron. He pointed to the successful experience of India when its government decided to impose controls on the prices of medicines. When the Philippine government opened its doors to limited importation of medicines as a "partial" antidote to the unconscionable escalation of prices in the local market, it had been India that was, and remains to be, the pre-eminent exporter of affordable yet equally effective medicines to the Philippines.

As an example of how successful India has been in its national drug policy, an anti-hypertensive drug – Plendil (Felodipine) 10 mg. tablet is retailed at the equivalent of P10 in India, but is retailed by a big drug retailer in the Philippines at P61.25.

The incredible mark-up in the prices of medicines is what drives counterfeiters to get into the market, said Biron. The passage of the bill will not only result in low-cost medicines, but will also drive the counterfeiters out of business.

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Biron is serving his first term in Congress. He took up the medicine course at the West Visayas State College, and graduated within the top 20 of his class in 1989, the year he passed the board exams for medical doctors. It was during his post-graduate internship at the West Visayas Medical Center in Mandurriao, Iloilo City that he saw the need for a 24-hour drugstore to serve the needs of patients.

He put up Ferj’s Pharmacy, which in a short time, became the biggest 24-hour drugstore chain in Iloilo City. To enable Filipinos to afford life-saving drugs and medicines, he set up a pharmaceutical company, Phil Pharmawealth, Inc. in 1993, specializing in the importation and distribution of injectable or "parenteral" pharmaceutical products. After seven years of prudent and dedicated management, Phil Pharmawealth Inc. is now considered the largest importer and trading house of injectable products.

The phenomenal success of the company moved Biron to set up in 2000 the first and only multi-facility sterile pharmaceutical plant located in San Pablo, Laguna. The state-of-the-art pharmaceutical plant aims to meet the increasing demand for life-saving injections in the Philippines and also in the emerging markets in Asia, Latin America, Middle East, and Africa. To prepare for this challenging task, he took up courses in strategic manufacturing management and finance for senior executives at the Asian Institute of Management.

Recognizing his expertise and commitment, his colleagues elected him president of the Medical Parliamentarians in the House. The young (40 years old) neophyte congressman was cited for his incisive inputs in matters ranging from the inquiry to the unusually high drug procurement costs at the AFP Luna Medical Center and in the systematic depredation of the Iloilo State College of Fisheries (ISCOF) whose facilities are located in his district.

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