Lives at risk
The COVID-19 scare has brought to greater awareness how important drugs are to our health. During earlier pandemics, millions died as curative drugs or vaccines weren’t available. Today, they are for most illnesses that would otherwise be widespread.Recently, we had our own pandemic that killed an estimated 800 Filipino children from dengue from January to August 2019, because mothers stopped vaccinating due to the hysteria caused by irresponsible reporting on Dengvaxia: a self-inflicted cure when there was one available.
Now there’s a worldwide pandemic from COVID-19 because there is no cure—as yet. But there will be, as a worldwide search for a cure is rushed. A number of global pharmaceutical companies have partnered with international research institutions for potential vaccines, medicines, and diagnostics for this coronavirus. But will we get it here in the Philippines? The answer may well be no. Drug companies are now reluctant to introduce innovative products into the Philippines because the government has forced massive discounts (reductions) on the prices of drugs.
The immense cost of finding and manufacturing a COVID-19 cure will have to be recovered, so the innovators will sell into markets where they can recoup that cost. The Philippines is no longer one of those markets. In mid-February, the government issued an executive order (EO 104) that controlled the wholesale and retail price of 133 drugs, with another 72 to follow. The possibility, nay, probability that the DOH would control the price of a COVID-19 cure means the Philippines will be the last market to be supplied.
This is a risk now for any innovative drugs. Who will risk bringing in a product when you may have your margins slashed, even eliminated? You’ll concentrate on open markets where the market determines the price.
And for a COVID-19 cure or vaccine, controlling its price is likely given the DOH thinking that essential drugs are those that must be controlled. That’s the problem of Executive Order 104; the Maximum Drug Retail Price (MDRP) scheme ignores that companies have spent millions, even billions, to find cures for some of our worst illnesses. And they’ve been successful. Almost everything has a cure today; cancer has yet to be beaten, but it will eventually be as a huge effort at huge expense is underway.
In 1928, Alexander Fleming discovered penicillin. That was the discovery that revolutionized medicines. The growth of medicines to cure diseases, and of vaccines to prevent them in the first place, has been almost exponential. That has to be paid for. In the early 1900s, you died or was crippled for life if you got tuberculosis or polio. Today, after a course of pills, you live. Some P3,000 to P4,000 has saved your life. Are you going to quibble over that? Are you going to deny pharmaceutical companies the money they need to pay for the cost of manufacturing and delivering that drug to you, and not provide them with the funds they need to find a cure for cancer?
What you can afford is not the determinant of the cost of a drug, or of anything else. Cars can’t be sold for $1,000 because that’s all you can afford. The manufacturer must cover his costs. For drugs, it’s the same.
I raised this in my Feb. 6, 2020 column where I discussed the case of one drug where an inferior medicine was being considered because it was cheaper. Cost should not be a consideration when it comes to health.
With the introduction of price control on drugs vital to our health, some may disappear from the market altogether, as companies will be unwilling to sell at a loss. Or the limited supply of drugs may shift to more profitable markets.
What was strange about the MDRP, though, was that it seemed to confuse its intent. The intent was to reduce the cost patients would have to pay. Yet for a number of drugs, there was no reduction for the patient but there was for the pharmaceutical companies. Why? Why hurt the very companies that give us drugs without helping the patient? Even stranger, in a large number of cases, the reduction forced on the pharmaceutical companies was more than that imposed on the retailers. It makes no sense.
We are in a crisis the world has yet to understand. It’s not a time to be forcing the very companies we need to resolve this crisis to put the Philippines last on their list to help. EO 104 offered an alternative. Section 4 allowed for pooled procurement and negotiation. That’s the way to go. The President should rescind EO 104 and negotiate. COVID-19 gives more than sufficient reason.
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