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Saturday, July 18, 2009

Importation of patented and off-patent branded essential medicines is the short term solution

Despite the passage of Republic Act 9502 or the Universally Accessible Cheaper and Quality Medicines Act of 2008, a big number of essential medicines or medicines for life-threatening illnesses that are either patented or off-patent branded medicines still maintain astronomical prices. The high prices of these medicines are a big impediment to the therapeutic and health needs of millions of Filipinos.

High prices of medicines in the Philippines are perpetuated with impunity through patents that insulate patented medicines from competition, thereby enabling the patent holder pharma firms to freely impose exorbitant prices and secure the market for their medicinal products. Other off-patent drugs still command high prices because of the strong demands for their brands brought about by successful promotional ads, strong patronage from doctors, and wide spread brand loyalty among the public.

Recently, the government addressed the continuing problem of high prices of medicines by implementing R.A. 9502 via DOH endorsed MRP listing of 22 medicines or the MalacaƱang initiated voluntary compliance from pharma firms to reduce prices of the listed medicines by 50%. These efforts are laudable well-meaning and sincere attempt to bring down the prices of medicines in the country.

However, the DOH endorsed Maximum Drug Retail Price (popularly known as MRP) listing or the MalacaƱang voluntary compliance scheme is merely a palliative. Due to their very limited converage to 22 medicines, the benefits would be restricted to a few who take these medicines listed under MDRP (MRP) or subjected under voluntary compliance. Either of these could not trigger nor influence substantial downwards movement of prices of other much numerous essential medicines that would benefit the great majority of patients and the interest of public health. If the agenda were to cut down prices of essential medicines, the MDRP (MRP) list or voluntary compliance would hardly fit in the equation.

In order to bring down the prices of the patented and off-patent branded medicines for life-threatening illnesses, competition must be introduced and allowed to flourish. And for competition to happen, a substantial parallel importation of patented essential medicines and importation of off-patent branded essential medicines must be done to get the imported medicinal products in the market. As a consequence, a sizeable supply of affordably priced patented essential medicines and off-patent branded ones shall be made immediately accessible to the public. Sooner or later, the ensuing fierce competition between the imported medicines and its local counterparts would further drive the prices down of both to the great advantage of public health.

In this light, the government must take the lead to make importation of patented and off-patent essential medicines happen soonest. In the same way that billions of public funds are appropriated and spent to import rice and subsidize local palay prices annually to insure stable supply and prices of rice,  the same treatment must be accorded to finance the importation of essential medicines since this also involves public welfare.

The local pharma firms in the country can not be relied upon to make the importations as the imported medicines would compete against their own products in the market. Private trading firms would eventually venture into this activity after the government has successfully trail blazed the importations of these essential medicines.

Aside from the short term solution of making available from importation cheaper yet quality essential medicines in the market, a long term solution to sustain competition and insure stability of supply and prices of essential medicines is the development of the local pharma industry. This pharma industry development strategy is what the government of India, Pakistan and Thailand pursued, enabling these countries to be self-reliant for their affordable and quality medicines requirements. Again, the government must take the lead in collaboration with other local industry players and stake holders in crafting and implementing a strategic road map towards such direction.

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