Drug industry had it coming

The drug industry’s worse case scenario is hopefully just about to happen. And as far as I can see, they have no one else to blame but themselves. Through the years, the drug lobby had been horrible. They bully and yes, I can almost believe allegations that they are not above bribery too but not what Senate President Enrile accused Pfizer of early this week involving the already ongoing promotion using the “sulit” card.

The problems of the pharma industry today are self-inflicted. This is one industry that swaggers with the confidence of a colonizing power. But now, a new day has dawned. Assuming Ate Glue signs that MRP order as promised, this country would have finally made a declaration of independence from a cartel that simply refused to run their business with the compassion that should go with it.

They also lost the one political leader who understood their business needs. Sen. Mar Roxas led the campaign for cheaper drugs even while he was Trade and Industry Secretary. And he led the congressional drive to pass legislation that would lay the legal basis for the nation’s fight for cheaper prescription drugs. But the drug lobby simply alienated him.

All Mar wanted was for the drug industry to be reasonable. He wanted them to match the retail prices of prescription drugs sold in neighboring countries. Like most of us, Mar couldn’t see any justification for higher prices for the Philippines compared to Thailand, for instance. Is it because we are so free market oriented that the multinational drug companies are taking us for a ride?

If their Philippine subsidiaries cannot lower their prices, Mar wanted the ability to do parallel importation and let the market force prices to go down. This means, being able to import the drug from the same company in India, for instance, at less than half the local retail price here.

But the local drug industry would have none of that. They even obfuscated the issue saying they cannot guarantee the quality of that drug… which is bulls—t because we are not even talking of importing generics but the same branded drug made by the same company in India or Pakistan or wherever.

I am sure that the Norvasc Obet Pangdanganan brought home from India and Pakistan is of the same quality as the Norvasc I used to buy from Mercury. Even with Pfizer’s sulit card, I recall the Indian variety from Pfizer India was cheaper. Well, my cardiologist dropped Norvasc for another drug so that does not personally concern me now. But I just wanted to cite Obet’s experience to lay the basis for the frustration of Mar and the general public on the unreasonableness of the drug industry.

The drug lobby fought tooth and nail to stop this law from being passed. They even had spokesmen from among the congressmen. At one point, one of the lawyers of the drug lobby mistakenly passed on a note giving instructions on what to say during the debate to Rep. Teddyboy Locsin who quickly denounced them. If I recall right, the lawyers representing the drug lobby were thrown out and even banned from the House gallery after the incident.

And after the bill was signed into law, they lobbied the Health department on how the implementing rules would be crafted. Luckily, we have someone like Health Undersecretary Alex Padilla who refused to be distracted from the task he was supposed to do. The Cheaper Medicines Law could have been rendered useless by the wordings of the implementing rules.

In fact, the law was disappointing the public greatly. It had failed to live up to expectations. That is because the government allowed a lot of time for the drug industry to come to terms with the spirit of the law and voluntarily bring down their prices. But when that was obviously not going to happen soon, the DOH has no choice but to invoke the provision that would mandate a maximum retail price for the most essential prescription drugs.

You have to give the drug lobby “A” for effort (or is it chutzpah) for playing the last card… going to Ate Glue to persuade her not to sign the order for the MRP. They tried to throw her crumbs in exchange, but to the credit of Ate Glue, she also firmly demanded at least a 50 percent cut in the retail prices of essential prescription drugs. If she gets it voluntarily, good. Otherwise, she must sign the Executive order for the MRP or she will look bought by the drug lobby.

Price control is not a very palatable way of accomplishing the ends of the Cheaper Medicines Law and I, for one, am inclined to oppose price control as a concept. Even Mar Roxas is normally not in favor of price control and was responsible for removing it from the provisions of the law except as a last resort.

But the drug lobby is giving our government no choice. Government has to make sure our people benefit from this law. We cannot allow ourselves to be abused in the name of protecting the free market. We have been taken for granted much too long just because our market looks so much like the American market.

The drug industry is not about to go belly up with the implementation of the MRP. Their profits may be moderated a bit but let their professional managers improve operational efficiency by cutting excessive marketing costs. Maybe, with the prospect of reduced profits, the drug industry can finally be more ethical in selling their products to the local medical profession. Even some of our doctors who are addicted to their freebies can regain some amount of self respect. It is important for these doctors to regain their objectivity, or even just the public perception of it, when they prescribe drugs.

The Filipino people must be able to finally realize what the Thais, the Indians, the Pakistanis have been enjoying all these years… reasonable prescription drug prices.

Pfizer’s side

I asked the Pfizer people what happened at the Senate. Did the industry lobby offer Pfizer up as sacrificial lamb just because Pfizer resigned from the Philippine Healthcare Association of the Philippines?

They told me they were shocked at the bribery accusation. The sulit card is an ongoing program, they explained, and what they did was to merely offer to expand its coverage. Of course they would rather that Ate Glue did not sign the MRP order but if she does, they have no choice but to comply.

They claim that they actually have more drugs covered by their sulit card program than those already listed for MRP coverage by the DOH. They don’t know precisely how the MRP will affect the sulit card program but they presume those products not covered by MRP will continue to be covered by the card as usual. Even for those covered by the MRP like Norvasc, assuming a mandated 50 percent price reduction would mean Norvasc sulit card holders can still claim a 10 percent discount because the discount now being given without the MRP is 60 percent.

But I do not understand why Pfizer is vigorously opposing the MRP and previously, the passage of the Cheap Medicines Law, if it is true as they claim, that they are giving more discounts voluntarily now. I suppose they just want more control. The sulit card program has enabled Pfizer to build up a fairly large database of Filipino patients and I suppose that has marketing value.

Whatever their reasons for looking so intransigent on this matter of lowering drug prices to the level of our neighbors, Pfizer and the rest of the drug industry will have to change their approach if they want to win back the goodwill of the public. While I understand they are running a business and not a charity, drug companies must also realize they are not an ordinary business. Their decisions spell life and death for millions of Filipinos.

But I believe them when they say there was no attempt to bribe Ate Glue with sulit cards just so she won’t sign the MRP order. Unfortunately, it does seem to look that way.

Viagra

Pfizer, one of the most profitable drug companies in the world, is responsible for a number of important life saving drugs but is probably better known for Viagra. Here is a take on the drug by a stock market trader.

Q: Do you know the difference between a Catholic wife and a Jewish wife who both just heard about the marvels of Viagra?

A: The Catholic wife tells her husband to buy Viagra. The Jewish wife tells her husband to buy Pfizer. –Boo Chanco, philippine Star

Boo Chanco’s e-mail address is bchanco@gmail.com