CHEAPER MEDICINES BILL
CHEAPER MEDICINES BILL
These past few days the physicians’ mobile phones have been busy with text messages that read:
To all MDs: A provision in the cheap med bill states dat all MDs shud write prscriptns n generics only & imposes heavy fines and revocations of license 2 practice if we nclude a brndname. Dis provision totally disregards & removes d MDs ability 2 ensure dat pts get most effective trtmnt…. Dnt be on d sidelines. D bill s up 4 ratificatn in d nxt few wks. We nid 2 be united & move as 1.Register ur support now, b involved, organize in ur area & pas ds 2 all ur friends. God bless.
This is tough. I was deeply involved with the campaign on Rational Drug Use in the 80s because I was a member of Philippine Drug Action Network then. This is one strategic issue that refuses to die because the very structures and system that make the medicines inaccessible are very much alive… wanting to take more money from the ailing population.
When confronted with an issue like this I always try to determine who is affected most by the issue? What is the voice of those who are affected most?
The one that is affected most by the issue is the typical poor Juan dela Cruz. He may probably be the fisherman or the farm tenant we meet in our clinic or in our medical missions.
The doctors are also affected by the issue. They are the ones who treat and prescribe the medicines. They have tremendous responsibility of curing and healing the total person. Medicine as a profession is not only about prescribing drugs.
The pharmacists are also affected because they are the ones who dispense the drugs. Then also in the scene are the other key players within the pharmaceutical industries like the drug agents, and the business people within the industry.
Everybody is affected by the issue. But it affects different people unequally. To the typical Juan dela Cruz, this is about survival. This is a matter of how he can have access to his anti-TB drug or antibiotic for his pneumonia with the very meager resources he has, or else he dies an untimely death needlessly.
To a doctor, this is an issue of his/her clinical freedom. But in the real world, this so-called, this clinical freedom is limited by the patient’s freedom of choice. The patient’s choice in the developing nations (Oswaldo de Rivero would rather call them NNEs – Nonviable National Economies) is limited by his/her pocket. That is, if this patient still has any purchasing power left.
The multinational drug industries, that have dominated the Philippines for eons, are affected only in as far as profit margin is concerned or in the degree of control over market share.
If you think of yourself as a well-meaning Filipino citizen who would you have for a priority in making a decision? If you think as a devout Christian, what stand would be consistent with the so-called “preferential option for the poor?”
As a doctor, I agree that there is an infringement on my clinical freedom. But I have to acknowledge that my clinical freedom is not absolute. The clinical freedom of my patient precedes mine because I do not own my patient’s body. If we assume that all the medicines that flood the market, whether, with a brand or generic labeling, are quality drugs, then it would be convenient to write down only the generic name. Heaven knows I would not want to spend the whole day writing more than 50 brand names of amoxicillin.
However, many doctors fear that the wrong medicines may get into their patients bodies, with all the fake drugs and low-quality drugs existing in the market. Many doctors fear that their patients may inadvertently get the wrong drugs if they do not specify brand names. Take note also that I have seen Viagra being sold by vendors at the bus stops going to resorts that are famous among tourists. Everything illegal is possible in the Philippines.
The clinical freedom is also a ticklish issue. Prescribing generics only would just shift the power of choice on the pharmacists who in turn can choose for the patient the brand to use. It is easy for the multinational drug companies to work on the pharmacists applying the same evils and corruption as they have done on physicians. Well at least, physicians are the ones following up the patients if indeed cure is taking place. The physicians are the ones who ensure that the drugs are working or else they have to change the medications. The pharmacists only dispense. They do not follow up patients.
Patricio Diaz, a columnist of Mindanews, wrote a very good column that explained the system working within the drug industries, how they corrupt physicians, and how physicians wittingly and unwittingly get corrupted and the like. These things are true. I confess I have had my share of these evils and I hope to be forgiven. But still if the freedom of choice is taken away from the physicians, the drug industries would come up with mechanisms to transfer the same power and corruption pattern on the pharmacists.
What I am trying to say is, the CHEAPER MEDICINES BILL, if the intention is really to benefit the poor populace should be comprehensive. The government should now start to muster enough courage and political will to work on strategies like nationalization of drug industries, change in intellectual property code, adopting a more ethical promotional and marketing scheme for the drug industries, and the like.
Whether the CHEAPER MEDICINES BILL gets ratified or not, the biggest winners will always be the multinational drug industries in the Philippines. The CHEAPER MEDICINES BILL gives only a glimmer of hope…a very small share to the economically marginalized sick Juan dela Cruz? But still it means a lot to those whose issue is SURVIVAL.
I just hope that the effort to make the drugs accessible to the poor and ailing population does not end with this bill.
These past few days the physicians’ mobile phones have been busy with text messages that read:
To all MDs: A provision in the cheap med bill states dat all MDs shud write prscriptns n generics only & imposes heavy fines and revocations of license 2 practice if we nclude a brndname. Dis provision totally disregards & removes d MDs ability 2 ensure dat pts get most effective trtmnt…. Dnt be on d sidelines. D bill s up 4 ratificatn in d nxt few wks. We nid 2 be united & move as 1.Register ur support now, b involved, organize in ur area & pas ds 2 all ur friends. God bless.
This is tough. I was deeply involved with the campaign on Rational Drug Use in the 80s because I was a member of Philippine Drug Action Network then. This is one strategic issue that refuses to die because the very structures and system that make the medicines inaccessible are very much alive… wanting to take more money from the ailing population.
When confronted with an issue like this I always try to determine who is affected most by the issue? What is the voice of those who are affected most?
The one that is affected most by the issue is the typical poor Juan dela Cruz. He may probably be the fisherman or the farm tenant we meet in our clinic or in our medical missions.
The doctors are also affected by the issue. They are the ones who treat and prescribe the medicines. They have tremendous responsibility of curing and healing the total person. Medicine as a profession is not only about prescribing drugs.
The pharmacists are also affected because they are the ones who dispense the drugs. Then also in the scene are the other key players within the pharmaceutical industries like the drug agents, and the business people within the industry.
Everybody is affected by the issue. But it affects different people unequally. To the typical Juan dela Cruz, this is about survival. This is a matter of how he can have access to his anti-TB drug or antibiotic for his pneumonia with the very meager resources he has, or else he dies an untimely death needlessly.
To a doctor, this is an issue of his/her clinical freedom. But in the real world, this so-called, this clinical freedom is limited by the patient’s freedom of choice. The patient’s choice in the developing nations (Oswaldo de Rivero would rather call them NNEs – Nonviable National Economies) is limited by his/her pocket. That is, if this patient still has any purchasing power left.
The multinational drug industries, that have dominated the Philippines for eons, are affected only in as far as profit margin is concerned or in the degree of control over market share.
If you think of yourself as a well-meaning Filipino citizen who would you have for a priority in making a decision? If you think as a devout Christian, what stand would be consistent with the so-called “preferential option for the poor?”
As a doctor, I agree that there is an infringement on my clinical freedom. But I have to acknowledge that my clinical freedom is not absolute. The clinical freedom of my patient precedes mine because I do not own my patient’s body. If we assume that all the medicines that flood the market, whether, with a brand or generic labeling, are quality drugs, then it would be convenient to write down only the generic name. Heaven knows I would not want to spend the whole day writing more than 50 brand names of amoxicillin.
However, many doctors fear that the wrong medicines may get into their patients bodies, with all the fake drugs and low-quality drugs existing in the market. Many doctors fear that their patients may inadvertently get the wrong drugs if they do not specify brand names. Take note also that I have seen Viagra being sold by vendors at the bus stops going to resorts that are famous among tourists. Everything illegal is possible in the Philippines.
The clinical freedom is also a ticklish issue. Prescribing generics only would just shift the power of choice on the pharmacists who in turn can choose for the patient the brand to use. It is easy for the multinational drug companies to work on the pharmacists applying the same evils and corruption as they have done on physicians. Well at least, physicians are the ones following up the patients if indeed cure is taking place. The physicians are the ones who ensure that the drugs are working or else they have to change the medications. The pharmacists only dispense. They do not follow up patients.
Patricio Diaz, a columnist of Mindanews, wrote a very good column that explained the system working within the drug industries, how they corrupt physicians, and how physicians wittingly and unwittingly get corrupted and the like. These things are true. I confess I have had my share of these evils and I hope to be forgiven. But still if the freedom of choice is taken away from the physicians, the drug industries would come up with mechanisms to transfer the same power and corruption pattern on the pharmacists.
What I am trying to say is, the CHEAPER MEDICINES BILL, if the intention is really to benefit the poor populace should be comprehensive. The government should now start to muster enough courage and political will to work on strategies like nationalization of drug industries, change in intellectual property code, adopting a more ethical promotional and marketing scheme for the drug industries, and the like.
Whether the CHEAPER MEDICINES BILL gets ratified or not, the biggest winners will always be the multinational drug industries in the Philippines. The CHEAPER MEDICINES BILL gives only a glimmer of hope…a very small share to the economically marginalized sick Juan dela Cruz? But still it means a lot to those whose issue is SURVIVAL.
I just hope that the effort to make the drugs accessible to the poor and ailing population does not end with this bill.
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