Pharma and Karma
Wednesday, March 28th, 2007As with most of
the progressive policy reform bills that we try to push in Congress, we
did not expect that passing the Affordable Medicines Bill (House Bill
6035) would be easy. When deliberations on the bill actually began, we
had mixed feelings about what was to come. On one hand, the bill was
certified as urgent by GMA (for once she did something right), which
meant that we could theoretically depend on the support of JDV and the
majority bloc. It has also been passed on third reading by the Senate,
which we hoped would somewhat strengthen the impetus for the Thirteenth
Congress to add something important to its less-than-impressive list of
laws made.
On the other hand, we heard through the grapevine that the lawyers
of PHAP, the umbrella org of pharmaceutical companies operating in the
Philippines (whom I personally think of as an evil bunch, subject maybe
to a few exceptions), were directed “to spare no expense” in making
sure that the bill would not see the light of day.
This, of course, was far from surprising. For years, multinational
pharmaceutical companies have dominated the sale and distribution of
medicines in the country, and they could not be expected to give up
their huge profit margins without a fight. Imagine, on the
anti-hypertensive drug Norvasc alone, Pfizer earns more than a billion
pesos a year. That’s right. Not millions, but BILLIONS. That’s on ONE
drug alone, for ONE company, in ONE country.
Here are more facts to digest: The price of medicines in the
Philippines is said to be second highest (if not the highest) in Asia.
The difference in prices across the region is astounding. For instance,
Ponstan, a popular pain reliever produced by drug giant Pfizer, costs
around P21 in the Philippines but only P2.61 in India and P1.38 in
Pakistan. A 10-mg tablet of Norvasc costs about P70 in the Philippines.
In India, Pfizer sells the exact same product for only P9. Ventolin, a
drug for persons suffering from asthma, sells for P315 here while Glaxo
sells it for P123 in India and only P62 in Pakistan. Outrageous, noh?
Big bad pharma will say that the high price of medicines in the
country is due to their investments for research and development. This
is simply misleading. What pharma will not admit is that the costs for
R&D are considered to be “sunk costs” which are not really factored
in pricing. The fact of the matter is that MNCs price drugs according
to market forces or “what the market can bear.” The problem here is
that the only markets they consider when they formulate prices are the
A & B markets! I guess they think that the A-B crowd are the only
people who matter since they are the ones who can afford to buy
medicines in the first place, in effect placing often life-saving
medicines further beyond the reach of the ordinary Juan and Juana dela
Cruz. (Makes me angry, really. I’d buy me some Norvasc, only I couldn’t
afford it.) In a country like ours, where only a tiny fraction of the
population has decent access to healthcare, this is simply
unacceptable. Health should not be a matter of privilege. It should be
a matter of right.
MNCs are able to dictate drug prices
because of the virtual monopoly that they enjoy over the sale and
distribution of medicines in the country where almost 80% of the total
sales of medicines belong to MNCs. This domination is caused by many
factors, one of which is the prevailing laws on patents and
intellectual property rights. The grant of a patent gives to the patent
owner the exclusive right to exploit the patented product and control
its sale, use, distribution, manufacture and so forth. In a country
where up to 45% of the top 20 medicines sold are patented, reforming
patent laws is therefore extremely important.
By pushing for the passage of the Affordable Medicines Bill in
Congress, what we at Akbayan are trying to do is to amend existing
patent laws to make them more responsive to the healthcare needs of the
Filipino people. In particular, the bill proposes to:
• Allow for parallel importation of drugs as a tool for price
reduction, by adopting the principle of international exhaustion of
rights. What this does is enable the government to import the same
brand-name medicines that the MNCs sell in other countries at much
cheaper prices;
• Introduce the so-called Bolar or early working provision in the
Intellectual Property Code, which would accelerate the production of
generics by allowing commercial research on the production of drugs
whose patents are about to expire;
• Prevent the practice of “evergreening” or the issuance of frivolous
patents resorted to by pharmaceutical companies to unjustly extend the
life of a patent ; and
• Widen and enhance the power of the government to use patented products.
We believe that these measures are essential if we are to begin to
dismantle the monopoly that MNCs have in the pharmaceutical industry
and bring down the prohibitive costs of medicines in the country. While
patent rights should give the patent holder a reasonable degree of
protection, they should not be used to create monopolies especially
when they undermine something as fundamental and inalienable as the
right to health. I mean, we’re not talking about some luxury consumer
product here like cars, plasma TVs, or branded clothes. As the Akbayan platform on health
asserts: “public health is not a question of market imperatives or
trade, and that human development and social equity should never be
made subservient to profit.” Contrary to what the MNCs seem to believe,
for us, drugs and medicines which heal people and save lives should not
be luxury items that only the rich can afford.
By now, most people know about the infamous note-passing incident
that led to the ejection from the Plenary Hall of Congress of four
pharmaceutical industry representatives who attempted to block the
passage of the Affordable Medicines Bill by asking a congressman to
question the quorum. As my boss Risa would say, we should thank them
for “shooting themselves magnificiently in the foot.” After
all, that brazen attempt led not only to the immediate passing of the
bill on second reading, but also to calls by members of Congress to
actually ban big pharma from Congress, and on the part of Akbayan, to
call for an investigation into their lobbying practices so that House
rules or national legislation on ethical and professional lobbying
practices in Congress may be crafted.
For me, that was one of the best days ever. Talk about real-life
drama! (It even made dropping a 5-unit subject under an excellent
professor worth it!) It was especially worth it for the bill’s
advocates, especially the senior citizens, NGO workers, and other
advocates including supportive government agencies who were there with
us keeping vigil over the proceedings for the past two weeks. (I should
give due recognition to our friends from the Cut the Cost Cut the Pain
Network such as Oxfam GB, Medical Action Group, and Coalition of Services for the Elderly; FTA; Third World Network; Ayos na Gamot sa Abot na Presyo; PLCPD;
and DDG Bim Galicia - my hero!- and his staff from the Intellectual
Property Office). The presence of those pharma lawyers in their fancy
suits and the show they were making every now and then of chit-chatting
with some of the congressmen like they were such buddies were
understandably disheartening to the advocates. I mean, a few millions
to spend on a few congressmen would just be a drop in the bucket of
this billion-peso industry. We, on the other hand, could hardly come up
with funds to stage a few pickets. But sometimes, arrogance and greed
can be a backfiring bitch…
Besides facilitating the bill’s passage, what that incident brought
to fore is the truth that the battle over the bill is simply a battle
between corporate interest and the Filipino people’s right to have
access to safe, effective, and affordable medicines. This battle,
however, is not over yet. We await its approval on third reading and
passage into law when the 13th Congress reconvenes for the last four
days in June. In the next few weeks and months, we anticipate those
opposing the bill to continue to do what they can to protect their own
vested interests. We don’t really know what other tricks they have up
their sleeves, but we shall be ready for them. We may not have the
millions of pesos that big bad pharma has at its disposal, but we have
something much better — that is the heartfelt conviction and sincere
motives of true advocates with unwavering commitment to the cause of
bringing public health back in the realm of basic rights and human
dignity.