by Lovely Carillo
Hundreds of people gathered at the SM City Event Center last Wednesday to witness a one-of-a-kind boxing bout. The fight between perennial loser, 50-pounder George Mamahaling Gamot Kalahati and defending champion and winner Saver Generics was the fourth between the two. Saver Generic’s victory was supposed to reflect the Filipino people’s acceptance of generics medicines as the alternative to their more expensive counterparts for quality health care.
But how many Filipinos, nay, Dabawenyos for that matter, actually know that there is a way to get cheaper medicine other than what their doctors prescribe for them? Evrybody knows that most doctors almost always tend to favor branded medicines because of the perceived perks they get from pharmaceutical companies. No wonder acceptance of generic medicines by the general public has not been as fast as expected by the authors of the Generics Law.
A long-time advocate of generic medicines, however, said it is not yet time to be euphoric over what is being trumpeted as the success of the Generics Law’s enforcement.
Considering the time that has lapsed since the law was approved, a public acceptance rate of 55 percent is not something to be ecstatic about, said Dr. Ruben G. Robillo, chief of the Calinan General Hospital.
Admitting being unpopular with fellow physicians and med reps (sales representatives or promotional agents of pharmaceutical companies) due to his passionate advocacy for generic drugs or decades now, Robillo said inroads of generic drugs against branded medicine would have been bigger if not for certain negative factors.
He said resistance of many medical practitioners to the law using all kinds of excuses is one of one of the stumbling blocks.
Many of the holdouts among medical practitioners, aided by propagandists of medical companies, claim that generic drugs are usually less potent or less effective than branded medicine.
“Of course, this is a lie,” Robillo said, adding that his hospital in Calinan has stuck to generic drugs for 20 years now and is doing well.
He also belied claims that the Generics Law has given rise to the proliferation of fake generic medicine. Robillo said there will always be fake generic drugs as there are fake branded medicines for as long as the counterfeiters are around.
He said many beautifully packaged branded medicines from India, for instance, have been found to be fake.
He said the government must do something to provide the atmosphere for the wider and faster acceptance of generic medicine among Filipinos.
He said government has been unable to build a drug manufacturing industry.
“What we have is a medicine packaging industry, whose players buy raw materials from abroad and pack them into medicine formulated more than 100 years ago.
We are excellent in manufacturing softdrinks, and yet we can not manufacture the life-saving dextrose and pay for it 10 times higher when the technology is almost the same, Robillo said.
While unimpressed by the sluggish public acceptance, Robillo does acknowledge the generic law has been instrumental in bringing down prices of medicine, although not enough.
“At least, medicines are no longer priced like diamonds; only like gold,” he said half-joking.
Republic Act 9502, an Act providing for cheaper and quality medicine, has been around since 2008. But, after almost two years, the effectiveness of the Generics Law is still subject to scrutiny, not only among the poorest of the poor, but even to the growing middle class, most of whom are not covered by complete health insurance for their basic medication needs.
“In 2003 only 47 percent of the population used generics, but today 55 percent are into generics,” Department of Health assistant secretary Paulyn Jean R. Ubial said during the Philippines Generics Expo 2010 held in Davao City.
The Davao Expo was the 3rd in the country, the first one was held at SM Cebu last August and the second at SM Clark in September.
Ubial said generics medicines are much cheaper than the branded ones although they have the same quality. “It’s just that generics have no patent and promotional expenses unlike branded medicines which incurred expenses for patent and advertising that are passed on to end consumers,” she added.
Take the case of two medicine brands, Augmentin and Bactolav. The first one will sound familiar to someone who had used antibiotics before, but the latter would be unfamiliar.
Augmentin is a branded but expensive antibiotic priced at P38.85 for the 375 mg and P48.90 for the 625 mg. On the other hand, the lesser known and generic Bactolav is way, way cheaper at only P29 (375mg) and P38 (625mg), respectively.
“Though medicine prices are going down due to voluntary price cuts and other initiatives, we can see that quality generics medicine prices are still much cheaper in comparison,” DOH secretary Enrique Ona said.
He said generic medicines “allow patients suffering from hypertension, diabetes and other chronic diseases to better comply with, and maintain, their daily medication needs at much less cost.”
“Five or six out of ten Filipinos are now using generics,” Ona said.
Thanks to the Generics Law, 300 children living with leukemia were served generic anti-cancer drugs during its pilot implementation in 14 DOH hospitals. Ona said that before generics, the same amount would have only benefitted 60 patients due to the high cost of treating leukemia.
“RA 9502 has lifted a heavy burden among Filipinos; it is also a big help to the underprivileged members of society and those under maintenance medication,” said Mayor Sara Duterte-Carpio in a message delivered on her behalf by lawyer Zuleika Lopez, acting city administrator.
Do generics owe R&D companies?
“People should also appreciate the work of research-based companies because without them, there is no generics,” Pharmaceutical and Healthcare Association of the Philippines (PHAP) assistant vice-president Eufe Tantia said. PHAP is a group of pharmaceutical companies engaged in research and development.
“We invest in Research and Development to discover new medicines and provide better treatment opportunities to our patients including neglected disorders,” he said.
But more than its R&D work, he said, PHAP members also innovate and help bring about significant changes to benefit patients.
Tantia said patients benefit from such innovations in the following ways:
Development of a complicated mechanism that allows patients with blinding trachoma to take an antibiotic in a single, easy-to-take dose that delivers a year’s worth of cure.
Sparing epileptics from seizures, not simply because scientists developed a drug for epilepsy, but because they managed to find a novel way of manufacturing it safely for the intended indications.
Freeing patients from the stabbing pain of angina, not because researchers developed calcium channel blockers, but because they took the next step: finding a way to lengthen the potency and therapeutic benefits of these drugs in the body, through extended release tablets.
Making a person living with HIV-AIDS survive for years, not just because of the discoverer of a protease inhibitor, but because teams of researchers found a way to surmount the low solubility of a compound that previously could not be taken orally.
“The pharmaceutical market has always been a comparison between generics and branded products,” Philippine Chamber of Pharmaceuticals, Inc. PRO Willie Fabroa said.
While branded products are known as the “original”, he said, the non-branded products are perceived as generics. The perception is that generics drugs are products other than the innovators’ drugs, he said.
Fabroa said there are two kinds of generics—the branded generic and the generic-generic.
“The next time you or a friend gets sick and given a generic prescription, then here is the guideline: if it is the more expensive then most probably it is the innovators’ product; ask if they have a more affordable brand—it could be the branded generic; but if you still can’t afford it, then there’s always generic-generic,” he said.
