Published at the Philippine Daily Inquirer last September 17, 2008 and Manila Bulletin last June 29, 2009.

The cost of medicines in the Philippines is high. And that is a reality that is palpable on several levels. That the same drug, and even the same brand, cost surprisingly less if bought in another country is a sorry truth.

The economic fever that has begun to grip the country today is causing the cost of medicine to rise even further, making for a sadder situation.

And, third, the Philippines is a poor country, and when the poor are sick take less medicines than required, or none at all. When the cost of medicine is higher than what can be afford, the sick remain sick. Productivity is low, the country remains poor.

After more than three decades working in various roles in the pharmaceutical industry, allow me to offer my humble suggestions on how to re-engineer the Generics Law of 1988 to effect actual reductions in the prices of basic drugs and medicines.

HOW TO REDUCE THE PRICES OF BASIC DRUGS AND MEDICINES IN THE PHILIPPINES BY 50% OR MORE

1. The Government, through its implementing agencies (the Departments of Health and the BFAD  specifically),  must create a National Drug Core List (NDCL). The list will include drugs and medicines most commonly used, prescribed and dispensed, using the IMS figures as reference.

2. The Government, through the Department of Finance and the Bureau of Customs, must establish a National Drug importing Company (NDIC)  to exclusively source our and import, tax free, all raw materials and finished products from foreign suppliers offering the best price for all products under the Core list Acceptable quality will be the criterion, of course.

3. The Government must either put its own National Drug Manufacturing Company (NDMC)  or enter into toll manufacturing agreements with existing and reputable toll  manufacturing companies to manufacture and/or repack these products. Bidding for these products at the Department of Health will no longer be necessary.

4. The Government must also establish a National Sales and Marketing Company (NSMC) to take care of all the marketing and promotion of these products, either directly ethically or through tri-media.

5. The Government must invest on new and advanced quality control equipment and training to improve the technological capacity of the BFAD.

6. The Government should also appropriate some amount to make the good performance of the BFAD know to the general public and to promote their new capability. This will be necessary to assure customers of the quality of the products under the Core List.

7. The Government must print the Fixed Maximum Retail Price (FMRP) on individual  foils, labels and trade boxes of these listed products. This FMRP should respect the current profit margins being enjoyed by the drugstores. This will be computed base on average Peso Value and not on Percentage.

8. As an option, a GenKard can be issued to all qualified citizens through the DSWD and other related government agencies. GenKard is an acronym for Generic Card.

This proposed program is intrinsically biased for the poor. When the price fo drugs and medicines are reduced across the board, as envisioned in the Cheap Medicine act, the rich benefit more.

Right now, the rich can afford to buy 8.00 to 14.00 per capsule of Amoxicillin 500mg. If this is reduced to 5.00, it is still a big amount for the poor. Likewise, the Government must request all drugstores to carry and provide a special counter for all the products in the core list exclusively for GenKard holders.

The Government, at all times, must defer to the wisdom of doctors and other healthcare practitioners on the matter of which drugs and medicines to prescribe to their patients. Doctors and healthcare practitioners should likewise respect the decision of patients in the choice of brand of the drugs prescribed to them.

Should a patient decide to exercise his freedom to choose between brands and differ from that prescribed by the doctor, he frees the doctor from any responsibility or accountability. Respect and trust and belief in the freedom of all parties must be the guiding principles, at both clinic and drugstores levels.

Branded generics are branded drugs and medicines  at generic prices. I believe that this is viable compromise that we should do well to consider. The concept of branded generics protects all stakeholders, and this is a more tangible program in reducing the cost of medicine in the country.