The cheapest medicines in the country are sold in government hospitals and these should be made a major outlet to help more people, the pharmaceutical industry said.
“The Department of Health [DOH] should consider making these hospitals as a major outlet of medicines. We have been making medicines available to the government at very low prices through bulk procurement and we are committed to keep doing this,” said Pharmaceutical and Healthcare Association of the Philippines executive director Teodoro Padilla.
The government has been effective in implementing bulk procurement to bring down medicine prices. Under the Universal Healthcare Act signed by President Rodrigo Duterte earlier this year, bulk procurement and price negotiation with pharmaceutical companies are important provisions that must be maximized and expanded to lower medicine prices.
In a comparison of prices by the DOH Drug Price Reference Index, prices of medicines drastically dropped when a government hospital purchased medicines in bulk or in volume. The DOH-DPRI data showed that the price of a breast cancer medicine took a nosedive from P38,372.00 per vial for 100 units to P13,000 per vial for 6,100 units, representing a 66.12 percent price reduction.
For maintenance medicines, Padilla said an anti-cholesterol tablet sells in a government hospital for only P0.35 but sells for as high as P71.55 in private hospitals and P33.75 in retail outlets; P0.19 per tablet against high blood pressure compared to as high as P38.50 outside; and a tablet for diabetes at P0.56 compared to many times higher outside. The availability of low-priced medicines in government hospitals give patients an option either to buy in public or private pharmacies.
“The list could go on. Our point is that price reduction has been happening and the benefits could be expanded. The solution is the UHC Act, not price control. Price control shifts the burden of buying medicines back to the individual Filipino patients even when more recent landmark laws have provisions to make medicines finally be available and accessible to all,” said Padilla.
Signed by President Rodrigo Duterte in February 2019, both the UHC Act and the Cancer Control Act provide for mechanisms to lower medicine prices, and even provide them for free. These are (1) bulk or pooled procurement, (2) price negotiations, (3) expanded medicine benefits, (4) early access to innovative medicines, (5) special access scheme from the private sector, and (6) health technology assessment.
In the Philippines, he said individuals pay for 54 percent of their own healthcare costs compared to 12 percent in Thailand, 38 percent in Malaysia, 37 percent in Indonesia, and 45 percent in Vietnam.
Governments in other ASEAN countries set aside bigger budgets for medicine purchases, reducing in effect the healthcare costs to individuals.
The Thai government, he added, accounts for 91 percent of a patient’s pharmaceutical costs, compared to 54 percent in Malaysia. The Philippine government covers only 15 percent. In other advanced countries, medicine prices are subsidized by the government.
In spite of this, medicine prices in the Philippines are comparable with those in ASEAN countries. For some medicines, Philippine medicine prices are lower compared with neighboring Malaysia and Thailand.
An anti-diabetic 80 mg tablet is being sold at P7.13 in the country but is priced at P9.17 in Thailand and P10.19 in Malaysia. An insulin being sold in the country for P713.44 is priced at P968.75 in Thailand.
“We have been participating in several discussions to explain the impact of price control on patients and us, in the pharmaceutical sector. We believe that since we are the affected sector, our position should also be heard. It is part of the democratic process that is equivalent to due process,” said Padilla.
He added that price controls in other countries did not work because when prices are set too low, manufacturers are being told to sell at a loss, eventually leading to the withdrawal of needed medicines from the market.