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Cures & Snake Oil

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Winthrop YuRecently there was considerable discussion on implementing Republic Act 9502, the “Universally Accessible Cheaper and Quality Medicines Act of 2008.” Among its provisions is allowing generics firms to test and register their versions of patented drugs even prior to patent expiration. RA 9502 also allows parallel importation: the purchase of branded drugs from countries where they are manufactured and sold at a lower price.

The pharmaceutical companies, of course, objected to this bypass of the differential pricing schemes they implement across countries. Nevertheless, media and public attention is often directed at one provision of the Cheaper Medicines Law— government-mandated price controls.

Naturally, there are valid, free-market objections against price controls that, no matter how well meaning, dampen innovation and competition. Note that under RA 9502, price controls aren’t strictly required. Perhaps this provision was intended as a last resort, to be used only when other mechanisms fail to lower drug profit margins.

Dr Robert Louie So of the Department of Health (DoH) thinks the threat of price controls may be more effective than its actual implementation. The price control provision is a Sword of Damocles, encouraging lower profit prices over a wider range of drugs, without the need for drastic government intervention.

On the other hand, HealthWatch champion Roberto “Obet” Pagdanganan insists that Maximum Drug Retail Price provisions should be implemented immediately. This, in order to provide clear, immediate benefits across the entire medicine supply/distribution chain and to forestall dilatory or decoy tactics such as discount cards for only a few patients.

A mixed implementation of voluntary reductions, bolstered by mandatory price controls for the recalcitrant few should now be taking effect.

This focus on cheaper medicines brings some other important things to mind. For one thing, many other-branded (usually called “generic”) equivalents of expensive drugs are already on the market. These equivalents sometimes cost less than a fourth of the cost of the well-known brand.

One problem may be that the cheaper, but equally effective “generics” may not be readily available at major drugstore chains. Since most of us would understandably be wary about buying generic or unknown brands from a hole-in-the-wall botica (drugstore), the emergence and growing acceptance of “Botika ng Bayan” is a good thing. The DoH must further strengthen alternate distribution networks so more options and better choices are available for all. As a matter of economic policy, fostering competition and improving distribution is far sounder than restrictive price controls.

Another sore point is that legitimate drug companies are already heavily regulated. Strange then that all these restrictions are not applied equally to alternative concoctions that are marketed as if they were real drugs. Unproven herbal-du-jour alternatives are heavily advertised in mass media. Some premium-priced ones are being distributed through direct-selling networks.

Blinded by the hype, many fail to understand that “BFAD-certified” simply means that the stuff won’t kill you outright. “No Therapeutic Value/Claims” means there is no guarantee of any health benefits at all. You are certainly free to spend money on them. Even a placebo can be useful at times. Hype notwithstanding, anything that comes as a pill or powdered mix is hardly “natural.” Fads are not science.

As an example, one day I was standing at a Mercury Drug counter stocking up on my usual vitamins (generic B-complex + C and Ferrous Sulfate), when an elderly matron next to me started a discussion with counter personnel. She had her husband’s prescription in hand and wanted to cut down on the prescription in order to save money. After she’d reduced the amount to less than half, she then casually ordered an expensive “alternative medicine” that cost twice as much as the amount she just saved on the doctor-prescribed drugs!

The woman not only spent more money, she could have even been doing her husband harm. If you intend to self medicate, it would be better to base your decision on scientific facts, not paid advertising.

In fine, while it’s a good thing that government is widening our choices and options, in the end it’s our choice. No matter how many laws we legislate, government is not responsible for and will not make personal life decisions for you. It’s up to us as individuals with purchasing power to decide whether we want to spend our money on a cure, or make the snake oil salesman happy. Plain common sense, sharp judgment and, perhaps, a bit of skepticism would be helpful.

Print ed: 09/09

 

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