Ensuring Access to Safe, Affordable and Quality

Essential Medicines

3rd MeTA Philippines Forum

Dr. Edelina P. Dela Paz, MDHealth Action Information Network

January 27, 2009

Maximum Drug Retail Price (MDRP) and Government Mediated Access Price

(GMAP)

Implemented starting August 15, 200921 medicines (5 under MDRP and 16 under

GMAP)• 5 cardiovascular drugs• 1 anti-diabetic• 5 antibiotics• 10 cancer chemotherapy drugs

Maximum Drug Retail Price (MDRP) and Government Mediated Access Price

(GMAP)

Prices reduced by ~50% based on price of originator or leading brand

Impact on access to medicines for the poor?

45% of Filipinos live on less than 2$ a day

22.6% of Filipinos live on less than 1$ a day

Human Development Report 2009, UNDP

Survey on Medicine Prices and Availability

HAIN survey on prices and availability of selected medicines in 1st quarter 2009

Prices and availability across 27 private pharmacies and 21 public outlets

Affordability computed based on median prices and wages for lowest paid government worker at the time of survey

Survey on Medicine Prices and Availability

Philippine prices were compared to international reference prices and described as median price ratios (number of times Philippine price is more expensive than int’l reference price)

Prices in public outlets are lower than in private outlets, but…

The prices of surveyed generic medicines in private outlets is about

3 times more expensive than those in public outlets.

…availability in public outlets is poorer than in private outlets.

% Availability* # of outlets surveyed

Private sector – originator brands 48.1 27

Private sector –Lowest priced generics

61.1 27

Public sector –Lowest priced generics

31.0 21

*availability of 30 selected essential medicines

Much cheaper generic equivalents, compared to the MDRP,

have already been available.Price of amlodipine 5 mg cap/tab (in ₱)

Median price – originator brand 42.83

MDRP 22.85

Median price – lowest priced generics 14.00

Lowest generic price surveyed 8.00

International reference price 1.30

*in surveyed private outlets

Affordability of 30-Day Treatment Course of Amlodipine 5 mg tablet

*Based on salary of lowest-paid government worker at the time of survey

“Cheaper” may not always mean “affordable.”

Price of ciprofloxacin500 mg cap/tab (in ₱)*

Median price – originator brand 76.99

GMAP 41.91Median price – lowest priced generics 25.00

Lowest generic price surveyed 2.30

International reference price 1.5158

Much cheaper generic equivalents, compared to the GMAP,

have already been available.

*in surveyed private outlets

*Based on salary of lowest-paid government worker at the time of survey

“Cheaper” may not always mean “affordable.”

Affordability of 7-Day Treatment Course of Ciprofloxacin 500 mg tablet

“Cheaper” may not always mean “affordable.”

45% of Filipinos live on less than 2$ a day

22.6% of Filipinos live on less than 1$ a day

Human Development Report 2009, UNDP

“Cheaper” may not always mean “affordable.”

Medicines are not the only source of expense for a patient.

- laboratory exams/procedures - if hospitalized, room and board - professional fees

Human Development Report 2009, UNDP

The imposition of price regulatory control for medicines may be a positive step for patients at this time, but a combination of more comprehensive policies is needed for medicines to be truly affordable to the poor.

• Clearly the MDRP and the GMAP are not the prime solution to making essential medicines available and affordable to our people, especially the poor.

• The duration for patent on medicines must be shortened so as not to allow monopoly or control of foreign transnational companies in the Philippines

Drug Price Regulatory Board with a democratic representation of consumers and other stakeholders can be set up temporarily for 3-5 years until processes and mechanisms for price regulation will now be in place. Price regulation can not be left only on the authority of the Secretary of Health and the President of the Philippines. Stakeholder consultations must be conducted.

• Implementation of National Drug Policies and programs

• Generics Law• ensuring the quality of generic medicines• improving the availability of generic medicines in public

and private outlets• more intensive promotion of low priced generic

medicines to the public

• Develop a self reliant national drug industry that is responsive to the health needs of our people, especially the poor

• Develop technology that will extract and refine raw materials and chemicals for medicine production locally

• Improve the potentials of herbal medicine and natural components that are found locally in the Philippines

• Access to essential medicines is part of the people’s right to health.

• Currently, this right is indeed being violated and the people must demand that it be freely given.

• The need of Filipinos for safe, efficacious, affordable and quality essential medicines can only be met when a strong national health care system is in place and under a government whose policies consider the best interest of its people.