Better access to bitter pills

 

 

My medical check-up last Thursday surprised me with a bad news: my blood pressure is way beyond normal. “Take a rest for a few minutes and let’s take your BP again,” said the nurse. How ironic, I thought, to deliberately command your body to relax when your mind voluntarily tortures itself with the horrifying thought of being sick for life.

 

“You are too young to be hypertensive,” said the doctor, as if I don’t realize it myself. “But with the current lifestyle many of us live, I am not surprised that people as young as you are could develop high blood pressure.” Oh yes, that helped me relax, doc, thank you very much.

 

So starting last Friday, I’ve been monitoring my BP in the morning and afternoon as the doctor advised. I will do this for a week so she will have basis, together with the results of my Panel 11 test and abdominal ultrasound, to conclude that I’m indeed hypertensive. But I started to record my BP reading only yesterday because a part of me hates the whole idea of documenting it on paper—writing down the figures feels like counting the days to your death. Of course I’m exaggerating.

 

But I know it’s no joke having this chronic cardiovascular disease; you’ll be on medication for the rest of your life and suffer the risk of stroke, among other threats. Worse part is, you don’t even feel the symptoms so you are literally like a walking time bomb.

 

By next week, I will already know if I join my mom and the rest of over 10 million Pinoys suffering from hypertension. The 10 million figure is alarming enough, but the sadder news is that majority of Pinoys with hypertension don’t get any kind of treatment because they simply cannot afford to buy the medicines.

 

So what a coincidence that at this stage in my life when I come face-to-face with the threat of a lifestyle disease that requires long-term medication, the Philippines has recently signed into law the Cheaper Medicines Bill that is hoped to bring down drug prices so that as many Pinoys as possible can afford treatment. It feels strange saying this because now I am a potential direct beneficiary.

 

But I temper my happiness for this new law with the reality that in this side of the world, effective implementation is a totally separate struggle from passing the bill into law. So the next issue to deal with here is no longer the strong lobby by multinational pharmaceutical companies out to protect their business interests at the Pinoys’ expense, but government will and capability for sustained enforcement.

 

Interestingly, many Pinoys assume, including my mom, that because the bill has been signed into law, the next time they visit their neighborhood botika, drug prices have already been reduced. How I wish this is the case, but it’s far from being so. The law has no immediate bearing on prevailing costs of drugs in the market; it’s effect will be felt in the long-term: introduction of more affordable medicines in the market because of the following flexibilities:

 

• Adopting an “early working doctrine”

Local companies can now start experimenting on generic substitutes of patented drugs so that when the patent expires, generic versions will immediately be available in the market at more affordable prices. Today, a generic company can only begin to experiment on a generic version only after the patent expires.

 

• Disallowing “evergreening” practices

This is related to the first one, because the problem with the current set-up is that, the patents on some drugs don’t seem to “expire” at all. Why so? Drug companies file fresh patents for a different use of the same drug, thus extending their monopoly rights, and ultimately preventing generic substitutes that are more affordable from being available in the market. This is called the ‘evergreening’ practice.

 

• Allowing “parallel importation”

If an essential, patented drug is necessary when public health is at threat, government can import the same medicine from other countries and sell it for a lower price here, thus providing the market an option on which of two versions to buy. The existing intellectual property law precludes the government from doing so because drug companies have the exclusive rights to sell patented medicines in the market.

 

These are just three of many salient features of this law expected to help bring down drug prices in the long run. Again, these are all good in principle; carrying these out in actual, sustained practice will be the true test of the law’s effectiveness to provide the much-needed relief for quality and affordable medicines that millions of Pinoys need for their long-term treatment—and yes, myself possibly included.