After years of waiting for the passage of the much-contended legislation, the debacle over the Cheaper Medicines Bill hounds the public even after its celebrated passage in June of 2008.

More than a roller coaster ride

 To say that the campaign to pass the Cheaper Medicines Bill was complicated is a complete understatement.

The legislation with its noble purpose to ensure affordable medicines to Filipinos had gone through various controversies before it gained the passage it rightfully deserved.

In the 13^th Congress, the Cheaper Medicines Bill as it was popularly known, initially sought to amend the Philippine patent law to make room for flexibilities provided under the World Trade Organization’s Trade Related Aspects of Intellectual Property Rights (WTO-TRIPS).

Flexibilities under the IP amendments includes parallel importation of drugs with patent protection without the consent of the patent holder; issuance of license to the government or any third party which can manufacture patented medicines in the event of a national emergency, disaster or any similar emergency situations, further limiting the criteria for granting patents to drugs and medicines, allowing the early working of a generic drug application before the patent protection of its originator drug expires. And others.

The Cheaper Medicines Bill then was not a popular legislation even among legislators in both the Senate and House of Representatives because of the technical issues surrounding intellectual property rights. It remained unpopular until a major turning point presented itself in the form of a note.

In February 21, 2007, days before the Congress closed its session for a much-awaited recess, lawyers from a prominent law firm trooped to the session hall of the House of Representatives to monitor and lobby against the bill’s passage. A few minutes later, Congressman Ferjernel Biron went ballistic and confronted the lawyers; apparently, one of the lawyers has passed a note to Cong. Teddy Boy Locsin bearing the message, “We desperately need someoneto question the quorum now. Can you do it?”. The note also requested Cong. Locsin to call Mr. Leo Wassmer, vice-president and Chief Executive Officer of the Pharmaceutical Healthcare Association of the Philippines (PHAP) at __________. Chaos soon followed the commotion as Cong. Locsin threw the lawyers out of the session hall with the media at their tracks.

After a series of statements identifying the lawyers as representatives of the Pharmaceutical Healthcare Association of the Philippines (PHAP) and later the denouncement of the lobbying act as a desperate attempt to control the inevitable end in the patent regime of the pharmaceutical industry, the Cheaper Medicines Bill became a symbolic legislation. An essential weapon in the waging war between patients’ rights and patent rights.

Soon after the incident, it gradually became evident that the bill will not pass in time for the closing of the 13^th Congress. Nevertheless, what the public lost during the end of thirteenth congress, it gained in the opening of the next congress. The bill gained enough publicity to solicit support from legislators in both chambers. Before the committee hearings were even conducted, majority of the house representatives have signed the pending legislation as authors and co-authors.

Complications ensued after various legislators filed their own version of the Cheaper Medicines bill. After several public hearings and consultations, salient points of the bill included more than just the Intellectual Property amendments. The bill contained amendments to the Generics Act and pharmacy law. The establishment of a drug price regulation was also included along with a provision to strengthen the Bureau of Food and Drugs (BFAD).

Seemingly repeating history, the House version of the bill again faced contention with some of its provision ruffling feathers within and beyond the halls of the lower house. The Drug Price Regulation vs. IP amendments debate was consistently drowning all other issues on the Cheaper Medicines bill in the first stages of the hearings by the House Committee on Trade and Industry. Legislators sponsoring the provision were vicious in their critique of the IP amendments with allegations centering on the premise that the IP amendments will not really translate into affordable medicines.

The Philippine Medical Association (PMA) meanwhile, were passionate about a certain provision on the amendments to the Generics Act. The amended provision mandates for prescribing in drugs in its generic name only, no brand name shall appear in any part of the prescription pad. This provision seeks to promote the use of generic drugs at the same time prevent multinational pharmaceutical companies from using the prescription pads as a marketing tool for their branded drugs.

The PMA went as far as threatening to conduct a nationwide Hospital Holiday, a boycott in which hospitals will refuse to accept patients once every week except for emergency cases. PMA conducted a nationwide motorcade to signify the doctors’ opposition against the “Generics-only” Prescription. PMA’s steadfast supporter was Senator Pia Cayetano, which during the bicameral deliberations was adamant about including the provision and moved to scrap the Generics only prescription from the final Bicameral version of the bill.

The Department of Health after a much-publicized show of support for the generics only prescription, retracted their recommendation with statements saying that 54% of Filipinos are already purchasing Generic medicines. Thus, the need to amend this specific provision no longer merits the urgency it was given before. 

In the midst of allegations against the generic name only prescription and even generic drug itself, the public health advocates remain steadfast in their stance, challenging the PMA to renounce their commission-oriented view of prescribing in the drug’s brand nme so that they can give way to the needs of their patients.

The debate over whether or not to drop the generic name only prescription were seen by the Office of the President as the sole hindrance to the passage of such a noble legislation. Thus in May of 2008, President Gloria Macapagal Arroyo publicly appealed to the Bicameral Committee members to drop the said provision to be able to pass a more important piece of legislation.

With that statement, the provision was indeed scrapped, with committed legislators promising to soon amend the Generics Act in an omnibus bill.

After the controversies hounding the public health legislation, President Gloria Macapagal Arroyo finally signed the Cheaper Medicines Law, which in its final form is officially referred to as the Universally Accessible Cheaper and Quality Medicines Act of 2008 in June 6 of this year.

Consumer group Cut the Cost, Cut the Pain Network (3CPNet) and patient group Cancer Warriors Foundation urge the government to implement drug price cut measures contained in the Implementing Rules and Regulations (IRR) of the Cheap Medicines Law during the first 100-days of its implementation.

The groups ask the Department of Health to identify patented medicines for cancer and other critical ailments that may be bought outside the country as these are reported to be not affordable and not available to poor patients.

“Aside from the importation, the DOH can start working on the monitoring of prices to help set the maximum retail prices of life-saving medicines,” said Edel Hernandez, Co-Coordinator of 3CPNet.

The IRR of RA 9502 or Universally Accessible Cheaper and Quality Medicines Act of 2008 allow private parties aside from the government to import more affordable and quality patented medicines through the Philippine International Trading Corporation Pharma Inc.

“The people deserve to have access to patented medicines from other countries that are priced lower than the same patented brand of medicines here. The ultimate test of the effectiveness of the law is to commence the implementation of the critical provisions that will give the people immediate relief,” said James Auste, spokesperson of CWF.

The groups were the proponents of the law during Congress deliberations and pushed for non-government organizations and civil society groups’ participation in drawing up a comprehensive and effective price monitoring and regulation system.

“People’s vigilant monitoring of prices of medicines particularly those that are unjustly high due to pharmaceutical companies’ greed for profit should start now,” added Hernandez.

The IRR defines the imposition of maximum prices at all levels of the supply chains including but not limited to manufacturer’s price, trader’s price, distributor’s price and wholesaler’s price, and retailer’s price.

The rules cite the medicines that will be subject to price regulation include treatment of chronic illnesses and life threatening conditions, such as, diabetes, gastrointestinal disorders, cardiovascular diseases, pulmonary diseases, HIV-AIDS), among others.

The groups also ask the Intellectual Property Office to revise the Manual for Substantive Examination Procedures that guide patent examiners in the review and examination of patent applications.

“This document should be subjected to public hearing to ensure that the guidelines set are consistent with RA 9502 and its IRR,” said Hernandez.

The effectivity of the law is set to commence on November 22, 2008