Affordable medicine

In the Philippines, one dies not because he is sick, but because he is poor.

This, in essence, was the startling revelation made by leading cardiologist, Dr. Esperanza Cabral, secretary of social welfare and development.

According to Dr. Cabral, there are an estimated 7.76 million Filipinos currently suffering from hypertension who she aptly labeled as "walking time bombs." The label merely dramatizes what could happen to any of these Filipinos – that a vein supplying blood to the brain could just erupt anytime, causing either death or paralysis.

The sadder part of this story is that most of these countrymen of ours are either not on treatment or are inadequately treated. The reason – the price of what used to be the only medicine for hypertension that is locally available is beyond reach.

Friends who are on this anti-hypertension drug wince at the amount of money they have to set aside for their treatment. At the current price of P44.75 per five-milligram tablet, they spend about P313.25 per week or P1,342.50 for a minimum use of one tablet per day, assuming they only require one tablet a day. That is easily more than 10 percent of the take home pay of a hypertensive employee who makes a measly P12,000 a month.

The question is, would a person raising a family set aside 10 percent of his monthly salary just to stay on the minimum treatment?

The irony is this – by staying out of the expensive treatment, the breadwinner succumbs eventually to the complications of hypertension. And his poor family ends up without a provider.

The greater irony is that this drug is sold by the same drug company at a tiny fraction of the Philippine price tag in other Asian countries.

These ironies, however, are things of the past. Recently, the government welcomed the launching of the anti-hypertension treatment called Amvasc, a product of the Therapharma division of Filipino-owned United Laboratories, Inc. (Unilab).

My friends were ecstatic with the launching of Amvasc. The reason: it costs 60 percent less than their current medication. Instead of spending P44.75 per five-milligran tablet, they will only have to shell out P17.50.

If you multiply what one would save by shifting to Amvasc, one is able to set aside P190.75 per week. That savings with Amvasc means eight kilos more of rice that can go to the average Filipino hypertensive patient’s food budget.

The introduction of Amvasc by Unilab stirred long discussions in coffee shops on the price of medicine being sold in the country by multinational drug firms. There are two nagging questions. The first is why are these medicines usually expensive? Second, why are they expensive in the Philippines yet cheap in other Asian countries like India and Pakistan?

For example, an over-the-counter painkiller manufactured by the same multinational that churned out what used to be the only locally available anti-hypertensive drug is sold at P21.82 per 500-milligram tablet in the Philippines. The equivalent price of the very same drug in India and Pakistan: P2.61 and P1.38, respectively.

The analysis of this depressing disparity in the price is interesting. Some say the huge difference in prices go to the salary of expatriates who are detailed in the Philippines. So keep in mind: when you try to relieve a headache with an expensive pain killer, you might be subsidizing the local country club membership of an international drug company executive.

Others say the price difference goes to astronomical operating expenses that go with multinational presence. Multinationals can’t own properties in the country. They, therefore, have to rent spaces for offices and warehousing.

The speculations are myriad as they are funny. These multinationals never explained to us fully why we have to deal with expensive price tags

At least, we can afford to speculate even if our blood pressure rises in the process. What the heck, we can afford to buy Amvasc. It's high quality and affordable. Something Filipino made for Filipinos. No club membership for expats and office space subsidies built-in into the price tag.

Just plain affordable medicine.

Telco war heats up

It’s the homestretch towards the end of 2006, and the telco war is in full swing. Market aggressiveness is critical in the last quarter because it will determine how a telco will end the year and provides the momentum to start the coming year.

In the past, Smart has always been the runaway winner, with one strong campaign after another and ending the year with a bang. This year, it looks like the last quarter swing is hotly contested by Globe and Sun.

After launching its successful 10-centavo per second rate and making it permanent, Globe dropped its IDD rates, and then adopted a similar per second charging. Then in a bid to dislodge Smart’s hold on texting, they recently came out with a P10 unlimited text offer via TM. Globe now boasts of the lowest voice rates, the lowest IDD rates and even the lowest text rates among the three. A 10-second call costs a Globe subscriber P1 to make, while it costs a Smart sub P6.50 for the same 10 second call. Now that Globe combined this cheap voice rate with a low priced unlimited text rate, Globe has given their subscribers everything they could want.

After gathering steam in the prepaid market with their unlimited call and text cards, Sun now attacks the postpaid market with an unbelievable offer of three free phones with unlimited on-net calls and text for only P999 a month. And even before Smart or Globe can react, they lowered the price to P699 per month. Smart and Globe still seem to be shell shocked by Sun’s offer. Sun also launched significant discounts for a calling party of three subscribers. So not only do they give unlimited calling and texting, they will even reduce the face value of the load by as much as 10 percent if you form a calling circle of three people. These plans have driven many people to the Sun offices and has made Sun the cell phone of choice for budget conscious Filipinos.

Smart on the other hand has turned tentative in the second half of the year. They started with strong offers like 258 unlimited texting plus voice and Unli 20 that offered an unlimited texting load. But recently, they dropped that and launched a P20 load with a cap of just 100 texts. Worse, they lost to a complaint of Globe that now limits their text offers to within Smart or Piltel subscribers only. Smart can no longer use its offers for Talk N’ Text subscribers and vice versa. It seems like someone shifted the Smart race car (that’s what Boy Martirez used to call his marketing team) in reverse. Smart however is betting on a text-based raffle. They are giving away P1 million to lucky subscribers who load up. Whether raffles really work when your competition is giving low priced unlimited texting to everybody is the question.

But then again, Smart may get the last laugh if they show higher yearend revenues. But subscribers aren’t laughing. According to some dealers, they are shifting. Some of the dealers I talked to said that Globe showed strong SIM take up in September. They project more subscriber growth in Globe for the third quarter of the year compared to Smart. But I recall that Smart walloped Globe in the first half by over 500,000 new subs, so year to date, Smart may still be ahead. But if it is true that Globe beat Smart in the third quarter, then the tide has shifted.

On the landline side, PLDT remains the most aggressive of the lot. Even if they are the dominant provider, they still manage to keep the pressure against competitors. PLDT recently launched their "National Telebaba Promo" just in time for the Christmas season. Using the Pwede card as their weapon, they dropped outbound calls to the Middle East by up to 50 percent to just P10 per minute, lowered local and NDD calls, and offered access to their popular dial-up Internet product, Vibe for only P1 for 10 minutes, excellent for quickly checking your email. But you can only avail of these rates if you use the Pwede Card. Not a bad strategy. It gives subscribers access to low rates but protects PLDT’s primary revenue base from cannibalization. This "National Telebaba Promo" comes at the heels of their Telepwede prepaid landline product that allows OFW’s to have a phone for incoming calls for just P115 a month. Perfect for OFW families who wait for their relatives overseas to call them.

BayanTel and Digitel have chosen to focus on their wireless landline products for now. Digitel’s "MANGO" or "Man on the Go" seems to have the edge though it remains to be seen how many subscribers they can actually get. This could be their answer to growing their landline subscriber base without having to roll out an expensive landline network since the service can provide both voice and data. This may yet be the next big winner in the landline business so it makes sense PLDT’s competitors take this route.

There are still a few days left before the year comes to a close. Let’s see who gets the biggest Christmas bonus from the people whose choice really matters – the subscribers.

Not so hidden agenda

Moral lesson: Not all investments are good, no matter how big they are. This appears to be the message which Bukidnon Gov. Joe Zubiri wants delivered to President Arroyo, after she invited Malaysian megabusinessman Robert Kuok to expand our sugar areas by 30,000 hectares. Zubiri, national president of the Confederation of Sugar Producers Associations (Confed), has suggested instead that any additional lands to be planted to sugarcane should be devoted to ethanol production. Sugar prices are now dangerously low, as the low consumer demand could not absorb the increased sugar production brought about largely by higher farm yields. High cost of farm inputs is also aggravating the situation for sugar farmers. Increasing sugar production for food rather than for fuel will be disastrous for the country.

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