You should know better….

You should know better.

This in effect was the statement of the Philippine College of Physicians when they collectively came out with their full page statement yesterday formally responding to the provisions of the proposed: Cheaper Medicine Bill. The PCP along with 14 affiliate medical societies made the surprise move apparently fed up with the attempts to railroad the bill regardless of its many flaws and self serving interests of politicians.

The PCP highlighted their position against legislative attempts to violate and interfere with patient-doctor relationship, lack of adequate safeguards to prevent “practice-of-medicine-at-the-drugstore-counter”, disregard for the fact that not all medicines are created equal, the inherent inability of the Bureau of Food and Drugs (BFAD) to monitor and manage the industry, legal liability resulting from prescription, and the need to establish a Drug Quality Council.

In brief their collective sentiments declared that “the patient-doctor relationship is sacred and cannot be undermined by legislation. The physician is ultimately responsible for the care of the patient, the choice and/or selection of the appropriate drug must remain under the physician’s control”.

The opening statement in itself is equivalent to drawing the line on the sand. It is one thing to legislate for cheaper medicines but it is another to interfere with patient-doctor protocol or relationship. In essence it reminds us of many rights and relationships that must remain inviolable such as lawyer-client confidentiality, or freedom of the Press where the Constitution declares that NO LAW abridging the freedom of the Press shall be passed.

Apparently the doctors are not going to be pushed around. One of the proposed ideas in the bill is that doctors must prescribe ONLY generic drugs and can no longer prescribe “branded” medicines. It was suggested that any doctor who violates this can face a stiff fine or jail time. Given that their success in their profession is largely determined in their ability to relieve pain and cure a specific illness, the exclusive and mandatory provision reduces treatment options of the doctors and denies the patient and all consumers the right of choice.

The middle class and upper class who have long complained that their medicines were expensive will certainly get answered prayers for cheaper medicines, they just won’t be the “best” medicines they’re accustomed to.

If this bill even passes in its present form, it will probably end up being questioned or challenged in the Supreme Court. First of all it already interferes with the physicians authority to practice medicine which includes prescribing the correct or the best medicines available. The second serious issue will be the legal liability of doctors who have declared that they will not be held liable for the consequence of legislatively mandated prescriptions. If so, do we now presume that all legal liabilities will then be the burden of the state?

If this were the United States the prospect of collecting multi-million dollar compensatory judgments may offer some consolation but in a country where the government wants to collect the tax money even before you earned it or before you know if it’s a good year or not, the idea chills my spine.

In a country where many restaurants exercise exclusivity in the soft drinks they sell, how can the House of Representatives circumvent the exercise of free trade by passing a law that forces drug stores to sell medicines they did not buy, order or import?

In analyzing the statement and the position of the Philippine College of Physicians it is ironic that they had to spell out to members of Congress the serious flaws of the proposed bill especially since the prominent authors of the House version are doctors as well as legislators. As the heading suggests: They should know better. Or don’t they?

The PCP’s call for the establishment of a Drug Quality Council is a very serious challenge directly poised against suspicions and accusations that the bill is intended to help certain parties corner the Pharmaceutical market, parties whose history and integrity in the manufacture and sale of medicines have been questioned by government experts. The proposal for establishing a Drug Quality Council in effect also challenges the proponents of the bill to show their sincerity and to prove that they want a law that addresses the entire process of bringing cheap medicines to Filipinos.

In its present form the two versions focuses on drug pricing through a price council, parallel imports, and amendments to the generic act, all of which is about buying and selling the medicines but not about quality controls. Speaking of controls, my source informs me that the reason why Senator Mar Roxas was against a pricing council or price control is because it would surely create a black market. Senator Roxas has certainly not forgotten his years of experience at the Department of Trade where he had to deal with such manipulations. Rather than bring prices down, price councils as well as prices can be manipulated through an artificial lack of medicines that could be agreed upon by the local cartel.

The irony would be if the price of medicines actually became higher just like gasoline, cement, and LPG.

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It has not escaped the eyes and ears of Congress observers that the Cheap Medicines Bill has become the battle of the Bisaya’s but hinted that a number of Congressmen are aware of certain conflicts of interests surrounding the proposed bill. Apparently no amount of distancing and divesting can convince the boys from Luzon that there is no “Kamag-Anaks Incorporated” waiting to reap millions. Apparently the buzz has affected some people so much that they are now announcing to colleagues that they have put up a partnership with some Indian businessmen engaged in the Pharmaceutical industry. 

Don’t expect really cheap medicines, just look out for even richer politicians and new pharmaceutical millionaires.