President Gloria Macapagal Arroyo only has to sign a document in order to halve the prices of 21 essential drugs – yet she hasn't done it, a senator said Tuesday. According to Senator Manuel Roxas II, co-chair of the bicameral Quality and Affordable Medicines Oversight Committee, a draft executive order prepared by the Department of Health (DOT) to cut the cost of 21 essential drugs has been awaiting the president's signature since June 10. In an interview on Tuesday with GMA Network's “Unang Hirit," Roxas said: "Hawak na ng pangulo ang martilyo para pukpukin pababa ang presyo ng mga gamot, pero ayaw pa rin niyang gamitin ito. Pipirmahan na lang niya at bababa na ng kalahati ang presyo." (“The President has in her hands the hammer that will drive down the prices of medicines, yet she hasn't used it. All she has to do is sign and prices will be halved.") The unsigned document contains a list of essential drugs and their compulsory maximum retail prices (MRP) – limits set by Republic Act 9502 (the Universally Accessible Cheaper and Quality Medicines Act), which Mrs. Arroyo signed into law on June 6 last year.
Her failure to act on the DOH recommendation has led to charges that the government is being pressured by powerful lobbyists for the multinational-dominated pharmaceutical industry. Senator Roxas claimed that Roberto Romulo, executive director of President Arroyo's International Board of Advisers (IBA), arranged a “confidential" meeting on July 8 between Mrs. Arroyo and representatives of pharmaceutical firms to find ways to circumvent the law. Malacañang denied Roxas' allegation that the meeting was proof of collusion between the Palace and the drug firms. But DOH Secretary Francisco Duque III confirmed the meeting took place, clarifying that it was only an avenue for Mrs Arroyo to hear the side of the drug companies.
Conflict of interest South Cotabato Rep. Arthur Pingoy, chairman of the House Committee on Health, pointed out that Romulo, who holds two government advisory positions and heads a powerful pharmaceutical company, had no business attending the meeting.
Romulo is chairman of the Zuellig Family Foundation and Interpharma Investments Ltd, a Zuellig investment arm. Zuellig Pharma Corp. accounts for 80 per cent of drug distribution in the Philippines, according to a study by the research group Ibon Foundation. Congressman Ferjinel Biron, one of the principal authors of the House version of the cheaper medicines bill, said Romulo had a conflict of interest. “You cannot serve two masters at the same time," Biron told GMANews.TV. In a statement sent to GMANews.TV, Romulo neither confirmed nor denied accusations of conflict of interest. He claimed he opposed any move to impose price caps on essential medicines because it would “send the wrong message to the international community regarding the commitment of our nation to a free-market economy and intellectual property rights and it will discourage job-producing foreign direct investment." He added: “I have great respect for all efforts to meet the needs of the disadvantaged members of our society, particularly those that can bring down the cost of health care and make health care more accessible to everyone in our country. However, I believe that imposing price controls on a limited number of medicines is not the right approach." According to Romulo, prices of medicines should be decreased through the promotion of “increased manufacture and sale of generic drugs and working with pharmaceutical companies to get them to voluntarily reduce the price of drugs and to manufacture generics in the Philippines."
Powerful drug lobby The delays in the implementation of the MRP have prompted a congressional inquiry. In Monday’s bicameral hearing at the Senate, lawmakers led by Senate President Juan Ponce Enrile claimed that powerful and politically connected lobby groups from big pharmaceutical companies had exerted efforts to either delay or compromise the implementation of RA 9502. Among Mrs. Arroyo’s IBA advisers is Dr. Stephen Zuellig, chairman of the Zuellig Group, who has been honorary general consul of the Philippines to Monaco for the last 40 years. In May 2007, President Arroyo awarded Zuellig with the Order of Lakandula with the rank of Bayani, one of the highest honors given by the Philippine government to a Filipino or a foreign citizen. Enrile claimed that leading multinational drug firm Pfizer had attempted to bribe the government by offering five million medicine discount cards worth about P100 million to the DOH, which he said was a move to stop the government from enforcing the law. "Congress has already passed that law. It is already an indication that the purpose of the offer is to thwart, to stop, to impede the enforcement of the law. To me, as a lawyer, I will say that that is an offer of a bribe," Enrile said during the bicameral inquiry on the delay of the issuance of Mrs. Arroyo’s EO setting the MRP of 22 essential drugs. Reiner Gloor, executive director of the Pharmaceutical and Health Care Association of the Philippines, said Pfizer made the offer before the DOH released the list of essential drugs that will be subject to MRP. DOH Secretary Francisco Duque III confirmed that Pfizer indeed offered to donate suki cards to the government about two to three months ago. He said that while the department rejected the offer, he did not think that it was tantamount to bribery. "No, I don't think it was a bribe. Probably they thought that is one way of bringing down the price of medicines. I rejected it because we don't believe in discount cards," Duque told GMANews.TV in an interview on Monday. Meanwhile, Pingoy claimed that the law was being compromised because Mrs. Arroyo had chosen to give more lobby time to pharmaceutical industries instead of issuing the long-overdue EO. "The President should sign the EO, the sooner, the better, without waiting for the position of the firms, otherwise the law will be compromised," Pingoy told GMANews.TV.
Letter of undertaking vs. EO According to Dr. Robert Louie So, program manager of the DOH’s pharmaceutical management unit, Mrs. Arroyo gave the drug companies until July 18 to come up with a letter of undertaking stating their willingness to cut by 50 percent the prices of medicines, or she will sign the executive order prepared by the DOH. So said the reduction of drug prices could be fast-tracked if the companies would voluntarily comply, instead of requiring them to slash prices through the EO. “The government will no longer face enforcement problems if they will comply voluntarily. And there will also be less red tape," So told GMANews.TV on Tuesday. He said that if compliance would be through the EO, every manufacturer, wholesaler, trader, and retailer of medicines would have to conform with drug labeling requirements as mandated under Section 26 of R.A. 9502, delaying the implementation of price cuts. But Pingoy expressed puzzlement that the Palace should ask the companies to voluntarily lower drug prices when the law mandates the government to impose mandatory price cuts. "Why is there a need for voluntary price cuts when there is already a law that mandates that price reduction of medicines? Why would there be a need for a letter of undertaking from the firms to cut the prices when there is already a law? Why should the law be subjected to negotiations?" Pingoy said. Pingoy surmised that if a letter of undertaking would be issued instead of an EO, it would be easier for the firms to adjust the prices of medicines in the future. "A letter of undertaking could easily be changed. It could only be effective for the last 10 months of the Arroyo administration. But an EO is more permanent, and will have to be subjected to a legal review if it needs to be amended," Pingol said. –
with a report from Amita O. Legaspi, GMANews.TV 
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