Saturday, January 26, 2008

the battle rages...


The past two days I've been posting about the response of the Dumaguete and Negros Oriental doctors to the proposed amendment of the Generics Act Bill. What follows below is a continuation of the Official Position Paper of the collective bodies of the Negros Oriental medical community. Yesterday's post elicited a comment from someone who calls himself/herself Purdoy, raising some issues which I believe have merit for discussion.

I just realized that some of my readers are not very familiar with how a weblog works. Here's a little lesson: when you see some words or texts that have a different color from the rest of the text (meaning the color black or gray) then please click on the colored texts and that will link you/bring you to another page where there is more data/information relevant to what is being discussed. It's actually much simpler than it sounds. Try it.

Happy navigating and reading!

(This is the last part of the Official Position Paper of the Negros Oriental Medical Societies.)

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DRUGS OF THE SAME GENERIC NAME DIFFER IN TERMS OF ITS THERAPEUTIC EFFECTS AND SAFETY


SUPPORTING DOCUMENTS AND EXPERIENCES OF GOVERNMENT PHYSICIANS

The advent of the Generics Act spawned the proliferation of drug companies, many of which have questionable origin, carrying fake, sub-standard and violative products, obviously considered to be detrimental to our patients (see attached Sub-standard Alert of the Department of Health Region VII, and other pertinent documents pertaining thereto and its eventual effects on our people).

Only medical doctors have the scientific knowledge, expertise, and experiences to recognize proven clinical responses of success treatments, failures, and idiosyncratic manifestation of drugs, drug interactions, contraindications, adverse reactions, and other effects of drugs on their patients.

Only medical doctors have the competence to determine which drugs have the most beneficial effects on their patients. Hence, the physicians should not be denied of their preference for medicines that have long track records of proven quality and efficacy that would result to early recovery, shorten hospital stay, good quality of life, and thereby, making it more economical, cost-effective, and cost-beneficial to their patients.

Only the medical doctors are morally, ethically, and legally accountable and subject to legal actions should any untoward effects happen to his/her patients. Available data show that not all drugstores are manned by or under the direct operational supervision and control by a licensed pharmacist.

Delegating the power to the salesperson with no or limited knowledge of drugs or medicines and their interactions poses great threat to public safety. Observations have shown that most salespersons change the medicines prescribed by the physicians with other generic product of unknown quality.

Some government hospitals are often made the dumping ground of generic products because of its low cost, some of which are expiring or near expiry. However, many government physicians have observed that these generic products are of poor quality, have less or no therapeutic effects, and even prolong the hospital stay of patients. Hence, government physicians often resort to the combination of medicines to treat an illness rather than giving the drug of choice.

Generic drug companies also change their prices at whim to increase their profits several folds, which is clearly disadvantageous to the patient and to our government. Medical doctors are held hostage in this situation because they cannot do anything with the bureaucracy, which has created a big obstacle in achieving an efficient health care delivery to the needy.


OUR ISSUES WITH THE BUREAU OF FOOD AND DRUGS (BFAD)

Is BFAD capable of assuring strict compliance with the standards of efficacy and quality of pharmaceutical products?

Does BFAD have enough resources to monitor drug companies and outlets?

Can BFAD cope with random sampling of questionable generic drugs?

Has DOH instituted the necessary sanctions on drug companies carrying sub-standard, violative, and fake drugs? (What happened to the Sub-standard Medicine Alert of DOH Region VII released on January 17, 2001 concerning PHILIPPINE PHARMAWEALTH, Inc. products?).


PUBLIC SAFETY IS A PUBLIC TRUST AND SHALL BE NON-NEGOTIABLE

Direct patient care is the primary responsibility of doctors and hospitals and nobody else is held accountable for the welfare of the patient, in its preventive and curative aspects in our Health Care Delivery System. Only the medical doctors are subjected to legal sanctions and must bear the consequences thereof if any untoward effects in the treatment of patients occur.

Curtailing medical doctors from pursuing high level of performance, which is expected of them in the choice of the best possible drugs or medicines for their patients, is an act of disenfranchisement of the human spirit, and would lead to diminishing their rights to practice the Art of Healing, which is God given.

Hence, we need to redirect our efforts to the improvement and strengthening of existing and flawed laws (What happened to the recommendations made by the government and private hospitals and practitioners to the Oversight Committee in 1988, re: Generic Act of 1988) and we should not allow these flawed laws to remain forever and become part of the archives of history.


RECOMMENDATIONS

Price Monitoring Index for all drugs and medicines, both generic and branded.

Acquisition of drugs or medicines through bulk procurement

Procurement of drugs or medicines through Parallel Drug Importation (selective)

The government must strengthen the capability of BFAD to assure strict compliance with the standards of efficacy, safety, and overall quality of pharmaceutical products.

BFAD must be provided with enough resources to ensure that its operations are at par with International Standards.

BFAD must perform with equal regularity random quality checks on Drug Companies and their products.

There must be BFAD laboratories in Luzon, Visayas, and Mindanao or if possible per region
BFAD must exercise its functions of monitoring supervision, and regulation of drug outlets

Revisit the Generic Act and its implementation by the oversight committee
Consultation with people, specially the concerned sector (Health Sector), before any amendments are passed.

Lastly, consult your doctor for the best medicine for you.


The prescription made my physicians for their patients is a sacred document between the Doctor and the Patient. The Rx stands for the command “Take thou”, so please do not bastardize our prescription and, most importantly, protect our people who are the beneficiaries or recipients of health care.



(SIGNED)


KENNETH T. COO, M.D.
President, Negros Oriental Medical Society


JONATHAN C. AMANTE, M.D.
President, PCP – NegOr Chapter


JOHNNY B. YEE, M.D.
President, PAFP – NegOr Chapter


VERNA T. REYES, M.D.
President, PMWA – NegOr Chapter


ELY V. VILLAPANDO, M.D.,
M.P.H. Consultant


DANTE G. DOMINGO, M.D.
IPHO – Negros Oriental PHO II, NOPH


FELIX A. SY, M.D.
Chief of Clinics, NOPH


QUINTIN C. BASCOS, M.D.
COH, Bindoy District Hospital


EDGARDO P. PIALAGO, M.D.
COH, Gov. William Villegas Memorial Hospital


CLEMENTE S. HIPE IV, M.D.
COH, Siaton District Hospital


GERVACIO S. SALATANDRE, JR., M.D.
COH, Bais District Hospital


HENRISSA M. CALUMPANG, M.D.
COH-OIC, Bayawan District Hospital


TRIFONY D. LUCHANA, M.D.
COH-OIC, Canlaon District Hospital

1 comment:

GeenaMacs said...

Every organization has its bad eggs. There are doctors who cheat, lie,falsify, manipulate and even kill, intentionally or unintentionally. Finishing medical school only gives us credence to wear a doctors'gown/blazer/smack and a stethoscope but certainly not a halo. No. Not a halo. In short, the MD that is attached to our names does not stand for Moral Doctor. We are just Medical Doctors. Although we deal with lives, we are not gods. We are as human as the bum on the street. WE ARE SO LIMITED. We sin. We get tempted.
If I am a bad egg and refuse to change,I can continue to be one even if there is a law prohibiting me from writing the brand name. I can still make my patient buy the brand of the pharmaceutical company that promised me a trip to the US. All I have to do is write on a separate piece of paper the brand name to avoid any legal snag and take advantage of the trust accorded to me by my patient by convincing him that this brand and only this brand will make him well. This amendment certainly will not affect me or make my coffers any lighter. I will not even bother to fight this amendment. I might even see it as another opportunity to enrich myself by going into the business of selling generic drugs!
But there are good eggs in the medical organization who sincerely want what is best for their patients. With this amendment, they no longer have the option to write the brand they feel will make their patients heal faster regardless of whether the pharmaceutical company can offer trips and other perks.

I am reminded of what happened a few weeks ago. My car broke down and i needed to replace the battery but before I bought a new one, I asked around for the most durable and cost effective brand. There were many suggestions but I chose to go for the brand recommended by my mechanic because I felt he was the one who knew best.
Making it a crime to have the option to write a brand proven by experience to work is similar to silencing my mechanic from making any recommendation as to the best type of battery around.
I appreciated my mechanic. I think patients will appreciate their doctors when they give them their preferred drug that works best based on their doctor's experience.

It's an incontrovertible fact. There are good eggs and bad eggs in every organization thus the need for patients and doctors alike need to be vigilant.