Position Paper

of the

Negros Oriental Medical Society,

the

Negros Oriental Chapters of the

Philippine Academy of Family Physicians

Philippine College of Physicians

Philippine Medical Women's Association

and the

Negros Oriental Hospital Systems

on the

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CHEAPER MEDICINE BILL (HB 2844)

Chapter 5, Section 33, Section 6b

of the Repubic Act No. 6675

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(Generic Act of 1988)

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This position paper is in response to the newly amended Cheaper Medicine Bill (HB 2844) passed by congress that prohibits medical, dental and veterinary doctors from prescribing the brand name of their medicine of choice in addition to the generic name in every patient encounter.

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The Cheaper Medicine Bill (HB2844), Chapter 5 Section 33, Section 65 of he Republic Act No. 6675, otherwise known as the Generic Act of 1988, is hereby amended to read as follows:

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"Sec. 6 Who Shall Use Generic Terminology: "(b) All medical, dental and veterinary practitioners, including private practitioners, shall write prescriptions using the GENERIC NAME OF THE DRUG OR MEDICINE ONLY AND ITS BRAND NAME SHALL NOT APPEAR ON ANY PART OF THE PRESCRIPTION."

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Having studied and thoroughly discussed the meaning and implications of this Bill, we, the physicians fo the Negros Oriental Medical Society (NOMS), the Negros Oriental Chapters of the Philippine Academy of Family Physicians, the Philippine College of Physicians, the Philippine Medical Women's Association as well as the Negros Oriental Hospital Systems have arrived at a consensus to collectively support this Cheaper Medicine Bill since lowering the cost of medicines would make it more affordable to the general public.

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However, we strongly object and protest against the specific provision of the said Bill found in Chapter 5, Section 33, Section 6b of RA 6675 for the following reasons:

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Whereas, Section 4 of the Philippine Bill of Rights states that "no law shall be passed abridging the freedom of speech, of expression, or of the press, or the right of the people to peaceably assemble and petition the government for redress of grievances." In the context of this provision, we claim that, since we doctors are ultimately responsible for the well-being of our patients, we should, at the very least, have the right to express what we believe will be beneficial to our patients.

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Whereas, writing the brand name in addition to the generic name is an exercise of our right to choose. It does not in any way prevent the right of the patient to choose other drugs with the same generic name. However, preventing doctors to write the brand name in addition to the generic name is a violation of their freedom of expression and therefore, unconstitutional. This amendment removes the physician's right and prerogative and discretion as to the choice of the best possible brand of drugs or medicines for the treatment of their patients.

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Whereas, depriving the physician of the option to write the brand name would mean transferring such option to the pharmacists, who will be dispensing these drugs but do not have a complete knowledge of the health status of the patient. It is the doctor's prescription name and license that are placed on the line, hence, it is appropriate that it should be the prescribing physician who should have the option to choose the best drug for his/her patient, whether generic or branded. Relegating this responsibility to pharmacies could endanger the safety of our patients and questions our competencies as practicing physicians. If a dispensed drug would cause adverse reactions with fatal consequences, it is the prescribing physician who is accountable to his/her patient and not the pharmacies.

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Whereas, it is our professional and moral obligation to give the best treatment to our patients, it is proper to maintain our right to choose what is deemed most beneficial for our patients. Hence, we protest any Bill that would deprive us from exercising our right to protect our patients with our intelligent choice of medicines, which is primarily based on our clinical assessment of the overall health condition of our patients.

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Whereas, we physicians believe that not all drugs are equal in terms of efficacy and safety, we are not convinced that the government has adequate resources and efficiency to monitor the bioavailability and bioequivalence of generic drugs, which would ensure a superior quality of commercially available drugs. If the goal of the bill is to make cheaper medicines available to the greater majority of Filipinos, prohibiting physicians from writing the brand name will not achieve such purpose.

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Whereas, since the Generic Law has been around for sometime, it has become an existing practice that if the patient cannot afford the branded medicines prescibed by the physicians, he/she has the option to ask for the cheaper brand. However, this provision merely opens the field to unscrupulous businessmen who are hungry to market drugs with questionable efficacy and safety.

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Whereas, we physicians are trained in evidence-based decision making, hence, prescribing our personal drug of choice is mainly on efficacy, safety, suitability and cost (in such order of importance). Choosing a drug should be based first on efficacy followed by safety and suitability, then lastly the cost.

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Much as we want to prescribe the most affordable medicine for our patients, cost is never the primary reason for choosing the right drug. It should always be the efficacy and safety of the drug that should be considered first. The cost is an added important consideration but should not be the sole basis for prescribing medicines. Establishing the good quality of a generic drug necessitates bioavailability and bioequivalence studies to determine its effectivity, suitability and safety.

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Until we are convinced that the government and our political leaders have fully understood the ideal concepts and principles of pharmacotherapy and have an unbiased implementation of the Generic Law, as far as efficiency in drug monitoring and quality control measures, we, physicians, continue to protest and be vigilant in guarding our professional rights and, foremost, the safety and trust of our patients.

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