- The Washington Times - Sunday, June 25, 2006

MANILA — Stroke survivor Edmund Lising is supposed to take four tablets of two medicines each day, including the anti-hypertension drug Norvasc. But to save money, the 58-year-old retiree takes only two a day, supplementing the dose each time with a fervent prayer.

Mr. Lising is luckier than most Filipinos. According to government statistics, 70 percent of the 85 million Filipinos have no regular access to lifesaving drugs.

Next to affluent Japan, the cash-strapped Philippines has Asia’s second-most costly medicines, with some drugs priced five to 45 times higher than the same medicines sold in India or Pakistan.

Fed up with the situation, officials, consumer groups, health workers and fair-trade advocates have organized Effective Medicine at Affordable Prices, a coalition seeking to have pharmaceutical companies cut the staggering cost of medicines in this country. The group backs legislation that would make it possible to import cheaper drugs and encourage production of generic drugs.

The campaign began as the Philippine government battled the pharmaceutical giant Pfizer Inc., seeking to import cheaper Norvasc from Pakistan.

In March, Pfizer sued two government agencies — the Philippine International Trading Corp. (PITC) and the Bureau of Food and Drugs (BFAD) — on charges of patent infringement.

Pfizer’s case

Pfizer asked a suburban Manila court to order BFAD to revoke an approved import registration for the anti-hypertension medicine covered by the drug maker’s patent. The 17-year patent expires next June.

Roberto Pagdanganan, head of PITC, said his office submitted 80 sample tablets from Pakistan last year to BFAD so the government could be ready to import the cheaper medicine after Pfizer’s patent expires.

Mr. Pagdanganan said a 5-milligram tablet of Norvasc sells for 86 cents in the Philippines, nearly five times as much as in Pakistan, where it costs 19 cents. Another Pfizer brand, the painkiller Ponstan, costs 14 times as much in the Philippines as it sells for in Pakistan.

Pfizer’s case has angered officials and consumers in the Philippines, where a third of the population lives in poverty and where hypertension is a major killer.

Government data show multinational drug companies supply 70 percent of the estimated $1.9 billion Philippine pharmaceuticals market.

Rep. Ferjenel Biron, in a speech to the Philippine House of Representatives, recently called for a boycott of Pfizer products. He accused the company of “persecuting millions of Filipinos who simply could not afford to buy the said medicine and are left with no choice but just to die.”

Innovation vs. greed

Pfizer said its actions upheld the importance of encouraging innovation by protecting intellectual property of companies that discover and develop lifesaving drugs.

“This is simply a matter of protecting our patent for amlodipine besylate (the chemical name of the drug sold as Norvasc) through its expiration date of June 2007,” Pfizer said. “We are seeking legal assurance that there will be no importation of an unauthorized amlodipine besylate product for the duration of this patent term.”

Mr. Pagdanganan called the Pfizer suit “a harassment case” and filed a countersuit.

“It’s greed and arrogance,” he said.

Mr. Pagdanganan said it takes more than a year to get import approval from BFAD, so by suing, Pfizer is effectively extending its patent. Every year’s delay in the entry of the drug from Pakistan translates into $23 million in Pfizer sales of Norvasc in the Philippines, he said.

Mr. Pagdanganan said PITC has not sold a single amlodipine besylate product in the Philippines and has promised not to do so until Pfizer’s patent expires. The only issue, he said, is whether importing samples of patented drugs for registration purposes constitutes patent rights infringement.

The practice is allowed under the “Bolar Provision” of the World Trade Organization’s (WTO) trade-related aspects of intellectual property rights, known as TRIPS. But the provision is not spelled out in the Philippines’ Intellectual Property Code.

TRIPS also allows countries to do “parallel importation” of a medicine, sold at a cheaper price in another country, even without the approval of the patent holder.

Obstacles abound

Philippine officials blamed the country’s high drug prices on a pharmaceutical marketing and distribution cartel, the myth that cheaper generic drugs are less effective, a patent system skewed in favor of multinational companies and heavy dependence on imported raw materials.

“The system has been so co-opted, if not corrupted, by some of these companies that the people are not left with so much choice,” said Mr. Pagdanganan, whose office aims to cut in half by 2010 prices of medicines commonly bought by the poor.

Sangeeta Shashikant, a researcher for the Third World Network, a Malaysia-based nongovernmental organization, said that big pharmaceutical companies often have a monopoly of patents and that frequently there is not much innovation to add to the cost, because drug companies are able to obtain new patents for only slightly modified versions of a drug — a practice known as “evergreening.”

A World Health Organization report in April said that in developing countries with inadequate technological capability, the fact that a patent can be obtained may contribute nothing or little to innovation. “Patents may contribute to increasing the prices of medicines needed by poor people in those countries,” the report added.

Local laws faulted

Jim Nibungco, a stroke survivor and officer of the Stroke Survivors Support Foundation, said he has seen so many stroke survivors unable to buy the medicines they need.

“Once they see the price of the medicines, they just close their eyes because they could not afford to buy them,” he said.

The coalition for cheaper medicine supports a bill that would amend local patent laws to keep them in sync with WTO rules, including clearly allowing parallel importation of drugs. The bill has been endorsed by a joint Senate committee for plenary approval. An aide of the main proponent, Sen. Mar Roxas, said the bill has the support of a majority of senators and may reach the Senate floor by next month.

The bill also seeks to shorten the period of patent protection, empower the local generics industry to experiment on drug formulas even before their patents expire, and deny new patent protection for slightly modified versions of a patented medicine.

PITC said the government will put up more “people’s drugstores” selling cheaper medicines to provide competition to big pharmaceuticals. Price controls for off-patent medicines and a cap on spending for pharmaceutical advertising also are being considered.

Proponents of the bill said it has a good chance of being passed. A majority of the senators, including Senate President Franklin Drilon, have signed the bill as co-sponsors.

Mr. Nibungco said he hopes that with passage of the bill, poor Filipinos will be able to buy the medicines they need.

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