CHEAP OR not, one problem with generics is that “quality is a little bit more difficult to control,” admits avid generics supporter Romualdez. “But,” he adds quickly, “it can be done with BFAD equipped with the proper people and technology.”

Table 4: Top 20 Ethical/Prescription Drugs Source: May 2006 IMS Drugstore and Hospital Sales *off-patent **local company
RANK	DRUG NAME	SALES (January-May 2006, in +000 PhP)	MANUFACTURER/DISTRIBUTOR
1	Ventolin*	1,401,196	GlaxoSmithKline
2	Norvasc	1,190,016	Pfizer
3	Augmentin	801,850	GlaxoSmithKline
4	Plavix	731,852	Sanofi-Aventis
5	Plendiler*	672,874	Astra Zeneca
6	Zinnat	558,730	GlaxoSmithKline
7	Lipitor	554,618	Pfizer
8	Cherifer*	508,480	Intermed Marketing**
9	Neobloc*	504,607	GX International**
10	Diamicron*	460,620	Servier Phils.
11	Seretide	438,928	GlaxoSmithKline
12	Tazocin*	431,953	Wyeth
13	Unasyn*	426,979	Pfizer
14	Ponstan*	410,962	Pfizer
15	Nexium	404,711	Astra Zeneca
16	Ciprobay*	403,607	Bayer Pharmaceuticals
17	Zegen*	366,882	United Laboratories**
18	Imdur	360,214	Astra Zeneca
19	Vastarel	355,959	Servier Phils
20	Zithromax	353,549	Pfizer

BFAD, however, is severely undermanned. Compared to the 44,333 licensed establishments it regulates, the agency has only 220 food and drug regulation officers (FDROs) nationwide. Of 48,416 registered products, the central office has only 32 evaluators, or a ratio of one evaluator for every 1,513 products.

The good news is that BFAD expects its request for an additional 400-plus staff approved soon. “We should be following the optimum ratio between the number of employees and the products and establishments we regulate,” says Ramos, “so that we maintain the credibility of the seal or certificate that we award to them.”

“The government should ensure that generic drug competitors are credible and viable,” insists Banzon. Once that happens, doctors and their patients may stop looking at brands and price tags, as in the case of Neobloc, a generic equivalent of the high-blood pressure medicine Betaloc (Astra Zeneca brand for metoprolol tartrate).

Neobloc, which is manufactured by GX, has been able to capture a healthy share of the market, says Banzon. “If there is credible competition,” he says, “people will definitely go for the cheaper product.”

In the meantime, the government has been trying to offset the imbalance in generics distribution with its “Gamot na Mabisa at Abot-Kaya (Effective and Affordable Medicine)” program. Aimed at halving the 2001 price of selected drugs by 2010, the program has included parallel drug importations by the Philippine International Trading Corporation (PITC) benefiting 72 DOH hospitals and three local government units.

Botika ng Bayan and Botika ng Barangay outlets nationwide to ensure accessibility and availability of low-priced quality medicines have also been set up. As of last July, Botika ng Bayan branches — full-blown pharmacies located in cities and municipalities — have reached 1,135. Botika ng Barangay outlets, which are limited to generic over-the-counter drugs and a few selected prescription drugs, now number 7,004.

The PCIJ tried but failed to interview the Pharmaceutical and Healthcare Association of the Philippines (PHAP), which has multinational drug companies among its members, in time for this article. PHAP, however, has been quoted in other media reports as saying that forcing its members to lower prices “would discourage innovation in an industry where innovation is key to discovering new cures for new diseases.”

"Losses that will be incurred by the pharmaceutical industry,” it said, “which may translate to profit for the generic drugs industry, would, in the end, prejudice consumers in the form of less investments and research and development of better medicines."

Interestingly, PHAP has also said that the way to reduce medicine prices in the country is through strict implementation of the generics law, not through parallel importations. It did not, however, elaborate any further on that.

UPDATE