MeTA Launch in Philippines

Publication date: 2008

16 May 2008 Hon Francisco T. Duque Secretary Department of Health MeTA Philippines: Sharing Responsibility, Achieving as One MeTA * Country XMeTA 16 May 2008 THE MEDICINES ACCESS GAP * RP has low to medium regular access to quality medicines. Country XMeTA 16 May 2008 Challenges in the Philippines High cost of medicines Non transparent mechanisms of medicines pricing High out-of-pocket payments – burdening the poor and the disadvantaged Preference to branded medicines Country XMeTA 16 May 2008 Goal: Improve access to essential medicines by: Cutting the price of Medicines to 50 % from base prices in 2001 Reducing out-of-pocket payments Improving generic competition and assuring quality Instituting mechanisms for transparency and good governance Country XMeTA 16 May 2008 Basic Strategy Multistakeholder Collaboration Sharing Responsibility, Achieving as one through Country XMeTA 16 May 2008 Building MeTA in the Philippines Scoping Visit April 2007 TWG Meetings to form MeTA Structure May to July, 2007 Invitation and enlisting of prospective members July to September, 2007 Election of Officers November, 2007 Induction of Officers December 2007 Country XMeTA 16 May 2008 Who are involved? The MeTA Council 24-member Council Chaired by a former Health Secretary Policy Level Department of Health Senate House of Representatives Regulators and Service Providers BFAD Philhealth COA PITC LGUs Private Sector Involvement Professional Groups Academe NGO’s CSO Watch Groups International Development Partners WHO Worldbank EU, GTZ Industry Few MNCs PCPI ( Philippine Chamber of Pharmaceuticals, Inc.) Country XMeTA 16 May 2008 How do we work? Country XMeTA 16 May 2008 Integrating MeTA Support into Local reforms Health Reforms: Fourmula I for Health (F1) Service delivery Financing Regulations Good Governance MeTA Transparent Processes Assessment and Technical Support Development of systems for proper resource management and building sustainable financing models Improved access and support to decentralized systems Country XMeTA 16 May 2008 *www THE HARD CLIMB TO AFFORDABLE MEDICINES FOR ALL www.aafp.org GENERICS ACT of 1988 failed to anchor generics in the local market PARALLEL DRUG IMPORTATION cheaper drugs from India brought in competition against expensive branded products (up to 70% reduction since 2001) COMMUNITY DRUG OUTLETS - >12,000 Botika ng Barangay outlets spread out nationwide - >1,400 Botika ng Bayan outlets in major cities CHEAPER MEDICINES BILL Parallel importation Compulsory Licensing Amendments to the IP Code Early Working (Bolar Provision) Generics competition BFAD STRENGTHENING BILL - Beefing up capital and human infrastructure of BFAD to meet international standards in quality and safety assurance AFFORDABLE TREATMENT PACKS - Complete OPD treatment packs for hypertension, high cholesterol, diabetes and common infections at P25/50/100 Country XMeTA 16 May 2008 * MeTA * Thank You Country XMeTA Title of presentation Title of presentation * MeTA * Other Ministers of health, delegates to the WHA Assembly, Distinguished guests, ladies and gentlemen. The Philippines is very much honored to share with you our country experience in launching the Medicines Transparency Alliance initiative in the country. We are also happy to join the MeTA Secretariat headed by the honorable UK Secretary of State for International Development and the entire World Health Organization in this 2nd Launching of MeTA here in Geneva. I thank them for their commitment to bring quality medicines for the poorest people and for choosing the Philippines as a pilot country in helping governments build capacity, transparency and good governance in medicines policy and regulations. MeTA Title of presentation The growing crisis in medicines in developing countries is well known. Based on the 2004 publication of the World Health Organization (WHO), the World medicines Situation, as many as 2·5 billion people are estimated to have little or no regular access to essential drugs. This is precisely why the Millennium Development Goals, MDG 8 in particular, has as one of its targets, ‘to provide sustainable access to essential drugs in cooperation with pharmaceutical companies.” Based on this 2004 publication, the Philippines is among the 64 countries with low to medium regular access to at essential medicines (defined as continuously available and affordable at a health facility or medicines outlet, within one hour’s walk from the patient’s home). 66 percent of Filipinos had regular and sustainable access to drugs. * MeTA Title of presentation In the Philippines, we recognize that access to essential medicines is a basic human right, and that it must be urgently addressed. We are aware however of the wide range of obstacles to adequate access to essential medicines,these are: The high cost of medicines - the multinationals in the country corner around 75% of the supply in terms of volume, and such market monopoly has contributed to the high prices of medicines. The 2006 WHO/HAI survey for instance, showed that the prices of medicines in the Philippines are 3.4 to 184 times higher than the international reference prices Non-transparent pricing of medicines - We have a very little idea, how medicines are priced in the country, how much transfer costs are put by the multinationals and how much mark-up is put as medicines go along the supply chain High out of pocket payments - Currently, out-of pocket expenditures on drugs typically fall in the range of 18-55% of health in developing countries including the Philippines. Preference to branded medicines - Irrational drug use among both medical practitioners and consumers is a problem in the country as anywhere else in the world. Doctors may choose to prescribe branded products not necessarily based on the best evidence but favor certain brands because of intensive marketing strategies by Industry. Likewise, patients may self-prescribe or favor certain brands as prescribed by their physicians without a cost-effectiveness basis. MeTA Title of presentation What are our medium and long-term goals in improving access to essential medicines in the Philippines ? These are Cutting the price of Medicines to 50 % from base prices in 2001 Reducing out-of-pocket payments Improving generic competition and assuring quality Instituting mechanisms for transparency and good governance MeTA Title of presentation The achievement of these goals, calls for a shared responsibility between the government and the private sector. Sharing responsibility and delivering as one is therefore the reason for the Medicines Transparency Alliance’s being in the Philippines. Access to medicines after all is everybody’s business, and all of us need to be engaged and committed The Medicines Transparency Alliance was formed in the context of this idea- to form a multistakeholder collaboration to engage everyone in the task of providing access to medicines for all. The multistakeholder approach is not very new in our country, and forming one in the area of medicines is an affirmation of our belief in such approach. While the government is exhausting its best effort to deliver its share in making essential medicines accessible to our people, MeTA will challenge other stakeholders to do their part. It shall forge a national alliance and stir a national conscience to move the access to medicines agenda beyond political and commercial interests. It shall provide the venue for a strong public debate, introduce innovative approaches and help implement reforms in the area of pharmaceuticals. MeTA Title of presentation The work of MeTA in the Philippines started in April 2007, when DFID and WHO sent Ms Loraine Hawkins and Dr Guitelle Baghdadi Sabeti to explore the possibility of the Philippines’ becoming a pilot country. Immediately after, the WHO Office of the Representative in the Philippines, serving as the in-country coordinator, engaged the Department of Health to form a multistakeholder collaboration, involving the government, the private sector, academe, professional groups, international development partners working in the country and non-government organizations. The MeTA Council was then officially inducted into office during the Launch and the First National Forum for Transparency in Medicines held in Manila in December 2007. The Council is seen as a highly respectable and formidable group, with Dr Alberto Romualdez, a former Secretary of Health, serving as Chairman.   MeTA Title of presentation The Medicines Transparency Alliance in the Philippines involves the government, the industry and the civil society. It shall work to improve access to medicines by building a transparent and an accountable health system. It shall help improve the existing health infrastructure for an evidenced-based decision making, highlight good practices, and measure the results and impact of our performance. Four agencies of the government lead by the Department of Health are fully involved in the MeTA process. Others are the Bureau of Food and Drugs, the Philippine Health Insurance, the Commission on Audit and the Centers for Health Development in the Regions. The private sector includes medical professional groups, the academe, NGOs and CSO (civil society) watch groups. The Worldbank, the EU and the GTZ on the other hand have been fully engaged in the MeTA process as in the overall health sector reform of DOH. We also intend to expand this collaboration and partnership with the industry in accordance with the target on the Millennium Development Goal No 8, which is to improve access to medicines in partnership with the pharmaceutical industry. Presently there are few MNCs invloved which include the Philippine Chamber of Pharmaceuticals Inc. MeTA Title of presentation Our MeTA council is already fully operational, meeting regularly each month and conducting business as a collegial body. The Secretariat is lodged at the WHO Country Office. The Council is composed of three distinct Committees which have in the past months conducted a series of technical discussions with the academe, professional groups and the civil society on the issues surrounding medicines and crystallizing recommendations for the government and other sectors to act upon and support. MeTA Title of presentation The Medicines Transparency Alliance shall work to improve access to medicines by building a transparent and an accountable health system in line with parallel efforts to strengthen the health system through the Fourmula One Health Sector Reform Agenda. The Fourmula 1 for health, which includes the pillars of service delivery, good governance, financing and regulations, is a health systems approach that is anchored on the basic framework that a well-functioning health system must ensure equitable access to essential medical products, vaccines and technologies of assured quality, safety efficacy and cost-effectiveness, and their scientifically sound and cost-effective use. It also works on the premise that transparency and good governance must be instituted to make health systems reform work for the health welfare of the Filipino people. MeTA can greatly help by improving the existing health infrastructure for an evidenced-based decision making, highlighting good practices, and measuring the results and impact of our performance. MeTA will help to continually assess and monitor prices of medicines for example and look into how our regulatory, selection and procurement processes reach the standard of good practices. Moreover, MeTA will also help us to develop linkages with the industry to enjoin them to participate in these assessments. MeTA Title of presentation The Medicines Transparency Alliance in the Philippines will be a significant leap forward in the country’s effort to make quality drugs and medicines affordable for Filipinos. The timing of its launching in our country very opportune in that low-cost medicines is a primary agenda of Government. It is a continuing Government advocacy, with efforts that have begun even before the current Administration. Let me give you a general picture of how the politics for essential medicines is currently taking shape through efforts of the National Government. In the pursuit of equity, especially for the poor, one of the priority programs of the President and the DOH is the Low-priced Medicines Program. This is according to the objective of the MTPDP to "reduce the prices of medicines commonly bought by the poor to half of their 2001 levels by 2010,“ as directed by PGMA. To help address this problem, the government adopted measures to reduce the cost of medicines. For instance, in 2000, the Department of Health (DOH) and PITC initiated the Parallel Drug Importation Program (PDIP) to reduce the costs of essential medicines by up to 70%. These generic drugs are now made more available and affordable to our people at nearly 11,000 BnBs scattered in different communities all over the country In addition, DOH together with the Philippine International Trading Corporation (PITC) launched in December 2004 the Botika ng Bayan (BNB) project to set up a nationwide network of privately-owned and operated accredited pharmacies that shall sell low-priced PDI or generic drugs in competition with commercially priced medicines in the market. With the deemed passage of the Cheaper Medicines Bill and the BFAD Strengthening Bill, the pharmaceutical landscape of the Philippines will drastically change hopefully effecting a massive decrease in drug prices. DOH will also launch very soon the P25/50/100 project which aims to make available complete treatment packs for hypertension, diabetes, high cholesterol and common infections at very affordable prices. * MeTA Title of presentation Title of presentation * MeTA * To end, the goal towards making access to medicines available to our people is a continuing endeavour. We are confident that the Philippines is on its way towards achieving this especially with the support coming from MeTA. We are fully committed to the ideals of accountability and transparency in the management of the Medicines Program. Good governance is a pillar of our health sector reform. And I can say the the Philippine Department of health has the formidable ground and a high morale leadership in stirring the Medicines Transparency Alliance in the Philippines. In the past three years, we have worked hard in establishing an efficient and transparent health system and we have been consistently recognized as the leading government agency in terms of integrity development and fighting wastages and corruption in our processes By working together with actors coming from both government and outside government…by promoting a multistakeholder approach in creating a transparent and accountable system for Medicines… we can bring the access framework into the forefront of our governance and the access to essential medicines closer to our people. Thank you. MeTA

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