Transcript of interview with Sen. Pia Cayetano on the status
of Cheaper Medicines Bill

SPSC: Kagabi po nag-bicam kami, ang Senate at ang lower house tungkol dun sa cheaper prices of medicine. Halos lahat namn ng probisyon napagkasunduan naman na, ang medyo naiiwan na lamang po ay ang generics only provision. Hindi pa po kami magkasundo ng House kung paano ang magiging final na provision nito, sa aming pananaw sa Senate, importante na hindi po tayo gumawa ng bagong problema dahil ang kailangan po natin ay solusyon. Kinakabahan po tayo na sa ating nais na makahanap ng solusyon na mapromote talaga ang generics, we want that this would be studied in our committee hearings extensively so that we do not create another problem. So this is the problem that we face right now, dahil iba po ang posisyon ng House at ng Senate. The House wants to propose a generics only provision, ang ibig sabihin nun, ang ipeprescribe ng doctor ay generics lamang at hindi siya pwedeng magprescribe ng branded. Ang gusto naman naming sa senate is ma-retain yung dating probisyon dahil sa tingin namin ito ang pinakamagandang paraan sa ngayon na mapromote nag generics.

Q: Ano po yung existing provision?

SPSC: Ang existing provision natin sa batas ngayon ay required na ang mga doctor na maglagay ng generic name, pagkatapos pwede na siyang maglagay ng brandedkung gusto niyang magrecommend sa pasyente. Ang proposal ng House tanggalin itong authority ng doctor na maglagay ng branded, ang gusto nila, purely generics lang. ang posisyon ng Senate diyan, magandang tignan kasi ang unang impression diyan ay supportive of generics, dahil sa walang brand, ang effect is mapupush ang generics. Precisely why the Senate did not take this out of the Cheaper Medicines Bill, headed by the chair on the committee on Trade, is because this is a serious health issue which we felt should be dealt with in health hearings with extensive hearings with experts. Marami hong effect ito, kapag hindi naglagay ng brand ang doctor, at hindi na ang doctor ang magrerecommend sa kanyang pasyente ng brand, pagdating ng pasyente sa botika, kapag tinanong niya ang generic kung ano ba ang pwede diyan, salesgirl na ang kadiskusyon niya, hindi na po doctor. At madalas ho, hindi pharmacist ang kaharap niya. Alam naman po natin kapag bumibyahe tayo sa mga probinsya, hindi na pharmacist ang tumatao sa mga botika. Doon din pos a malalaking botika, eh kadalasan ang mga pharmacist ay nasa likod po. Ang concern natin is it is better that the patient has the opportunity to discuss what medicines he should take with his doctor at hindi po doon sa botika na salesgirl na lang ang kaharap niya. And there are so many issues that will come about dahil mashishift po ang lobbying sa drugstores, and do we even consider that, there are some drugstores that have their own generic brand, so chances are, yung brand na nila ang mai-pupush. Ang sa atin lang naman talakayin po natin iyan sa forum na we have more time, huwag ho natin sana nating ipilit na masama ito sa cheaper medicine bill ngayon para pumasa na itong main portion nitong cheaper medicine bill which is parallel importation.

Q: So there should be a separate bill?

SPSC: that has been our position, and we really have full respect sa position ng House dahil pareho naman ang motibo natin eh, na ipush ang use ng generics. Ang sa atin lang po what is the proper method. Iyon lamang po ang pakiusap ko na we'll have more patience to study this issue more carefully kasi madali hong sabihin na eh bakit sa ibang bansa, malakas ang generic, ditto kulang pa tayo sa pagsupport sa generics. Kasi po iba din ang sitwasyon sa ibang bansa. Kaya malakas ang generics ay dahil may malaki silang buyer ng generics. It's the state. Yun hong mga bansang effective ang generics mga socialized countries iyon where the state is the biggest buyer of generics. So pagbili ng state, tapos meron silang universal health coverage, yun na agad ang bibilhin ng tao, yung generic na pumasok na sa kanilang mga regulatory agencies. Their whole system is already set up and that's what we want for our country. Gusto ko po na ang makarating na gamut sa ating mga kababayan ay hindi lang muna, kundi quality. Quality na mura pa. we cannot rush that process. Nakikiusap ako ng patience na talagang mahimay natin yung issues na ito.

Q: Sa price regulation, may problema po ba?

SPSC: the price regulation provision seems to be good, seems like there has been an acceptance of the secretary of health to be the sole kumbaga who will have the authority to make recommendations to the President. That issue seems to have been resolved. It will be the secretary of health who will have to look into issues and regulations of prices, hindi na board.

Q: So iisa na lamang yung isyu na pinagtatalunan niyo?

SPSC: Yes. Medyo yun ang naiwan. But like I said, talagang pareho ang objective naming yung how to reach that solution nga to push the generics law further. That is what we want to achieve, but ang feeling lang namin sa Senate, medyo band aid solution if you would just say na tanggalin sa doctor ang pagsusulat ng brand, because not a single resource person said that that provision will ensure the success of generics, that provision alone will not. If it will open the doors to prevent a name of a brand to be put there, but it doesn't mean that there will be more support for generics.

Q: is there a strong opposition from the house for a separate bill filed on these generics?

SPSC: Parang, because in fairness to the House, eager naman talaga sila to push for the generics, which we are too, but their position is from what I understand is let's do it now or let's have a sunrise provision, ang sa akin naman po, I have a list of the bills that we have to look at, and I'm looking at like nine different issues, health financing, universal coverage ng ating Philhealth, I'm looking at (?) of government hospitals to make them more efficient, like PGH, NKTI, Phil. Heart Center, we're looking at amendments of the pharmacy law, BFAD restructuring, amendment of the generics law, looking into the issues of our human health resources. Lahat po iyan kabit-kabit, and so we need to look at this holistically which is why we feel it should be tackled immediately but separately. We would like the generics issue to also be looked into intensively.

Q: What's the next step for the bicam?

SPSC: to find a solution nga on the last provision.

Q: So parang deadlock po kayo dito?

SPSC: Kagabi lang naman, but we had a very free flowing discussion so I'm hopeful na there were proposals that have been made, I'm hoping na out of these proposals we can really also come into a solution. But I have made a commitment na ihehearing ko lahat ng bills na ito, to make sure that all the pillars that we need for a strong and long lasting health reform system are in place kasi the Cheaper Medicines alone, yung parallel importation is not enough.

Q: So matatagalan pa ba ito?

SPSC: Hindi naman, isang provision na lang naman. I'd like to focus on the positive, yung ganyang kakapal na bill eh ok na halos lahat. We have the same objective naman, its just a matter na pano tayo makakarating doon to ensure not just cheap medicine, but quality.

Q: What were the proposals and counter proposals last night...

SPSC: Yun nga yung proposal ng House is magkaroon ng sunrise provision such that, within three years, maging automatic na itong generics only provision. May concerns pa rin tayo doon, there are certain scenarios that we may not predict, that we cannot assume will be gone in three years. For example, yung decision as to what medicine will be chosen by the patient will be left to the patient and the pharmacist, do we realize that we already have a shortage of pharmacists? Even BFAD is having trouble hiring pharmacists. We know very well na in small drugstores walang pharmacists diyan. Ang proposal ko nga even if we have a joint hearing on all these issues, I will do that para ma-expedite yung ibang bill.

Q: Senator, what is stopping them na iaccept yung main provision muna ang ipasa...

SPSC: I know that they are very eager to do what can be done to push generics. We feel lang, that the bill should be studied extensively kasi ang hirap magbigay ng solution na baka naman band-aid lang yung effect na kelangan naman operahan ng konti.

SPSC: Ang sa akin lang naman I need to study this in a hearing, lahat ng resource person Makita natin ano ba repercussions nito. Yung lang naman sa akin, I'm not saying no to anything. Let's assure our people we owe them quality medicine, so we owe them quality time to study these effects, these repercussions.

Q: Have you ever considered that this generic only provision can be a Trojan horse?

SPSC: Yun nga ang concern ko sa senate, kasi initially, ang impact sa tao, generics only eh di ok tayo pero andami ngang repercussion na hindi natin nakikita na baka magback fire sa atin. That's why hiling ko na mapag aralan ito separately at the committee level at the committees on health of both houses.

ON JPEPA

Q: Sa environment committee, nuclear up na ba ang environmental concerns?

SPSC: Sa akin hindi na clear up iyon

Q: Are you going to change your position?

SPSC: No. there were enough conflicting provisions that were shown to us that if indeed the intention was for us to strengthen to have the preventive measures in place against the environmental issues, and even the trade issues, it could have been done. It was so lousily negotiated. Para tayong nagnegotiate tayo ng patalo and I know the repercussions, I'm familiar that we have a lot at stake, but at the end of the day, this should have been negotiated the proper way. Its not fair to the people na we say, eh wala eh let's just do it because nandyan na iyan. I don't think that's right.

Q: You don't share the position of Sen. Roxas?

SPSC: I've read his position and I have full respect for it. Very similar yung position ko except that as the chair of the committee on environment, I'll take the stand na hindi talaga.

SPSC: I feel strongly about the fact that there's a lot at stake, why didn't the negotiators think of that when they were negotiating it and ensure that we got the best out of it so we don't feel like being thrown some leftovers.

Q: Anong impression ninyo sa unity walk kahapon ni Presidente at ng kanyang cabinet members?

A: Let's see, when push comes to shove, will they run together? It's easy to walk