Frankly, I don’t know where or how to begin. I had just submitted my Opinion Article for this week to this Paper but this Cheaper Medicines Bill which I have just been introduced to thru the really expensive 2 page Ads in the National Newspapers, the commentaries over the radio, and the interviews of my fellow Physicians, has just given me a HEADACHE!

        I just couldn’t force myself to keep ‘silent’ on this matter despite the obvious repercussions that this brief Opinion write-up will bring. Ever since, I have always believed in J.P. Morgan’s saying that “A man always has two reasons for doing anything: a good reason and the real reason”. So thru this simple Opinion Article I will try to discern the ‘REAL REASON’ for the fuzz that almost all of my colleagues in the Medical Profession are raising, and, hopefully get everyone, including myself, to come to a happy compromise. This is one of those rare times when I just can’t agree with bashing the Government or P.G.M.A., even if most people think that doing so will earn them a ton of ‘Pogi Points’!

        Let me start with some really unforgettable incidents when I was still in the early part of my medical practice:

        Sometime ago, in order to save time, I used to write a drug’s BRAND NAME (e.g. ‘Decolsin’, whose harmful side-effects wasn’t yet revealed then) ONLY in my prescription pad as the GENERIC composition was relatively long that I had to do away with it especially on days when we had S.R.O. (Standing Room Only) in my clinic. Alright, to give you an example, can you imagine writing: phenylpropanolamine HCL, dextromethorphan, and paracetamol, PLUS Decolsin countless times especially during Cough and Cold Seasons? Because of this I was formally reprimanded in black and white by the Regional Health Office in Legazpi City so I had to literally force myself to master most of the Generic Names of all the drugs I usually prescribe. I, subsequently, also decided to do away with the Brand Names of most of the drugs, if I could, owing to several patients’ complaints that they didn’t understand how the Government’s Generic Law could help them buy the meds that they needed when they were almost always made to buy such expensive branded meds. When I started prescribing and writing down ONLY Generic compositions of meds in obedience to the Regional Health big bosses, I got another unnecessary shock: the pharmacists or the drugstore clerks sent my patients all the way back to my clinic telling them to ask me to write down the BRAND name! Well, I told my patients to tell the clerks to give them the most affordable drug which had the same Generic Composition as the ones in my prescription; otherwise it would be a futile and time wasting exercise to still insist on writing down such long Generic Compositions when it’ll still be the more expensive Branded meds that will just be given!

        Of course, following the dictates of my CONSCIENCE, I required myself to explain to my patients that CHEAPER Generic Meds just might be a bit INFERIOR to the Branded ones, QUALITY wise, and that it might even take longer to get a complete cure with them. However, most of them just simply shrugged their shoulders and explained in the dialect: “duman nalang po kami sa BARATO maski medyo mahaloy-haloy ta mayo man kaming pangsustener sa mga mahal na bulong na iyan. Kaya po ngani nagribay kaming Dr. ta dai mi na po kaya magduman sa iba ta puro marahal na bulong na pigrereseta samuya”. Some also told me that even if it took much longer for these Generic Meds to take effect they didn’t mind as it was just like paying for an appliance—the longer the term, the cheaper and more affordable the installment! Sosmaryosep! How could I argue with these practical and brutally frank reasons? Most of them even complained that most of the Antibiotics that the other doctors prescribed were, no doubt, really good and effective BUT they could hardly even buy 1 tablet which costs about P85.00 EACH! “Mayo na po kami kakarakanon. Si Orig mi pinabakal mi na po ngani!”.

        Of course we have to classify our patients. As it is most of my patients come from the small towns and barrios all over the Province even spilling over to as far out as Burias and Masbate. These people have barely enough for the long trip to Naga City so it would be ‘mercilessly crazy’ for anyone to require them to buy meds which would eat up most of their Fare and Lunch money! Considering these people the exceptions rather than the rule just won’t take as they comprise the poor and hapless MAJORITY of the Lord’s flock.

        So from the foregoing we can see that it should not be the Doctors who should be complaining but the sick and suffering poor patients themselves. Forcing our patients to take advantage of the benefits of Branded Meds vs. Generic Meds just will not help. IF our Doctors insist on prescribing all those RELATIVELY expensive meds, there just might come a time when we will be plagued with overcrowded Hospitals and/or clogged Cemeteries! We doctors have the Hippocratic (not ‘hypocritical’) Oath to help remind us of the main purpose of our noble vocation.

        I personally don’t give a heck whether those multinational drug companies can afford to give BIG or small perks (which nevertheless still have to be added to their burgeoning annual BUDGETS, which, consequently, have to be recouped thru their PRICES) or whether these are just in the form of ballpoint pens or a sumptuous dinner complete with some drinks and ‘entertainment’, plane tickets to Manila plus 5 Star Hotel accommodations, or free roundtrip tickets to Hongkong or Paris, plus Hotel accommodations, or high-tech Appliances which most Doctors just can’t resist. What I care about is the fact that it’s our suffering patients who are caught in the ‘crossfire’ of this Generics War. The threatened Hospital Holiday is, to say the least, quite OUT OF CHARACTER for the Doctors to involve themselves in (besides it really is crazy to ‘not treat’ the sick just to be able to bring home a point). Despite all the ‘well funded’ Sound and Fury, in the Final Analysis, it will be all about a medicine’s EFFICACY vs. AFFORDABILITY (and consequently, COMPLIANCE). A 7 day anti-biotic regimen, which just cannot be complied with by our dirt poor patients will, indeed, be next to impossible, if they are prescribed terribly expensive meds, despite our prodding that they are infinitely better than the more affordable but relatively INFERIOR Generic Meds.

        We are here to CURE THE SICK MAJORITY not to help these big multinational medical companies SURVIVE. Of course, IF this revised Generics Act, requiring us doctors to do away with the BRAND NAMES of medicines, is upheld, most, if not all, of these multinational corporations, just might fold up and head for home. Consequently, we doctors will have to grin and bear the lonely prospect of coping with the daily monotony of just treating the sick, which is, by the way, our MAIN CONCERN. Forget the ballpoint pens, the free lunches and etc. We can still survive without them.

        As a compromise, we doctors should, instead, belabor the Government thru the Departments concerned, like the Food and Drugs Administration, the Department of Health, etc. to pass laws STRICTLY REGULATING the purchase and manufacture of these Generic Meds, in order to UPGRADE them and improve their EFFICACY. Laws should also be passed and enforced sternly PENALIZING the sale of FAKE meds. Ladies and Gentlemen of the MOST NOBLE PROFESSION, let us not get bogged down in this war of survival now being waged by these ‘multinationals’. The Herbolarios have been practicing their trade using ‘alternative’ herbal based medications, perhaps, much longer than any of us, and they have, surprisingly, been able to cure the sick; so have the Faith Healers. And to think that they have been able to ‘cure’ without even the benefit of any of these BRANDED OR GENERIC MEDS! So I guess, Ladies and Gentlemen of the MOST NOBLE PROFESSION, let us not allow ourselves to be ‘used’ as pawns in this ‘war’. Let the Multinational Drug Companies go straight to Congress and present their case for their own survival, and why don’t we Doctors just try to stick to the bottom-line: curing the sick?!