Prior to the pandemic, the Philippines was experiencing unprecedented economic expansion. We were growing at the rate of 6% year on year for eight straight years.
And then COVID-19 hit us in 2020. At that time, we were plunged to a 9.6% contraction, one of the highest we’ve ever experienced in a post war era.
In the Philippines, millions were affected, but globally, the dislocation that resulted from the pandemic affected billions. Many countries got into unprecedented debt levels.
Worldwide, as of Nov. 16, 2023, there were 772 million COVID cases, according to the World Health Organization (WHO). Of these, around seven million were deaths.
The figure would have been much more if vaccines were not discovered in time. One study showed that in the first year of the pandemic alone, vaccines saved roughly 20 million lives.
Every day, the “power of innovation” surged through the life of each nation around the world. It could be seen in the vaccines administered to children and even infants, which resulted in the massive decline in the levels of vaccine-preventable deaths in the country.
The “Power of Innovation” itself is felt when we—as a country that is continuously evolving and developing—is able to fight our non-communicable diseases composed of cardiovascular metabolic diseases and cancer.
BREAKTHROUGHS
We now have the medicines to be able to address that. And at the same time, we see it when everyday infections that cause morbidity are able to be addressed successfully by our doctors because of the breakthrough medicines that are now available.
PHAP and its members have always been committed to a patient-centric approach. And that is why we have a variety of vaccines, prescription medications, supplements, diagnostics that we continuously bring to the market in an effort to uplift the quality of life and the health of all Filipinos.
As a result of this, we have one of the biggest industries in the country and we account for PhP238-billion in sales annually, as measured by IQVIA last year. And this figure is split equally between the multinationals as well as the local companies in the country.
Drug development is a risky proposition. As early as 2017, it was estimated that the cost of developing one drug can run up to $2.6 billion. It takes about 14 years to discover a drug and out of 10,000 molecules that are reviewed globally, only one or two will eventually make it to a medicine.
The financial cost of failure for pharmaceutical companies is steep. However, the safeguards around pharmaceutical development exist. And as a result of that, it continues to encourage many pharmaceutical companies to continue placing bets on molecules that will eventually, continuously fight the diseases that we encounter, COVID included.
In fact, we’re able to find out that innovative medicines do not just provide medications for the here and the now, but they also provide the proper blueprint for eventually the development of quality, safe, generic medication that can be made available to a much bigger part of the population.
INNOVATION & ACCESS
However, innovation and access to medicine need to go hand in hand. In the Philippines, it is measured that about PhP85 out of every PhP100 spent is paid for out-of-pocket expenses. This is one of the highest, particularly when you compare it against countries like Malaysia (45%), South Korea (42%), New Zealand (32%), and Thailand (9%).
PHAP has been working very hard through many of the decades that it’s been in existence in the country. It has worked hard during the time of the pandemic, and it remains an ongoing story.
Over the last 78 years, since PHAP was established on July 3, 1946, its work has been a testimony on how innovation—when brought into the market—can continuously uplift the lives of many Filipinos and at the same time contribute significantly to the development of the economy.
During the time of the pandemic, our partner members brought about 179 million doses into the country, either directly or via the COVAX facility.
Our pharmaceutical members like Pfizer, AstraZeneca, J&J, and Moderna were instrumental in the fight against COVID in the country.
And the innovations were not just about the vaccines. It was also about the testing kits that were made available by companies like Roche and Abbott. These kits were really critical at the beginning when we had to be able to measure the extent of infection in the country.
Digital technology was a major part of the whole process. Companies like AC Health, Zuellig, created apps that were able to help consumers monitor when they’re supposed to take the vaccine. They were able to monitor and report back if they had any adverse reactions.
Digital technology was also very powerful in helping many of the LGUs administer their own vaccination campaigns.
While there were things happening on the digital front, as Paolo (Borromeo) had already mentioned, many of our partner retailers kept open throughout the whole pandemic. Companies like Mercury Drug, Watsons, Generika, and TGP opened their doors and used innovative techniques to be able to make vaccines as accessible as possible to the whole population. We didn’t have to go all the way to vaccination centers. We could go to our nearby retailers, nearby drugstores, to be able to get vaccinated.
FIGHTING DISINFORMATION
Throughout the whole COVID-19 pandemic, one factor that was equally making it difficult for us to fight the virus was the massive amount of disinformation, particularly on social media.
PHAP played a very important role working with the DOH to be able to combat disinformation campaigns and to provide proper information about the vaccines; about the concerns on adverse events.
We communicated this continuously, not just to healthcare professionals, but equally to patients as well. And of course, while the battle against COVID had the vaccine as the lynchpin, it was equally important to be able to have antiviral medication available. Again, companies like MSD, Roche, and Lilly, very quickly responded, mustering supplies from different parts of the world to be able to bring it to this country. And this is really where innovation is extremely important.
Equally important is the bayanihan spirit that brought all of these vaccines, all of these medicines, all of these COVID testing kits into the country at the time when we needed it the most.
PHAP, though, was not just about fighting the COVID virus. PHAP has always been advocating for the patient. PHAP has always been at the front and center of making sure that whatever innovative vaccines become accessible to Filipinos.
NOT JUST AFFORDABILITY
One thing we must remember, though, is that access to medicines is not purely about affordability. While affordability is important, there is a complete spectrum that we need to be aware of.
AWARENESS. PHAP has been working very closely with the Department of Health to be able to increase awareness across the broad population. We are a major part of Healthy Pilipinas, a disease education campaign that goes on all year round to be able to talk about problems on cardiovascular diseases, diabetes, and lung diseases. These are very important educational materials conveyed to the masses of Filipino patients in a manner that is easy to understand.
ACCEPTABILITY. In the Philippines, as an emerging middle-income market, what we are seeing is the shift that is already being experienced—where you see in terms of total prevalence, infectious diseases are coming down.
On the other hand, we’re seeing an increase on non-communicable diseases which include cardiovascular, and of course, cancer. Over the past five years alone, PHAP and its members have introduced over 200 medications and at least 50 new ones were launched only over the past two years. Of these 50 new ones, quite a number of them address our biggest problems which are respiratory, cancer, diabetes, and cardiovascular diseases.
For cancer diseases alone, 13 new drugs were registered last year to be able to help address this increasing problem in the country. Definitely, affordability is a very important part of access. PHAP continues to work with a lot of government institutions, including the DOH, to be able to talk about how pooled procurement can in fact bring down the cost of medicines across the whole country—both in the private and, more importantly, in the public sector.
ACCESSIBILITY. This can also be measured in terms of how far our quality, safe medicines go into the deepest parts of the country, particularly Geographically Isolated and Disadvantaged Areas (GIDA).
There are about 10,875 barangays all over the Philippines. For quite a number of these barangays, retailers, like the generic pharmacies, are going out of their way to be able to help entrepreneurs set up franchisees to be able to ensure that safe, quality, and effective drugs are available.
Genuine drugs continue to be a problem at the grassroots level. This is one of the things mentioned by Secretary Carlito “Charlie” Galvez, who was then the Vaccines czar in the fight against COVID. Today, he is a major part of the Cabinet that addresses the Bangsamoro Republic, an area he underscored as requiring the greatest amount of help.
PHAP members are responding to the call. The PHAPCares (Foundation) creates programs to constantly increase even the most basic hygiene standards among our Filipino countrymen in GIDA.
It is one thing to get prescribed a medication. It is yet another to be able to stay on medication so that a patient is able to fully benefit from improved health outcomes.
The book that will be distributed later by PHAP discusses countless patient access programs and patient support programs made available by the multinational organizations to make sure that drugs for our needy Filipinos are within reach. All one has to do is to participate in these programs with the guidance of your healthcare professional.
UHC
Finally, we need to be aware that in a self-pay market like the Philippines, non-government organizations play a very, very important role.
We need to constantly push the agenda for many of our patient groups who are not able to do so themselves. The fight for creating a voice in society is something that PHAP takes very seriously. One major advocacy of PHAP and its members, for example, is the fight against cancer and rare diseases.
Universal Healthcare is something that is being championed by the government and it needs many local partners, many players in the pharmaceutical sector. PHAPCares is now expending effort to start the pilot of many UHC programs in different parts of the country.
We believe that the UHC must succeed in order to make sure that all our countrymen will benefit from the quality of life that they completely deserve. This is one of the major victories that we, as a community, have had over the past three years.
FAST-TRACKED REGULATORY REVIEW
Regulatory processes can be quite complex in different parts of the world. In the Philippines, we have had our fair share of challenges.
Of the 166 medicines launched in the United States and the European Union from 2014 to 2019, only 20 were registered in the Philippines within 27 months after the first launch. This will no longer be a problem.
Beginning the middle of last year, the FDA created a circular on a fast-tracked regulatory process review. What this means is that regulatory agencies recognized by the FDA, like the US FDA and the EU, reviews a drug and presents their files to the Philippine FDA, which then forms the basis for a fast-track review process.
Hence, we no longer have to wait for two to three years. These drugs can be made accessible to us. And it seems like that is such a process that just seems so straightforward. But for many patients who need access to life saving drugs, this can in fact be the big difference between life or death.
The Philippine Medicine Policy is a policy that continues to evolve. PHAP is always there, providing its views to the government, working as a convener for many discussions and participating in many technical working groups.
All of these efforts to be able to help the Filipino patient has translated not just into patients who have better lives, but to significant economic contributions to the Philippine economy.
THE PATIENT: FRONT & CENTER
As we already mentioned, the pharmaceutical industry is worth PhP238 billion in sales annually. We contribute roughly PhP32.6 billion in taxes every year.
We employ over 140,000 workers all over the country, which include medical representatives, manufacturing employees, and doctors.
We are a very important part of the healthcare ecosystem in the country because not only do we need to bring drugs into the country, we need to educate healthcare professionals on how to properly use them.
And it’s not just about the drugs. It’s all about making sure that throughout this whole ecosystem, the patient is always at the front and center, which is why we are also very active in bringing clinical trials for innovative vaccines and pharmaceutical products in the country.
There are over 154 clinical trials happening in the country, as we speak. This is a very high figure, one of the top three highest figures within Southeast Asia.
Clinical trials allow patients who are currently unable to access pharmaceutical drug discoveries to be able to participate in these clinical trials.
Not only do these trials bring in a lot of dollars into the country. There is also technological transfer to the clinicians who participate in these drug discovery trials.
Our doctors are among the most highly respected clinical trialists all over the country. We have no less than Dr. Lulu Bravo, who is globally recognized when it comes to infectious diseases, particularly among infants. This is the kind of stellar quality that we have among our medical professionals. We should be able to continue promoting them because the Philippines is a beacon for a lot of clinical trials all over Southeast Asia.
Still, PHAP cannot do it alone. It takes a village and PHAP acts as a convener as well as a consensus builder across the whole ecosystem—including regulators, researchers, supply chain members, payers, providers and organizations.
This is something that the PHAP Secretariat, all 10 of them, work over weekends, over holidays, all because our commitment is very clear. Patients are out there. Patients are not a statistic. They’re a loved one, they’re a brother, mother, best friend and we need to make sure that we are always talking about them, and we’re doing everything possible to improve patient outcomes and to be able to have them help the quality of life they deserve.
4 COLLABORATION AREAS
Moving forward, there are four areas of collaboration that PHAP will continue to focus on in the coming years.
The first one, of course, is to fortify our commitment to the success of UHC in the country. This includes working with government organizations like PhilHealth, DOH, and FDA, while at the same time working with new organizations like the Health Technology Advisory Committee (HTAC) in the DOST, to make sure that there’s a proper assessment of drugs that are needed in the country.
Second, we continue to help in terms of best practices-sharing of many of our organizations. Our research-based organizations have a treasure trove of learnings in the area of regulation, as well as research and development (R&D) all over the world.
We make all these accessible to our partners in government to make sure that we constantly use technology transfer and knowledge transfer to improve the quality of our collective knowledge in the country.
Third, we want to make sure that the Philippines is a center of excellence for R&D all over the country and all over Asia. We can definitely do this. There are a lot of supporters out there who recognize that both, the Filipino doctor and the Filipino clinician, are able to compete and provide considerable impact on a global scale.
And finally, our fourth collaboration: knowledge and technological transfer to partners in the government, particularly in the areas of end-to-end supply chain management as well as human capital development.
These are some of the priority goals of PHAP over the next two to three years to make sure that we are living and breathing our promise, which is to make sure that the Filipino patient continues to be at the front and center of everything that we do.
