Thinking out of the box

Just recently, the Department of Health came out with a warning against the overpricing of Remdesivir, one of the investigational drugs for COVID-19 requiring compassionate use permit (CUP) from the Food and Drug Administration (FDA).

According to the DOH advisory, a 100 mg vial of Remdesivir has a suggested retail price of P1,500 to P8,200. It cited joint administrative order  1 (series of 1993) which says that “any person found to have committed any illegal act of price manipulation as defined and prohibited under Sec. 5 of RA 7581 as amended, shall be penalized administratively and criminally.”

Last week, a student of mine posted on social media that one of their family friends had  died due to COVID-19 and that  the death could have probably been avoided had they been able to buy Remdesivir, which was nowhere to be found.

For some who are lucky to be in a hospital that is able to get CUP for Remdesivir, there are hospitals which charge as much as P30,000 per vial. Another student who was hospitalized due to COVID-19 said he received 10 shots of Remdesivir. That’s P300,000 just for one drug.

Lianhua Qingwen, a traditional Chinese drug, was able to acquire Philippines FDA registration “to help remove heat-toxin invasion of the lungs, including symptoms such as fever, aversion to cold, muscle soreness, stuffy and runny nose,” but its use in here is allowed only with a doctor’s prescription. It is not registered as a COVID-19 medication.

But in China, Lianhua is a commonly used Chinese medical preparation to treat viral influenza, including in the fight against SARS in 2002-2003. The China FDA has also recently approved  the addition of a new indication for Lianhua in mild and common COVID-19 patients. It is used in China as a complementary strategy for treating COVID-19.

Many have attested to the ability of Lianhua to cure COVID-19 related symptoms. Of course, when you have a mild or moderate case of COVID-19, you experience fever, cough, muscle soreness, all of which can be cured by Lianhua. After all, this herbal medicine has anti-viral, anti-inflammatory, and immunoregulatory activities.

There are now clinical studies being done in other countries for the use of Lianhua to treat diseases like COPD (chronic obstructive pulmonary disease). Because it has heat-toxin invasion property, it is said to be effective for purposes of lung protection and against airway inflammation.

It is for this reason that Lianhua is now highly in demand, so much so that from P150 per box of 24 tablets earlier this year, it is now selling for as much as P230 per box in the black market without doctor’s prescription.

Imagine my dismay and shock when someone emailed me a copy of a receipt from one of the major drugstores in the country, showing that she paid P288 per tablet of Lianhua. How can such company in conscience charge so much when it means saving a life?

The best way to avoid overcharging is to flood the market with these drugs and medicines.

Under the Intellectual Property Code of the Philippines, the director-general of the Intellectual Property Office (IPO) can issue a license to exploit a patented invention even without the permission of the patent holder, either through manufacture or parallel importation when public interest so requires. The law also allows the issuance of such license where the demand for patented drugs and medicines is not being met to an adequate extent and on reasonable terms as determined by the Secretary of the Department of Health.

It is good to hear that President Duterte has ordered the DOH and the Department of Science and Technology to study the use of Ivermectin, an off-label drug, as a possible treatment against COVID-19. According to the DOST, there was no need for local clinical trials given existing trials abroad.

If there’s a will, there’s a way. Maybe our government could dispense with some of the steps required before approving the manufacture and importation of  COVID-19 drugs and medicines to immediately bring down their cost. Even the emergency use authorizations (EUA) should not involve so many steps. We are allowing the administration of COVID-19 vaccines whose clinical trials haven’t been concluded. Why can’t we do the same for these drugs and medicines?

The country needs good leaders

One year into the COVID-19 pandemic, one city in Metro Manila continues to stand out for its effective management and successful control of the spread of the virus.

Taguig has risen through the ranks to join other countries in serving as models that others can follow in addressing the COVID-19 pandemic.

In numerous circumstances, the city has been lauded by several high-ranking officials for its COVID-19 response. For example, national policy against COVID-19 chief implementer and vaccine czar Secretary Carlito Galvez described the city as “a model city in terms of its effective response to the COVID-19 pandemic.”

According to latest reports, Taguig has been showing promising statistics with a ratio of more than zero, but less than 20 cases per 100,000 population. While this can be attributed to the concerted efforts of the residents and organizations of Taguig, this is definitely a testament to the kind of leaders they have in the city.

Even the DOH has bestowed on Taguig City Mayor Lino Cayetano the COVID-19 Response Service Award in January for his exemplary leadership and exceptional commitment in the implementation of COVID-19 response and ensuring health services in the community.

When the COVID-19 pandemic hit the country, it was no surprise that Taguig was among the first cities to establish a testing facility and launch various programs to aid its residents.

It should not come as a surprise then that it continues to be one of the cities in Metro Manila with the lowest number of cases.

Without a doubt, the true measure of success for a leader in the time of COVID-19 is reflected in the numbers.

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