Greater access to more affordable meds vs COVID-19

Losing someone to death is very sad and tragic to the loved ones they leave behind. This is especially more hurting if the cause of death could have been averted by timely medical intervention and treatment. Such were the reported cases for many of those who died of complications due to the coronavirus disease 2019 (COVID-19) infection.

Data validated by the Department of Health (DOH) reported a total of 45,808 COVID-related deaths here in our country as of last Monday. The death toll figures are cumulative of all COVID-related fatalities since the pandemic broke out in the Philippines in January last year.

The death toll would be less grim if looked at along with the total number of confirmed COVID-19 cases in the Philippines. In its regular monitoring of the pandemic situation, the DOH reported a total of 2,826,853 confirmed COVID-19 cases all over the country. Thus, the mortality rate would result to an average of 1.67%. Or this means, one to two deaths per 100 COVID cases. These statistics on COVID-19 cases in the Philippines are all reported to the World Health Organization (WHO).

DOH Secretary Dr.Francisco Duque lll clarified the latest findings showed the Philippines, in fact, had the lowest reported COVID-19-related deaths compared to eight other countries that have the highest number of COVID cases in the world. Duque particularly cited “Our World In Data” report that ranked the Philippines with the lowest mortality compared to pandemic stricken countries like the United States (US), Mexico, Brazil, Italy, United Kingdom (UK), Spain, France and Germany. The data compared the number of deaths from Jan. 5, 2020 up to March 31, 2021.

Like the rest of COVID-impacted countries, the Philippines had had this seeming rollercoaster ride on the COVID-19 cases in graphical presentation. The Philippines experienced a resurgence of COVID-19 cases largely due to the more transmissible foreign variants that can infect even children. The DOH authorities have time and again explained there is lagged or delayed reporting at times to explain the sudden rise or steep plunge of COVID-19 cases.

So the DOH uses as point of reference the ratio or mean average like the positivity rate, the recovery rate, the rate of hospitalization use, among other key indicators on the monitoring of COVID-19 cases all over the country.

Just last Monday, 984 additional cases around our country were reported positive with COVID-19 infection. For the second time this month, we are back to three-digit numbers of confirmed COVID-19 cases. Duque pointed to the seeming sustained low mortality could be attributed to the COVID-19 responses all over the country. Death was 2.6 times more likely to occur among the unvaccinated than those fully vaccinated individuals, according to the DOH.

The DOH Secretary credited the healthcare workers (HCWs) for the “improved clinical care management” of COVID-19 patients. “Good Living Clinical Practice Guidelines has guided our physicians in the use of life-saving meds such as Dexamethasone Tocilizumab and Remdesivir and (leading to) better detection outcomes,” Duque noted.

The cost and supply have been hounding Remdesivir and Tocilizumab which are the only medicines being used before to combat SARS-CoV-2 infections. It was somewhat eased after our own Food and Drug Administration (FDA) issued last Oct.1 an emergency use authorization (EUA) to Ronapreve as another “investigational medicine” for the treatment of COVID-19 infections. It is currently being used at St. Luke’s Medical Center and Makati Medical Center that were earlier given a compassionate special permit (CSP) by the FDA.

Further easing the situation came after the DOH finally allowed all hospitals and local government units (LGUs) to procure directly from manufacturers and suppliers of these anti-COVID medicines that either secured EUA or CSP from our FDA.

As new “investigational medicines” become more available here, they must also be affordable and accessible to the needy.

So when it was announced that the world’s first anti-COVID oral drug molnupiravir will be brought to the Philippine shores soon, price and accessibility naturally became the major concerns also.  Reports came out saying full treatment using this anti-COVID oral drug would cost around $700. Aside from the price, questions were also raised on how “every Juan” can get hold of this Merck-developed life-saving medicine.

These fears were recently assuaged by the RiteMed Philippines Inc., the first local pharmaceutical company to distribute locally the molnupiravir. The Filipino-owned pharma rose to its brand name that carries the reputation of being the bearer of quality medicines at affordable prices. Even the stock market reacted positively when it was reported that RiteMed and its partner Faberco Life Sciences Inc. have received the initial batch of molnupiravir last Nov. 18.

Based on clinical trials, molnupiravir can cut the risk of COVID hospitalization and death by 50 percent and is effective against Delta, Beta, and other variants. To prevent progression, patients diagnosed with mild to moderate COVID will need to take the pill for five days.

RiteMed has begun distribution of molnupiravir under the brand name Molnarz in oral format unlike the other anti-COVID drugs that have to be injected. “It is our hope that molnupiravir will also be cleared for distribution to drugstores nationwide. This will allow patients to have easy access to the product with the proper guidance and prescriptions from their doctors. It will be an additional tool for doctors who are managing COVID-19 patients who have mild to moderate symptoms and therefore can be managed at home,” RiteMed president Jose Maria Ochave cited.

The FDA of the UK – which has one of the world’s most mature and stringent regulatory regimes – first granted an EUA to molnupiravir. This should give our own FDA a strong basis to tailor-fit its availability here under Philippine conditions where patients’ main access to medicines is through neighborhood drugstores at affordable prices.