After weeks of wrangling, the Philippines House of Representatives has finally, and unanimously, approved the Cheaper Medicines Bill (HB 2844) on both its second and third readings. The bill has now gone to the Senate for talks to reconcile the differences still outstanding between HB 2844 and the upper house’s version, SB 1658, but its supporters say they have given up hope of getting a reconciled version approved before the month-long Christmas recess, which starts Thursday (December 20).

HB 2844 is actually an omnibus bill containing over 20 separate pieces of legislation which seek to lower the prices of essential drugs in the Philippines, which are the second highest in Asia. Its passage was delayed by some legislators insistence’ on debating certain of its provisions which, they claim, have been included to protect the interests of multinational patent holders. One such critic, Representative Pablo Garcia, said that while the country’s existing Intellectual Property Code allows the government to override a drug patent if it deems this to be in the public interest, HB 2844 would require it to invoke a national emergency under a World Trade Organisation agreement in order to do so.

The bill would also require the IPC to be amended to allow patented drugs to be parallel-imported, but critics say the measure should also allow parallel imports of generics, as patented drugs represent less than 10% of the domestic drug market.

Philippines’ president Gloria Macapagal Arroyo has designated measures to reduce drug prices as priority legislation and expressed her frustration with the House bill’s slow progress; the Senate approved its own version some time ago. However, Rep Garcia and another critic, Representative Ana Theresia Hontiveros, blamed the bill’s “killer” (allegedly pro-industry) amendments and in particular its proposed changes to the IPC, for the delay.

Rep Hontiveros also claims that the US Trade Representative (USTR) has actively lobbied against the bill, by distributing a position paper to members of the House Committee on Trade and Industry warning them that its provisions would go against the free trade agreements which the USA has signed with other nations. The USTR had, “predictably,” taken the side of the multinational drugmakers, who do not want a stricter interpretation of patentability, said Rep Hontiveros, who added that the USTR needed “to be reminded that the Philippines is not a colony of the USA.”

One issue which is expected to test the House/Senate reconciliation process is HR 2844’s establishment of a Drug Price Regulation Board. 12 months after the bill becomes law, the Board would be empowered to regulate the prices of: all medicines to treat chronic and life-threatening illnesses; products to prevent disease, eg, vaccines, immunoglobulin and antiserums; contraceptives; anaesthetic agents; intravenous fluids; all products on the Philippine National Drug Formulary Essential Drug 3ist; and all other medicines which the Board may, at any time, decide to be in need of price regulation.

The Board will also have powers to determine fair prices for medicines procured for government and public health insurance, and to implement any other government measures which aim to reduce drug prices. It could impose heavy fines and prison terms of up to five years on those found to have illegally manipulated prices.

In contrast, the Senate’s bill would authorise the President and the Secretary of Health to impose drug price ceilings during natural disasters, public health emergencies, events that cause artificial and unreasonable price hikes, the prevalence of illegal price manipulation and whenever prices rise to unreasonable levels. SB 1658’s main author, Senator Mar Roxas, said the House version would simply add another layer of bureaucracy and also criticised it for not clarifying which medicines are included and those which are not, and why some products’ prices are fixed while others are not.

Nevertheless, some critics have doubted whether either measure will improve consumer access to cheaper essential drugs, as they contain no proposals to develop a national drug industry that is responsive to the needs of the population.