Tuesday, May 08, 2007

Medherbal Pharmacy in Drug Retail

There is politics and economics in every pill. In the Philippines, branded medicines cost almost twice as generics. Media hype often dictates the drug consumption, no matter how unfounded some of the claims and portrayals in commercial ads.

Still with the exorbitant prices of drugs, it has become impossible for most patients to properly complete their medication. Medherbal Pharmacy (MHP) is trying to change that.

MHP is a community-oriented pharmacy promoting quality and affordable generic and herbal medicine. It also gives training on herbal medicine preparation.

The pharmacy was initially a project of the Council for Health and Development (CHD) with the mandate of providing generic medicines for the use of communitybased health programs (CBHP). It also provided affordable but effective medicines to members of organized communities.

When it started to achieve sustainability, the CHD Board of Trustees has decided to transform the project into an enterprise so it could reach more clients. Now it is slowly gaining ground into a wider market with its expansion around Metro Manila.

In line with its mission to provide affordable medicines to the poor, its three branches are located near urban poor communities.

A different business philosophy MHP may be a business entity, but its approach is different from commercial pharmacies.

Unlike other pharmacies that place as much as 30 percent profit of margin per item, MHP’s profit of margin is low; just enough to cover the operational expenses and post a small profit.

The pharmacy also carries generic medicines and herbal medicines. The herbal medicines are sourced from CBHPs to help them support community projects as well as their own programs. MHP buys its herbal soaps from CBHP-Isabela, herbal teas from San Benito SIPAG-KO in Bicol, and ampalaya (bitter gourd) capsules from the Tuazon Community Center Foundation. To ensure the products’ qualities, MHP regularly conducts trainings on syrup making and sterilization.

MHP also assists in the setting up of community-based pharmacies by conducting rainings on herbal medicine and pharmacy management. Organizations who have finished the trainings are then provided with initial stocks of medicines. So far, six community pharmacies have already been established: three in Paranaque, south of Manila; one in Tala; and two in the province of Nueva Ecija. MHP is planning to set up five more community pharmacies before the year ends.

Another thing that differentiates MHP from other pharmacies is its advocacy on Rational Drug Use. Since most of their customers have virtually zero knowledge on RDU, staff actually takes the time to educate them.

Advocacy at work
MHP often encounters some people who still think of amoxicilin as vitamins. “People need to know the right medicines to take, the right dosage, at the right time” says
Socoro Torres, Medherbal’s chief executive officer.

Drug consumption remains a big challenge because of the lack of knowledge about rational drug use as well as proper appreciation of generic drugs. Often people buy medicines inappropriate to their sickness. A majority of the Filipinos still buy drugs based on hearsay from what family members or neighbors say. Most of the time, they tend to buy drugs from what they hear or see on television or simply buy prescriptions given to them some years ago.

Often, lacking proper diagnosis from physicians, their illnesses take a turn for the worse.

Torres explains that cultural factors remain an issue, relating to how multinational drug companies have controlled or overwhelmed popular media with ads. Such example is that of the world boxing champion, Manny Pacquiao. In his endorsement of ibuprofen, he says that he has been using it for 11 years. However, a scientific finding concluded that prolonged use of ibrufropen can likely makes a person’s bones brittle, entirely belying the high profile ad.

Here still lies most of the challenges for MHP, but here is where it has also made significant gains. From an offshoot of CHD’s drug procurement unit then only serving orgnized communities, now it is reaching out to larger crowd that is mostly unfamiliar to the concepts of RDU. The MHP staff are proud to say that they have been somehow successful in slowly influencing some people to follow prescriptions, take a full course of medication or go for herbal or generic versions rather than known brands.

Torres admits that economic issues hinder the promotion of RDU. She says other patients could not afford to buy full dosage of medicines. “There are those who buy one or two tablets of amoxicillin. We tell them the minimum dosage for antibiotics is 15 tablets. We try to lower prices so they could buy the full dosage.” It is unfortunate however, that even if people know about the proper intake of medicines, they have not enough money to buy them.

Even with the enactment of the Generics Act of 1988, she underscores the failure of the government to support local drug manufacturers as well as its failure to regulate the production of medicines.

Due to monopoly pricing, the cost of drugs in the Philippines is one of the highest in the world, second in Asia next to Japan. Branded medicines still dominate the market, accounting for 97 percent of sales.

The Philippines now heavily imports drugs from India through the government’s parallel importation program. If indeed the government really wants to end monopoly and significantly reduce prices, Torres insists that it should instead promote local pharmaceutical companies by increasing subsidy and lowering taxes.

To demonstrate the ill-effects of such problematic trade, experts believe that the rise in number of cases of multi-drug resistant TB is a result of the failure to comply with prescribed medication.

The irony remains starkingly real. Great advances have been made regarding treatment and cure of many ailments, but who can afford them? All these gives MHP more reasons to continue its work.

By Philip Paraan Council for Health and Development (chdmancom@yahoo.com)
Published at Health Alert Asia Pacific (www.hain.org)