The issue behind Senate Bill 1900

A few years ago, "An Act Regulating the Education and Licensure of Physicians and Their Practice of Medicine in the Philippines and for Other Purposes," otherwise known as Senate Bill 1900, caused a stir among pharmacists when an attempt to redefine the physician's roles was being "cooked" in the Senate.

If the bill passed the Senate, physicians will be allowed "to diagnose, treat, operate or prescribe and dispense any remedy for any human disease, injury, deformity, physical or mental condition."(1)

To air its position, the Philippine Society of Hospital Pharmacists issued an official statement for "A Call to Modify Senate Bill 1900." (2) The Drugstores Association of the Philippines also wrote the senate outlining its comments on the said bill. (3)

I suspect that maybe the reason why the word "dispense" found its way into Senate Bill 1900 is because of our failure to do properly what we are licensed to do.

For example, Dr. A.G. Romualdez, Jr. claimed that “here in the Philippines, until the advent of the Pharmacy Law…, most private Filipino patients obtained their medicines from the doctors who prescribed them. In most of the country, dispensing physicians were historically a big help in the distribution chain of drugs and they ensured that services were reasonably priced. Unfortunately, the practice has largely disappeared mainly because, under the Pharmacy Law, doctors were allowed to dispense only those medicines that they directly administered either by injection or inhalation or direct application to specific organs.” (4)

Now, this should be a wake up call to all of us...

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References:
1. http://www.inq7.net/globalnation/col_pik/2003/jul31.htm
2. http://www.pshp.org.ph/article.aspx?ID=5
3. http://www.dsap.org.ph/index1.php?fid=senate
4. Romualdez, A.G. Jr., MD. "Anti-poor conspiracies." Malaya 18 Aug. 2004.

Not a license to kill

"Lack of drugstore pharmacists kills patients." This is the title of an article written by David Dizon in 2002.*

It noted that "[p]harmacists play a crucial role in the process of dispensing safe and effective medicine to consumers" and that "they give valuable information that could mean life or death for patients."

Unfortunately, "some pharmacists actually 'rent out' their licenses and/or diplomas to drugstore owners while maintaining other jobs."

I don't know if we have improved already but I always tell my interns that their license is not a license to kill but a license to heal.

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* http://uw2.abs-cbnnews.com/images/news/microsites/onddot/DavidDizon08132002.htm

Quote of the day

"I am a survivor of a concentration camp. My eyes saw what no person should witness. Gas chambers built by learned engineers. Children poisoned by educated physicians. Infants killed by trained nurses. Women and babies shot and killed by high school and college graduates. So I'm suspicious of education. My request is: help your students to be human. Your efforts must never produce learned monsters, skilled psychopaths, or educated Eichmanns. Reading and writing and spelling and history and arithmetic are only important if they serve to make our students human."

- Anonymous

An inquiry regarding PITC's legal mandate

Last November 24 I wrote the Philippine International Trading Corporation (PITC) through pitc@pitc.gov.ph asking for clarification regarding its legal mandate.* In my letter, I asked the following:

"Isn't it that under Section 10 of the Generics Act of 1988, only raw materials and not finished drug products are to be imported 'during periods of critical shortage and absolute necessity' and that the government agency authorized under that law 'to import raw materials of which there is a shortage for the use of Filipino-owned or controlled drug establishments to be marketed and sold exclusively under generic nomenclature' is the Department of Health?"

Today, when I opened my mailbox, I found out I got a reply from Mr. Steve Francis A. Roldan, PITC's Legal Officer V, and this was his response:

Thank you very much for your e-mail dated November 24, 2006 expressing your support for PITC’s efforts in bringing down the prices of medicines to benefit the majority of our countrymen. In your e-mail, you seek clarification on PITC’s legal mandate, vis-à-vis Section 10 of the Generics Act of 1988.

In response to your query, please be informed of the following:

1. Under Section 11, Article XIII of the Constitution, the government is mandated to “…adopt an integrated and comprehensive approach to health development which shall endeavor to make essential goods, health and other social services available to all people at affordable cost …”

2. In order to “[r]educe by half the cost of medicines through increased and improved distribution importation through PITC and local sourcing, partnership with the pharmaceutical Industry, resolution of patent issues increased use of generic products, community based initiatives”[1] and consistent with the earlier quoted provision of the Constitution, the President issued Executive Order No. 442 on July 4, 2005, designating PITC as the lead coordinating agency to make quality medicines available, affordable and accessible to the greater masses of Filipinos.

3. PITC, as an agency under the Office of the President, is mandated under Section 1, EO 442, to “…establish retail outlets nationwide and supply these outlets with low priced quality medicines…”

As can be gleaned from the foregoing, while Section 10 of the Generics Act of 1988 authorizes the Department of Health to import raw materials for the use of Filipino-owned or controlled drug establishments to be marketed and sold exclusively under generic nomenclature during periods of critical shortage and absolute necessity, PITC’s mandate is distinct from, and is not precluded by, said Section 10.
We hope to have clarified matters.

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* http://www.pitc.gov.ph/mandates.html

Dr. Kenneth speaks

Quote of the day
"Imagine a doctor who made a mistake, and then there are no pharmacists to countercheck or provide warnings to patients and consumers."
- Dr. Kenneth Y. Hartigan Go
As quoted in the article "Dispensing doctors? A controversy in the offing."Medical Observer vol. 6 no. 6 June 1997:29-31.

Doctors prescribing Cytotec

Misoprostol (Cytotec), an unregistered drug product was featured last Saturday in the television show Imbestigador (Channel 7). Although the Bureau of Food and Drugs had already issued BFAD Advisory No. 02-02, * warning against dispensing/selling and using this drug product, there are still doctors who prescribe it and, sad to say, the illegal market still proliferates (Quiapo was identified in Imbestigador).

The BFAD Advisory enjoins all concerned parties "to report to BFAD... or police authorities any information that may lead to the apprehension of persons dealing with the subject drug."

You may report through these e-mail addresses:

ntlanuza@bfad.gov.ph and tmgutierrez@bfad.gov.ph.

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* To view the full text of this BFAD Advisory, visit the BFAD website at www.bfad.gov.ph (Click the heading "Advisory".)

MedExpress: changing the image of community drugstores

If there's one drugstore chain that is changing the image of community drugstores in the country, it is Med Express. This new retail drugstore chain "offers not only delivery and drive-thru pick-up but most importantly professional pharmacy services."*

"Medication safety issues [are] addressed by ensuring that only pharmacists will man all branches and call centers; strictly implementing a "No Rx, No Dispensing" policy; compliance packaging (patient's medication for a week is prepared in unit dose packaging); medication counselling; medication review; confidential medication profile system (a computer system that enables pharmacists to keep track of the patient's drug utilization and provide relevant pharmacist notes); and a patient compliance program (computer system that keeps track of the patient's supply of maintenance medications and enables pharmacists to monitor patient's adherence to medication regimen).

There are Med Express Drugstores in Ortigas Avenue, Mindanao Avenue and Filinvest Alabang.** Patronize this drugstore chain.

SAY NO TO DRUGSTORES WHO SELL PRESCRIPTION DRUGS LIKE CANDIES IN SARI-SARI STORES!

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Source:

* "MedExpress: A New Concept in Community Pharmacy Practice." The Hygeian. December 2005.

** http://www.manilatimes.net/national/2005/jul/19/yehey/life/20050719lif1.html

http://www.mb.com.ph/issues/2005/05/16/TECH2005051634854.html

http://www.mb.com.ph/issues/2005/06/12/HLTH2005061236258.html

Second lecture on counterfeit drugs

The second lecture on "Counterfeit Drugs" for our CE last Wednesday was given by Mrs. Maria Theresa M. Gutierrez, Food-Drug Regulation Officer IV, of the Bureau of Food and Drugs.

During the lecture, she mentioned that pharmacists who want to attend conventions, seminars and similar events which require them to be physically absent in the drugstores where they are hired to work, should file a leave of absence and have it received by the owners to protect themselves just in case the owners decide to run the business without a pharmacist on duty.

She was also very accommodating in answering our questions and I was very happy that she gave me her contact number and e-mail address just in case I have something to report to their office.

To report any malpractice or violation of existing provisions of the Pharmacy Law, Mrs. Gutierrez may be reached at (0919) 430-96-49 or at her e-mail address, tmgutierrez@bfad.gov.ph