Drug Quality & Prices:

Looking At The Cheap Medicine Bill

Jonas D. Policarpio MD, MBA
UERM Graduate School & Research Institute for Health Sciences
Ateneo Graduate School of Business
United Laboratories Medical Affairs
Lecture for Sienna College, March 5, 2008
Components of the Cheap Medicine
Bill
Senate
Shortening of Patents
Drug Parallel Importation
Strengthening the regulatory agencies (BFAD)
capability of monitoring quality of drugs
Congress
Establishment of a price regulatory board
Strictly generics prescribing
0 7-8 17-20
years
Research &
Development
Patent
awarded
Market
launch
invest harvest
Marketing Phase
Patent
expires
high prices high prices
high costs low costs
pressure to
? decrease prices
COMPETITION
Drugs: Life Cycle
Philippine Total Health
Expenditures 1991 -2003
47.4
54.6
65.2
76.2
87.1
93.5
103.4
113.5
116.6
115.4
136
35.9
39.6
0
20
40
60
80
100
120
140
160
'91 '92 '93 '94 '95 '96 '97 '98 '99 '00 '01 '02 '03
B
i
l
l
i
o
n

P
e
s
o
s
National Statistical Coordination Board : 2003

Total Pharma Market
49
97
89
82
73
66
56
9.7%
13.1%
9.0%
8.4%
8.5%
0
20
40
60
80
100
120
2002 2003 2004 2005 2006 2007
B
i
l
l
i
o
n

P
h
p
0%
2%
4%
6%
8%
10%
12%
14%
%

G
w
t
105
YTD June
+9.3%
LEGEND
ACTUAL SALES FORECAST SALES FORECAST GROWTH ACTUAL GROWTH
YTD
June 06
7.7%
Total Pharma Market
Drugstore + Hospital
73
79
87
44
8
9
10
11
64
5
10.7
2.4
8.3
9.6
9.9
12.9
6.5
2.8
14.4
9.2
0
20
40
60
80
100
120
2003 2004 2005 2006 YTD JUNE 2007
B
i
l
l
i
o
n

P
h
p
0
2
4
6
8
10
12
14
16
%

G
w
t
Drugstore Hospital DS Gwt Hosp Gwt
June 2007 MAT Sales (in B) % Shr %Gwt
TOTAL MARKET 101.3 100.0% 9.8%
DRUGSTORE 90.5 89.3% 10.3%
HOSPITAL 10.8 10.7% 5.9%
Total Pharma Market
Branded and Unbranded Sales
79
86
94
48
3
3
3
4
70
2
16.6
13.5
5.7
10.3
8.3
9.2
9.2
12.9
0
20
40
60
80
100
120
2003 2004 2005 2006 YTD June 2007
B
i
l
l
i
o
n

P
h
p
0
2
4
6
8
10
12
14
16
18
%

G
w
t
Branded Unbranded Branded Gwt Unbranded Gwt
June 2007 MAT Sales (in B) % Shr %Gwt
TOTAL MARKET 101.3 100.0% 9.8%
BRANDED 97.6 96.3% 9.9%
UNBRANDED 3.7 3.7% 5.9%
Top 10 Corporations
YTD June 2007
21.8
6.6
5.0
4.6
4.0
2.9
3.7
3.2
3.3
8.7
3.6
4.5
3.3
3.1
3.4
3.7
5.6
6.9
8.7
20.9
0
5
10
15
20
25
UL GSK WYE PFZ SAN-AVE ABT AZN ROC NVR J.J
%

S
h
a
r
e
YTD Jun 2006
YTD Jun 2007
Total Market YTD 6/2007
49.4 B + 9.3%
Up/Down arrows for companies with at least+/ 0.2 percent difference vs last year
-0.9%
-0.4% -0.4%
+0.6%
+0.4%
+0.5%
Top 11-21 Corporations
YTD June 2007
2.1
2.3
1.7 1.7
1.3
1.0
1.2
1.0
1.6
3.1
1.6
3.1
1.1
0.9
1.1
1.5
1.7
2.3
1.4
2.2
2.7
2.9
0
2
4
6
8
10
B.I BMS PASCUAL BAYER MSD SRVIER S.PLOUGH NATRA GX INT'L E MERCK INTERMED
%

S
h
a
r
e
YTD Jun 2006
YTD May 2007
Total Market YTD 6/2007
49.4 B +9.3%
-0.4%
+0.2%
Up/Down arrows for companies with at least+/ 0.2 percent difference vs last year
-0.2%
-0.2%
Shares of Major Segments
Source: IMS YTD June 2007
18.3%
12.8%
11.5%
9.0%
8.7%
5.7%
5.0%
3.9%
3.8%
3.1%
2.5%
15.6%
CARDIO
ANTI-INFECTIVES
VITAMINS
ENDOMETABOLICS
PAIN
GIT
COUGH-COLD
ANTI-ASTHMA
DERMA
CNS
ONCOLOGY
OTHERS
Segments Breakdown
By Branded/Unbranded
YTD Jun 2007
97.9
99.4
99.3
98.3
96.9
97.6
97.0
89.3
97.9
96.2
2.2
0.6
0.7
1.7
3.1
2.4
3.0
10.8
2.1
3.8
0.0 20.0 40.0 60.0 80.0 100.0
Branded Unbranded
TOTAL BRND UNBR
TOTAL MARKET 9.3 9.2 10.3
CARDIO 13.6 13.3 33.1
ANTI-INFECT 7.1 6.6 12.3
VITAMINS 7.3 7.8 -8.0
ENDO 12.7 12.6 16.7
PAIN 7.8 7.7 10.6
GIT 9.4 9.8 -7.1
COUGH-COLD -7.2 -7.2 -7.9
ANTI-ASTHMA 14.3 14.3 6.6
DERMA 6.0 6.4 -9.4
% GROWTH
96.7
93.2
98.5
87.6
88.6
95.4
72.0
92.8
89.7
3.3
6.8
1.5
12.4
11.4
4.6
28.0
7.2
98.1
1.9
10.3
0 20 40 60 80 100
Drugstore Hospital
Segments Breakdown
By Drugstore/Hospital
YTD June 2007
TOT DS HS
TOTAL MKT 9.3 9.6 6.5
CARDIO 13.6 15.2 -3.6
ANTI-INFECT 7.1 8.4 4.0
VITAMINS 7.3 7.6 -7.4
ENDO 12.7 13.0 6.6
PAIN 7.8 8.1 5.2
GIT 9.4 9.8 7.1
COUGH-COLD -7.2 -7.4 0.5
ANTI-ASTHMA 14.3 14.5 11.8
DERMA 6.0 5.8 12.4
% GROWTH
Prescription Share by Company - National
Project Harmony Projected Rx Data
-
5.00
10.00
15.00
20.00
25.00
30.00
Q
1

2
0
0
4
Q
2

2
0
0
4
Q
3

2
0
0
4
Q
4

2
0
0
4
Q
1

2
0
0
5
Q
2

2
0
0
5
J
U
L

2
0
0
5
A
U
G

2
0
0
5
S
E
P
T

2
0
0
5
O
C
T

2
0
0
5
N
O
V

2
0
0
5
D
E
C

2
0
0
5
J
A
N

2
0
0
6
F
E
B

2
0
0
6
M
A
R

2
0
0
6
A
P
R

2
0
0
6
M
A
Y

2
0
0
6
J
U
N
E

2
0
0
6
J
U
L
Y

2
0
0
6
A
U
G

2
0
0
6
S
E
P
T

2
0
0
6
O
C
T

2
0
0
6
N
O
V

2
0
0
6
D
E
C

2
0
0
6
J
A
N

2
0
0
7
F
E
B

2
0
0
7
M
A
R

2
0
0
7
A
P
R

2
0
0
7
M
A
Y

2
0
0
7
J
U
N
E

2
0
0
7
R
x

S
h
a
r
e

(
%
)
GENERIC UNITED LAB GLAXO SMITHKLINE PFIZER INC
NOVARTIS BOE. INGELHEIM PASCUAL LABS SANOFI-AVENTIS
WYETH PHILIPPINES NATRAPHARM
Q1 2004 - Q2 2005; Jul. 2005-Jun. 2007
Sample: 360 Drugstore per
Data Point (monthly data
point is equivalent to 3
months rolling data)
Drug Quality & Affordability
Stakeholders
Pharmaceutical companies : manufacturing
& marketing practices
Prescribers: prescribing patterns
Drug retailers and distributors
BFAD: Drug quality & safety
Congress: Good implementable laws
Phihealth: Drug quality, safety & access ?
0 7-8 17-20
years
Research &
Development
Patent
awarded
Market
launch
invest harvest
Marketing Phase
Patent
expires
high prices high prices
high costs low costs
pressure to
? decrease prices
COMPETITION
Drugs: Life Cycle
Drugs: Development to Selling
Raw Materials
Production
Packaging



Storage
Distribution
Sales /
Promotions
Retailing
Marketing/
Advertising
COSTS/
PRICES

Research & Development
US $ 400-800 M/drug




Transfer price
Product Cost
(Transfer Price)
Sales
Marketing
Distribution
Retailing
Dynamics: Branded Patented
Drugs

prescriptions
FUNDS & EFFORTS

Objective: Acceptance of new
molecule or therapeutic approach/
Brand preference

COSTS
P
Product
Sales
Marketing
Distribution
Retailing
Dynamics: Branded Off-
Patent Drugs

prescriptions
FUNDS & EFFORTS

Objective: Brand preference

COSTS
P
Product
Sales
Marketing
Distribution
Retailing
Dynamics: Pure Generics


FUNDS & EFFORTS

Objective: Brand preference

COSTS
Preferred
product at
drugstore
among
SUBSTITUTES
P
Product
Brand
Management
Distribution
Advertising
Dynamics: OTC


FUNDS & EFFORTS

Objective: Brand preference

COSTS
Top of
mind of
P
CONSUMERS
Cost Components: across categories
0
20
40
60
80
100
120
140
160
180
200
Patented OffPtnt Brand Pure Gnrxs OTC
Prod Costs Sales
Mktg/Adv Distrib
Retail Others
Use Restrictions
Rigid formularies
Prescribing guidelines
Generic prescribing
Reimbursement restrictions
Disease management
Rise of Healthcare Expenditures
Cost containment measures
Price Restrictions
Purchaser / provider power
Price reduction / freezing
Reference pricing
Reimbursement restrictions
US/UK/Canada Model

Why are medicines expensive in the
Philippines?

1. No fine chemical industry
2. Limited definition of market; low volume
3. No countervailing institutions to reduce drug
prices (e.g., universal health insurance, HMOs,
price referencing)
4. Marketing and promotion practices
5. Transfer pricing
6. Monopolies in distribution and retail
7. Failure to provide for TRIPS-compliant public
health flexibilities in the IP Code
8. Strategic litigation by originators

In short, a non-competitive market.
Components of the Cheap Medicine
Bill
Senate
Shortening of Patents
Drug Parallel Importation
Strengthening the regulatory agencies (BFAD)
capability of monitoring quality of drugs
Congress
Establishment of a price regulatory board
Strictly generics prescribing
Expiring/Breaking of Patents
Molecule Patent : wait till it expires
: local patent
Frivolous Patents
Patents on Salts : change the salts
Patents on Process : find another
process
Patent on delivery system : find another
delivery process
Parallel Drug
Importation: Philippines
Validate the claim that drugs sold in the Philippines are higher
relative to our neighboring countries
Gain leverage for government in negotiating with drug
companies to hopefully reform their market practices and
subsequently lower their product prices

1999
Initial talks with multinational drug companies for possible price reduction of
products

mid 2000
Government recognized that drug prices in the Philippines are high
Creation of DOH-DTI Task Force on Pharmaceutical Concerns
PITC designated as the importing agency

PDI - the Philippine Way
LIMITED to OFF-PATENT drugs
trademark rather than patent issues
45 different kind of products
The distribution network is generally limited to government retail
and hospital drug outlets
SOURCING
PDI products are sourced from wholesalers / consolidators and
not DIRECTLY from manufacturers; wholesalers and
consolidators are legitimate businesses; identities known only
to PITC
Documents cannot be authenticated with
manufacturer/trademark/patent holder
Products obtained from various sources and channels
STORAGE AND DISTRIBUTION


Biggest drug retailers in Philippines
# of Branches
Mercury Drug Corporation 568
Rose Pharmacy 123
South Star Drug 118
Watson 105
Manson 52
Effects of a credible competitor
Simvastatin patent expired in the Phils. Nov 2000
Generic simvastatin launched at 50% lower price Aug 2002
Atorvastatin (Lipitor) price by reduced by 20% Jan 2003
Originators Simvastatin (Zocor) price reduced by 52-57 % Sept 2003
Atorvastatin (Lipitor) price dropped further by another 20 % Oct 2003
Generic simvastatins price further reduced by 20% Dec 2003
Therapharma Vidastat
RiteMed Simvastatin
Pharex
Credible Competitor
Reputable company (quality products)
Priced at least 30% lower than the leading
brand
Effective marketing strategy and
organization
Adequate marketing firepower
Hospital Fluids: PRICE COMPARISON
BEFORE THE PULLOUT OF LVP (2005 to
early 2006)
Source: MDC & Hospital Bidding forms
LVP ERMD
NSS 1 Liter
P 87.00
P 21.00
P 85.00
P 18.00
D5LR 1 Liter
P 92.00
P 22.00
P 89.00
P 19.50
PRICE COMPARISON AFTER THE
PULLOUT OF LVP (2006)
Source: MDC & Hospital Bidding Forms
LVP ERMD
NSS 1 Liter - P 95.00105.00
D5LR 1 Liter - P 95.00-105.00
PRICE COMPARISON: AFTER RE-
LAUNCH OF LVP (Nov-Dec 2006)
LVP ERMD
NSS 1 Liter P 67.50 P 95.00
D5LR 1 Liter P 74.72 P 95.00
Source: MDC & Hospital Bidding Forms

PRICE COMPARISON: PRESENT
LVP ERMD
NSS 1 Liter P 55.50 P 65.00
D5LR 1 Liter P 55.75 P 65.00
Source: MDC & Hospital Bidding Forms

Consumers: Tri-Media
Campaign > High
quality drugs need not
be expensive.
MD Prescribers:
Pharmacoeconomics /
Cost-effective
prescribing
Drugstore Chains:
forego huge but short
term profits in favor of
long term continuity of
business

SUPPLY
Gawa ng
Unilab
RiteMed Model: Launch to Php 1 B in 5
years; priced 50% less + UNDP citation
Health Financing
Countervailing
Still mainly out-of-pocket (fee-for-service)
>>>>>> covered by HMOs
>>>>>> covered by insurance
Both have no influence on physician
prescriptions
Philhealth has covered majority but
marginal
Approaches to control drug
prices: Philippines
DEMAND SIDE
Prescription and treatment guidelines = cost-effective prescriptions
How? Pharmacoeconomics a new discipline! Data?
Rigid hospital formularies = cost-effective hospital services
How? Pharmacoeconomics a new discipline! Data?

MARKETING CHANNELS
Dispensing physicians.
Will they get substantial volume discounts? Will they shave off retailers
discounts?
Retailing
How do we maintain profitable operations while helping the cause of
cheaper medicines?
Government hospital pharmacies (funding, budget, etc)
Botika ng Bayan / Botika ng Barrangay


Approaches to control drug
prices: Philippines
SUPPLY SIDE
Substitutes: Generics & Parallel imports
How do we maintain patient and prescriber confidence and assure
product quality? Bioequivalence / ASEAN Harmonization
Experiences from Generics Act & DOHPITC Parallel Drug Importation
Exploitation of expiring patents
How do we achieve a swifter patent expiration to marketing
turnaround?
Enhancing competition among suppliers? credible competitor
Do we support smaller competitors? How?

FINANCING
Philhealths emerging role not only as a payor of drugs but also as a
leverage to quality, safety, and accessibility of drugs. (emerging)
(countervailing)



Filipino Household Ranking Eleven
Basic Needs

1. Food
2. Economic
Base/Livelihood
3. Water
4. Medical Services
5. Education
6. Clothing
7. Power/Energy
8. Shelter
9. Ecological Balance
10. Mobility
11. Sports
National Health Survey 1991
1988/97/00 Distribution of Expenditures of
Families by Major Expenditure Item I n Percent (%)
1988 1997 2000
1. Food 50.8 43.9 43.6
2. Housing 12.7 15.4 14.2
3. Fuel/Light/Water 5.5 5.3 6.3
4. Transpo./Communication 4.7 5.2 6.8
5. Clothing 4.2 3.3 2.7
6. Personal care 3.3 3.2 3.6
7. Education 2.9 3.7 4.2
8. Other Expenditures 2.9 3.1
9. Household Operations 2.5 2.3 2.3
10. Special Occasions 2.3 2.4
11. Furnishings 2.2 3.3 2.5
12. Tobacco 2.1 1.3 0.7
13. Medical Care 1.7 2.2 1.9
14. Alcohol Beverages 1.2 0.8 1.1
15. Taxes 1.1 2.7 2.1
16. Gifts 0.9 1.0 0.2
17. Recreation 0.5 0.4 0.5


1988/97/00 Family Incomes & Expenditures Survey
Household Level Health Spending
Estimates
In 2003

Per capita spending for health: P1,665 per
Filipino per year

Per capita spending for drugs: Php 770 per year or
Php 4,230 per household per year

Threshold income : Php 352,500/yr or
Php 29,375/month



Total Number of Families by Income, Class, Urban-Rural
1991 1994 1997 2000
Philippines 11975400 12754944 14192462 15269655
Income Class ... ... ... ...
Under P 10,000 306400 149537 66917 35556
10,000 - 19,999 1647500 933267 482827 329012
20,000 - 29,999 2145600 1644422 1132664 836651
30,000 - 39,999 1731700 1652896 1473041 1170541
40,000 - 49,999 1250900 1391055 1438575 1388507
50,000 - 59,999 978700 1133426 1163897 1196126
60,000 - 79,999 1234400 1698025 1828642 1983219
80,000 - 99,999 772400 1074314 1285026 1496280
100,000 - 149,999 1017000 1501550 2072417 2431060
150,000 - 249,999 593400 1054063 1853665 2382193
250,000- 499,999 237300 419355 1063498 1528433
500,000 and over 60000 103035 331293 492077
NEDA 2004 Report
Consumer Values
HIERARCHY OF NEEDS
Misc
Utilities/House/
Car
Health
Food
Areas of
Non-
Negotiability
Savings
Childrens Needs
Food/Utilities
Personal Needs
Savings
Health
Misc
Becomes
non-negotiable
only when at risk

MARRIED SINGLE
Childrens Needs: Tuition fee, baon, clothing, school project, personal care, medication/vitamins
Utilities/House/Car: electricity, water, cable, telephone, maids, amortization, mortgage, car maintenance
Health: Vitamins, medication, check-up
Savings: cash, placements, insurance, investments
Miscellaneous: party, gifts, expenses for guests
Personal Needs (Single): clothing, dating, personal care
A case of a 45 y/o diabetic hypertensive
father of 5 earning P20,000 a month
Plendil 5 mg OD (P33@) P 33.00
Capoten 25 mg BD (P22.75@) 45.50 TD 68.25
Treatment/day 78.50 101.25
Hypertension treatment/mo P2355.00 P3037.80
(11.8%) (15%)
Euglucon 5 mg BD (P9.25) P 18.50
Glucophage 500 mg TD (P7.60@) 22.80
Imdur 60 mg OD ( P24.00@) 24.00
Lipitor 20 mgOD ( P80.00 @) 80.00
Non-HPN treatments/mo P 4359.00
TOTAL TREATMENT COST/Mo P6,714.00 P7,369.80
(34%) (37%)


Method: interview on UHA
249 male/female patients, 21-60 yrs old
Belonging to ABC1 and C2D households
Clinical diagnosis: HPN, DM, HD
Taking maintenance drugs on therapy for 6
months or more
Have taken medications in the past 3
months
Base: Total respondents who have taken medications for (ILLNESS) in the past three months as prescribed
Whether Have Instances that the Prescribed
Frequency of Intake was Not Followed
Q21b / Q58b / Q94b. Sir / Maam, you mentioned that you take (mention Brand/s) (mention frequency prescribed) a day as prescribed
by the doctor. Was there a time when you did not follow the prescribed frequency of intake for (mentions Brand/s)?
4
8
43 44
46
57 56
54
0
10
20
30
40
50
60
70
80
90
100
Hypertension (124) Diabetes (86) Heart disease (90)
Yes No
However, more than 2/5 of those who claimed that they take
their medications as prescribed admitted that there are times
when they miss to take their medications as scheduled.
Reasons for Not Being Able to Follow the
Prescribed Frequency of Intake
Base: Total respondents who have taken medications for (ILLNESS) in the past three months and with prescribed
frequency of intake the same with the actual but skipped
Q21c / Q58c / Q94c. Why were you not able to follow the prescribed frequency of intake for (mention Brand/s)?
4
9
Forgot to take /
negligence
HPN 36%
Diab 39%
HD 32%
Financial
constraints
HPN 25%
Diab 34%
HD 24%
Have seen
improvement in
the condition
HPN 15%
HD 16%
Busy / no time
Diab (13%)
Hypertension (53) Diabetes (38) Heart disease (41)
Across the 3 conditions,
reasons for non-compliance
with the prescribed regimen
are primarily negligence and
financial constraints.
Additionally, improved
condition (hypertension and
heart disease) and lack of
time (diabetes).

Duration of Not Being Able to Follow the
Prescribed Frequency of Intake
Base: Total respondents who have taken medications for (ILLNESS) in the past three months and with prescribed
frequency of intake the same with the actual but skipped
Q21d / Q58d / Q94b. How long have you not followed the prescribed frequency of intake for (mention Brand/s)?
5
0
%
21
13 13
9 9
13
32
8 8
18
21
11
18
8 8
13
8
0
10
20
30
40
50
60
70
80
90
100
1 day 2 days 3 days 4 days 5 days 7 days 9 days refused
Hypertension (53)
Diabetes (38)
Heart disease (41)
MEAN:
HPN 4.83 days
DIAB 5.03 days
HD 5.42 days
Respondents would miss out
taking their medications up
to about 5 days.
Important Attributes or Factors in
Choosing a Brand for a Medication
Base: Total respondents who have taken medications for diabetes in the past three months (n=90)
Q63. What attributes or factors do you consider important in choosing a brand of medication for diabetes? What else?
5
1
EFFICACY 70%
PRICE 30%
SAFETY PROFILE 26%
OTHERS 21%
Lowers blood sugar, lowers blood sugar to
135mg/dl, easily relieves symptoms,
relieves symptoms like weakness, polyuria,
dizziness, numbness, helps feel relaxed,
gumagaan ang pakiramdam , effective
(unspec)
Mentioned specific price : P3.00, P5.00,
P8.00, P10.00, P12.00, P20.00, P30.00,
cheap, affordable, cost-effective
No/less side effects like headache,
dizziness, allergy, difficulty of breathing,
palpitations, no side effects (unspec)
Kung ano ang reseta ng doktor, hiyang,
once a day, packaging, brand is known, for
maintenance
Prescribed Quantity vs. Actual
Quantity Bought (One Drug)
Base: Total respondents who have taken medications for (ILLNESS) in the past three months and have bought
only one drug the last time
Q31 / Q68 / Q104. How many (mention Brand/s) did your doctor prescribed you to buy?
Q32 / Q69 / Q105. How many (mention Brand/s) did you actually buy the last time?
5
2
Among those who bought only one drug the last time, compliance in
terms of buying the prescribed quantity of drug is high, especially for
diabetes.
64
91
67
34 29
2
2
4
7
0
10
20
30
40
50
60
70
80
90
100
Hypertension (96) Diabetes (46) Heart disease (56)
No prescribed quantity but bought
Prescribed quantity different from actual
Prescribed quantity same as the actual
Prescribed Quantity vs. Actual
Quantity Bought (Multi-purchase)
Base: Total respondents who have taken medications for (ILLNESS) in the past three months and have bought
more than one drug the last time
Q31. How many (mention Brand/s) did your doctor prescribed you to buy?
Q32. How many (mention Brand/s) did you actually buy the last time?
5
3
On the other hand, when buying multiple drugs, respondents are
more likely NOT to buy the prescribed quantity of medications.
32
5
15
48
19
82 89
7
3
0
10
20
30
40
50
60
70
80
90
100
Hypertension (32) Diabetes (44) Heart disease (36)
Mixed practice
Prescribed quantity different from actual
Prescribed quantity same as the actual
Reasons for Not Buying the
Prescribed Quantity of Brand
Base: Total respondents who bought medications the last time and with prescribed quantity different from the
actual quantity bought
Q33. / Q70 / Q106. Why did you not buy the prescribed quantity of (mention Brand/s)? Why else?
5
4
HPN (55) Diab (45)
Heart
disease
(39)
% % %
Limited budget 62 71 62
(lack of money / lack of budget / don't
have money, di kaya ng budget, konti
lang ang nabibili ng budget)
Cost of medicines 13 16 10
(expensive, expensive P60.00, P50.00)
For maintenance 13 9 13
(maintence - for life, it's up to me how
many to buy for it's lifetime)
Non-compliance in buying the prescribed quantity of
drugs is mainly due to a persons financial capability.
Options if Cannot Afford the
Prescribed Medications
Base: Total respondents who find the price of medicines for(ILLNESS) as quite expensive / very expensive
Q38 / Q75 / Q111. The doctor prescribed you medicine/s for hypertension which you consider (quite/very) expensive? What would you do if
you can afford the medicine/s prescribed to you?
5
5
Ask doctors
advice
HPN 15%
Stop medications
HPN 13%
HD 18%
Diet / exercise
Diab 21%
Others (e.g., will just
take medicine OD)
HD 21%
Budget the money
HPN 23%
Diab 14%
Switch to herbal
medicines
HPN 15%
Diab 48%
HD 9%
Look for other
means (e.g., hihingi sa
anak, mangungutang sa
kamag-anak)
HPN 18%
Diab 17%
HD 35%
Among the hypertensives, budgeting the money is their more common option while
patients with heart disease would look for other means like borrowing money from
relatives. On the other hand, most diabetics would switch to herbal medicines.
Poor Economics,
Poor affordability
of therapy
Poor compliance
Poor control
More complications
More expensive
therapy, poorer
Quality of life,
earlier death
More economic burden
Thank You Very Much