Friday, July 29, 2016

Indonesia - High-quality medicine for better public health

Over the past year, we have seen two cases in which patients have fallen victim to low-quality anesthetics they received while undergoing hospital treatment.

In addition, the very recent cases regarding fake vaccines for children are proof that our public health system is under threat.

These cases have shown that the use and availability of quality medicines are paramount in sustaining public health and that any treatment with low-quality or counterfeit drugs can drastically affect the outcome of that treatment.

It seems that confidence in Indonesia’s public healthcare sector has been shaken by concerns over such low-quality or fake medicines. Moreover, the reputation of Indonesia’s healthcare sector may be irreversibly tarnished should such cases recur.

Unfortunately we still neglect healthcare even though it is one of our basic needs. Many are ready to spend a lot on material goods and services, but thrifty when it comes to health and wellbeing. They opt to buy medicine at lower cost, despite the risks they may face.

It is certainly true that when it comes to high-quality medicines — most of which are produced by international pharmaceutical companies — people have to pay premium prices. But people tend to take medicine for granted and many still question why some medicines are more expensive than others.

Furthermore, people tend to overlook the fact that some medicines are the result of 10 to 15 years of costly clinical research. Drug manufacturers must also comply with good manufacturing practice (GMP) prior to the discovery of the drug itself.

In addition, once a drug is produced, the registration process for marketing approval also takes time. And all of this contributes to increased costs.

For many Indonesian patients, however, high-quality and brand-name medicines are not a priority. But the sad fact is that such attitudes have the potential to harm the public health. The public should be prescribed, and have access to, genuine and innovative drugs when they need them.

Considering this, promoting correct healthcare habits and providing access to innovative medicine — as part of the government’s approach to improve overall public health — should be encouraged through the following approaches.

First, the government should remove all regulations that hamper the development of high-quality and innovative medicines in Indonesia.

Recently, the House of Representatives deliberated the revision of the draft patent law, which the government believes will complement its efforts in developing the local pharmaceutical industry, as well as the recent revision of the Negative Investment List (DNI).

From an R&D-based industry perspective, the revision of the draft patent law would weaken, rather than strengthen, Indonesia’s intellectual property rights system.

It would also dampen foreign investors’ interest in Indonesia’s pharmaceutical industry and prohibit patient access to new and innovative medicines.

In addition, the draft patent law would prohibit the use of existing patents for new medicines, while new forms of a known substance would be required to demonstrate enhanced therapeutic efficacy.

These restrictive patent requirements would be impossible to comply with and would potentially contravene World Trade Organization regulations.

Furthermore, such moves could inhibit pharmaceutical companies’ commitments to clinical trials for new medicines and, in turn, deny the public access to innovative treatments.

With regard to the compulsory licensing clause within the draft patent law, which is supposedly aimed at increasing access to better treatments, it is not an effective way to either improve access or accomplish other public health objectives.

It also does not necessarily lower the price of high-quality medicine, nor does it allow the public access to them in the short-term or provide a sustainable solution to longer-term challenges.

Therefore, the government should reconsider the compulsory licensing provisions within the draft patent law. Moreover, the government also needs to ensure that any future compulsory licensing decisions that are made on the grounds of public health are made through fair and transparent procedures that involve the participation of all stakeholders.

Second, the government should make it easier for high-quality medicines to enter the market.

One of the factors that result in poor access to innovative medicines is that to register a new drug in Indonesia takes approximately 300 working days, or 60 weeks, to process, while in Malaysia, it takes just 180 working days.

With such a long process, patients abroad have access to better-quality and newer medications compared with patients in Indonesia. So it is no wonder that many Indonesians prefer to receive medical services in other countries.

We should also consider that every patient has different needs and that it is his or her own right to determine the best medicine for the treatment.

If one particular necessity is neglected, it will hamper all of the progress that has been made. As such, it is the duty of the government to address the people’s needs.

To conclude, the public needs to be less frugal about its health spending. Healthcare should come first and proper healthcare habits are key to effective treatment.

The government wants international pharmaceutical companies to produce affordable and innovative drugs, but the government must realize that doing so requires a lot of hard work and a substantial amount of investment.

In order to improve Indonesia’s healthcare sector — as well as to increase access to innovative drugs—transparency and aligned commitment are needed between the government and industry players.

Parulian Simanjuntak

The writer is executive director of the International Pharmaceutical Manufacturers Group (IPMG), a non-profit organization that comprises 24 international, research-based pharmaceutical companies operating in Indonesia. The views expressed are his own.

You can find older posts regarding ASEAN politics and economics news at SBC blog, and older posts regarding health and healthcare at IIMS blog. I thank you.

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