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.
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