President Arroyo Tuesday signed Executive Order No. 821 mandating the Maximum Drug Retail Price over the remaining five essential drugs that failed to satisfy the recommended price slash by the government.

The five drugs that were placed under the MDRP scheme that represents a 50 percent price decrease include the Anti-hypertensive drug Amlodipine 2.5 mg, 5 mg, and 10 mg (including its S-isomer and all salt form) which are now priced at P9.60, P22.85 and P38.50 respectively; the Anti-cholesterol drug Atorvastatin 10 mg (P34.45), 20 mg (P39.13), 40mg (P50.50), 80 mg (P50.63), Amlodipine besilate 5mg+ Atorvastatin calcium 10 mg tablet P45.75, and Amlodipine Amlodipine besilate 5mg+ Atorvastatin calcium 20mg (P66.25) among others.

Also included in the list is the Antibiotic Azithromycin (and all its salt form) 250 mg (P108.50), 200 mg/5 ml powder for suspension (15 ml); 200mg/5ml powder for suspension (22.50 per mL), 500 mg tablet P151.43, 500 mg vial for injection (992.50) and 2g granules (P468).

Anti-neoplastics or anti-Cancer Drug Cytarabine 100 mg/ml ampul/vial (IV/SC) (P240), 100 mg/mL ampul/vial (IV/SC) (5mL) or 500 mg vial (R900), 100 mg/mL ampul/vial (IV/SC) (10mL) 5mL or 1g vial (P1800), 20 mg/mL (5mL) ampul/vial for injection (P1980). Doxorubicin and all its salt form 10mg powder vial for injection 1465.75 and 50mg powder vial for injection (P2265.74).

Department of Health (DoH) National Drug Program manager Dr. Robert So said they based the ceiling price of these drugs on the base price in the first quarter of this year.

Earlier, drug companies volunteered 16 drugs under the voluntary price reduction that include medicines for hypertension, diabetes, common bacterial infections, amoebiasis (a leading cause of diarrhea), cancers (like leukemia, the number one killer among pediatric cancer patients) among others. The DoH originally prepared a list of 21 drugs recommended for the voluntary price slash scheme.

"In addition, these pharmaceutical companies also undertook to reduce by about ten to fifty percent the prices of 22 other drugs and medicines not included in the initial list recommended by the DoH and DTI. The reduction of the prices of these drugs and medicines shall commence on Aug. 15, 2009 and shall be fully implemented by September 15, 2009," the EO said.

Dr. So said the government saw the MDRP as the 'last resort' in bringing down prices of medicines in the Philippines.

"Well, we believe MDRP is really a last resort. If companies will give us fair prices, which means, when we compare with other countries, our people are not disadvantaged, and if they continue to engage us in fruitful partnerships to help our people, especially the disadvantaged in a transparent and ethical manner, then hopefully we don't need MDRP," he said. "We have not stopped finding ways to bring down prices and improve access and we will exhaust all means to achieve this for our people."

Meanwhile, The Pharmaceutical and Healthcare Association of the Philippines (PHAP) said it will abide by the guidelines set under the EO. However, PHAP members said free market enterprise is still the best way to achieve the best drug prices instead of MDRP scheme. Moreover, the group said the government should focus on a sustainable solution to drug prices as poor Filipinos who earn less than P100 a day will still be unable to access the medicines.

"PHAP regrets that price control for certain molecules has been imposed since it believes that the same result could be achieved through free market competition. For example, there are already 20 amplodipine in the market which prices are lower than the most popular brand. A free market competition will also increase the competitiveness of the Philippines as an investment priority area for companies in various industries," PHAP said.

"Market competition will also ensure that new medicines will continue to be introduced in the country since the Philippines has been one of the countries in Asia where new medicines are launched after regulatory approval in the United States and in Europe. PHAP asserts that price control may deliver some short-term benefits but the long-term negative consequences not only on the pharmaceutical industry but in other industries must be considered. If price adjustments do not result in market expansion, then affected companies will have to study options to remain viable."