Monday, December 17, 2018
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Drug companies fight generics
Edgardo Ayala
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A bill that would allow production of low-cost medicines meets stiff opposition.

A bill that would encourage the production and promotion of low-cost generic drugs runs the risk of dying in Congress because of fierce opposition from El Salvador’s pharmaceutical industry.

The Association for Health in El Salvador (APSAL), a group of about 20 non-governmental organizations, presented a proposal to Congress for a Medications Law. The bill, introduced in September, would make high-quality drugs more accessible to low-income Salvadorans by encouraging pharmaceutical laboratories to produce and promote generic drugs. Because the medications do not carry a brand name, they are less expensive for consumers.

According to APSAL, many medications are currently out of reach of the majority of consumers in a country where the minimum wage of US$144 does not cover basic household needs.

"Because the cost of living is high, it’s hard for people to afford high-quality medications," said Margarita Posada, APSAL executive director. If more generics were available, she said, drug importers would also be forced to lower their prices. The bill calls for the Salvadoran Public Health Council (CSSP) to publish a list of about 200 generic drugs considered essential for public health, which labs would have to produce.

Pharmaceutical companies oppose the measure, however, saying that they should not be forced to produce specific drugs. Manufacturing decisions, they argue, should depend solely on their marketing strategies. Drug company spokespersons have also pointed out that many laboratories already produce generics.

Organizations supporting the measure, however, are also seeking more aggressive promotion of the generics, because most Salvadorans do not know that lower-cost versions of brand-name drugs exist. For example, Canesten, a brand-name anti-fungal skin cream produced by Bayer, costs about $4.50, while a generic version of clotrimazole, the active ingredient, costs $1 less.

Pharmaceutical companies worry that their sales will fall if consumers opt for generic drugs. Mario Ancalmo, executive president of Ancalmo International, said that the industry depends on sales of brand-name products, and if demand decreases, they will suffer financially. Pharmaceutical sales in El Salvador are estimated at $200 million a year.

Sales of brand-name products are high because many doctors distrust the quality of generic medications and tend to prescribe higher-cost, brand-name products.

Roberto Charlaix, president of Lafar Laboratories and head of the influential Association of Chemical-Pharmaceutical Industries of El Salvador (INQUIFAR) argues that brand-name medications are not necessarily more expensive. Once the manufacturer’s exclusive 20-year patent expires, he says, the price usually drops considerably.

One of the strongest factors boosting sales of brand-name products is the pharmaceutical laboratories’ practice of paying drugstore employees to push their products. An estimated 70 percent of Salvadorans self-medicate. Instead of seeing a physician and receiving a prescription, they go to a pharmacy and ask the employee to recommend a medication. Drugstore employees usually promote brand-name products.

"As a result, hardly anyone buys generics," Posada says.

The bill’s prospects in Congress are not encouraging, because right-wing parties, which hold the majority, tend to support the business sector. APSAL hopes to benefit low-income Salvadorans by hammering out a consensus that will satisfy both the organizations promoting the law and the pharmaceutical industry.


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