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Improving Access to Healthcare through the Regulation of Prices in the Retail of Drugs and Medicines

February 17, 2020

EXECUTIVE ORDER NO. 104

IMPROVING ACCESS TO HEALTHCARE THROUGH THE REGULATION OF PRICES IN THE RETAIL OF DRUGS AND MEDICINES

WHEREAS, Article II, Section 15 of the Constitution provides that the State shall protect and promote the right to health of the people and instill health consciousness among them;

WHEREAS, Article XIII, Section 11 of the Constitution declares that the State shall adopt an integrated and comprehensive approach to health development, which shall endeavor to make essential goods, health and other social services available to all the people at affordable cost;

WHEREAS, Section 2 of Republic Act (RA) No. 9502 or the "Universally Accessible Cheaper and Quality Medicines Act of 2008," declares it a policy of the State to protect public health and, when the public interest or circumstances of extreme urgency so require, to adopt appropriate measures to promote and ensure access to affordable quality drugs and medicines for all;

WHEREAS, Executive Order (EO) No. 821 (s. 2009) imposed maximum retail prices on certain drug molecules through a fifty percent (50%) reduction on their retail prices;

WHEREAS, drugs and medicines contribute to the huge out-of-pocket health expenditure of Filipinos;

WHEREAS, the government acknowledges that expensive healthcare, including costly medicines, pushes a significant number of Filipinos to poverty, discourages them from seeking the appropriate medical treatment, leads to drug and medicine resistance, as well as endangers lives, thereby increasing the morbidity and mortality rates across the different socio-economic classes;

WHEREAS, there is a need to revisit and update existing policies to improve access to healthcare including the affordability and accessibility of drugs and medicines, and formulate both short-term and long-term measures that are sensitive to all stakeholders; and

WHEREAS, consistent with the foregoing mandate, the Department of Health (DOH) proposed to regulate the retail prices of 122 drug molecules or 205 drug formulas;

NOW, THEREFORE, I, RODRIGO ROA DUTERTE, President of the Republic of the Philippines, by virtue of the powers vested in me by the Constitution and existing laws, do hereby order:

SECTION 1. Price Regulation in the Retail of Drugs and Medicines. — Price regulation through a Maximum Retail Price (MRP) and/or Maximum Wholesale Price (MWP) is hereby imposed on certain drugs and medicines, selected based on the following criteria:

a. Drugs that address the health priorities of the general public especially those that account for the leading causes of morbidity and mortality;

b. Drugs that have high price differentials/arbitrage compared to international prices;

c. Drugs that have limited competition in terms of lack of generic counterparts or lack of market access to these products; and

d. Drugs where the innovator product is the most expensive yet most prescribed and/or dispensed in the market.

After considering the factors provided in Section 19 (A) (2) of RA No. 9502, as amended, among others, an MRP and/or MWP were determined and are now imposed on select drugs and medicines totalling to 86 drug molecules or 133 drug formulas annexed to this Order.

Within thirty (30) days from the issuance of this Order, a technical working group composed of representatives from the DOH and Department of Trade and Industry (DTI) shall convene and review, in consultation with stakeholders, the prices of the remaining 36 drug molecules or 72 drug formulas previously proposed to be subject of the MRP and/or MWP.

SECTION 2. Applicability. — The MRP and MWP shall apply to all medicines specifically referred to under Section 1, which are currently registered with the Food and Drug Administration and available in the market.

The MRP of all drugs and medicines specifically referred to under Section 1 shall be imposed on all public and private retail outlets, including drugstores, hospitals and hospital pharmacies, health maintenance organizations, convenience stores and supermarkets, and the like.

The MWP of all drugs and medicines shall be imposed on all manufacturers, wholesalers, traders, distributors, and the like.

No public or private entity shall be allowed to sell, reimburse or demand from the public or patients payment in an amount higher than the MRP or MWP, as the case may be.

SECTION 3. Review. — The list of drugs subject of MRPs and/or MWPs shall be subject to review by the DOH, in consultation with the DTI, within six (6) months from the effectivity of this Order and every six (6) months thereafter.

SECTION 4. Measures to Improve Access to Medicines. — The DOH, in consultation with relevant government agencies, including the DTI and the Philippine Competition Commission, is hereby directed to study and propose measures, including, but not limited to pooled procurement, price negotiation and other mechanisms, which will influence the supply, demand and expenditure on drugs and medicines, in accordance with RA No. 9502, and other relevant laws and regulations.

SECTION 5. Implementing Guidelines. — As may be necessary, the DOH shall formulate guidelines for the effective implementation of this Order.

SECTION 6. Agency Support. — The Presidential Communications Operations Office is hereby directed to provide the necessary support and assistance to the DOH for the dissemination of information relative to this Order.

All other government agencies and instrumentalities including government-owned or -controlled corporations, government financial institutions, and state colleges and universities, are hereby directed to provide the necessary support to the DOH in the information dissemination, enforcement and implementation of this Order.

SECTION 7. Violations. — Any violation of this Order shall be dealt with in accordance with RA No. 9502, and other related laws.

SECTION 8. Transition. — Within a non-extendable period of ninety (90) days from the effectivity of this Order, existing inventory stock shall be allowed to be disposed of at prevailing prices. Thereafter, regardless of the status of existing inventory stock, MRP and/or MWP under this Order shall be strictly implemented.

SECTION 9. Separability. — If any part or provision of this Order shall be held unconstitutional or invalid, other parts not affected thereby shall continue to be in full force and effect.

SECTION 10. Repeal. — All executive issuances, orders, rules and regulations or parts thereof inconsistent with this Order are hereby revoked or modified accordingly.

SECTION 11. Effectivity. — This Order shall take effect upon its complete publication in a newspaper of general circulation or the Official Gazette.

DONE in the City of Manila, this 17th day of February, in the year of Our Lord, Two Thousand and Twenty.

ANNEX

List of Medicines and Corresponding Maximum Wholesale Price (MWP) and Maximum Retail Price (MRP)

No.

Molecule

Strength/Form

MWP

MRP

Antihypertensives

1	Amlodipine + Bisoprolol	10 mg + 5 mg tablet*	16.79	24.35
2	5 mg + 10 mg tablet*	15.74	22.82
3	5 mg + 5 mg tablet*	15.79	22.90
4	Amlodipine + Hydrochlorothiazide + Olmesartan Medoxomil	37.5 mg film-coated tablet*	12.82	18.59
5	57.5 mg film-coated tablet	22.25	30.75
6	62.5 mg film-coated tablet	23.50	31.25
7	Amlodipine + Hydrochlorothiazide + Valsartan	10 mg + 160 mg + 25 mg film-coated tablet*	20.02	29.03
8	10 mg + 320 mg + 25 mg film-coated tablet*	23.80	34.51
9	5 mg + 160 mg + 25 mg film-coated tablet*	19.09	27.68
10	Amlodipine + Indapamide	10 mg + 1.5 mg modified-release tablet	23.66	28.50
11	Amlodipine + Indapamide + Perindopril	10 mg + 1.25 mg + 5 mg film-coated tablet*	37.78	50.00
12	10 mg + 2.5 mg + 10 mg film-coated tablet*	35.75	51.84
13	5 mg + 1.25 mg + 5 mg film-coated tablet*	35.62	44.75
14	Amlodipine + Perindopril	2.5 mg + 3.5 mg tablet*	14.27	20.70
15	Bisoprolol + Hydrochlorothiazide	2.5 mg + 6.25 mg film-coated tablet*	11.29	16.36
16	5 mg + 6.25 mg film-coated tablet*	13.31	19.30
17	Eprosartan	600 mg film-coated tablet*	28.39	41.17
18	Eprosartan + Hydrochlorothiazide	600 mg + 12.5 mg film-coated tablet*	25.50	36.97
19	Imidapril	10 mg tablet*	17.67	25.62
20	Indapamide + Perindopril	2.5 mg + 10 mg film-coated tablet*	21.04	30.51
21	Levamlodipine	2.5 mg tablet*	8.16	11.84
22	Nimodipine	30 mg film-coated tablet	27.52	44.70

Antidiabetic Drugs

23	Dapagliflozin	10 mg film-coated tablet*	32.40	44.20
24	Empagliflozin	10 mg film-coated tablet*	48.28	55.31
25	Empagliflozin + Metformin	12.5 mg + 1 g film-coated tablet*	34.31	41.52
26	12.5 mg + 500 mg film-coated tablet*	31.64	41.52
27	5 mg + 1 g film-coated tablet*	34.25	41.52
28	5 mg + 500 mg film-coated tablet*	23.33	33.83
29	Insulin Aspart	100 IU/mL, 3 mL pre-filled pen*	327.23	424.04
30	Insulin Aspart + Insulin Aspart Protamine Crystalline	100 IU/mL, 3 mL pre-filled pen	328.90	477.26
31	Insulin Degludec	100 U/mL, 3 mL pre-filled pen*	598.72	763.40
32	Insulin Detemir	100 U/mL, 3 mL pre-filled pen*	541.34	691.67
33	Insulin Glulisine	100 IU/mL, 3 mL pre-filled pen*	336.14	435.18
34	Insulin Lispro	100 IU/mL, 10 mL vial*	941.80	1,192.25
35	100 U/mL, 3 mL pre-filled pen*	324.43	420.53
36	Linagliptin	5 mg film-coated tablet*	44.05	55.78
37	Linagliptin + Metformin	2.5 mg + 1 g film-coated tablet*	24.32	30.36
38	2.5 mg + 500 mg film-coated tablet*	24.44	30.56
39	2.5 mg + 850 mg film-coated tablet*	24.24	30.36
40	Metformin + Saxagliptin	1 g + 5 mg extended-release tablet*	47.16	68.38
41	500 mg + 5 mg extended-release tablet*	46.91	68.02
42	Metformin + Sitagliptin	1 g + 100 mg extended-release tablet*	49.45	62.50
43	1 g + 50 mg film-coated tablet*	25.10	32.55
44	500 mg + 50 mg film-coated tablet*	25.05	30.31
45	850 mg + 50 mg film-coated tablet*	24.68	32.14
46	Saxagliptin	2.5 mg film-coated tablet*	32.97	47.80
47	5 mg film-coated tablet*	40.16	57.00
48	Sitagliptin	100 mg film-coated tablet*	45.08	65.37
49	25 mg film-coated tablet*	31.85	46.19
50	50 mg film-coated tablet*	43.70	53.19

Anti-Neoplastic/Anti-Cancer

51	Afatinib	30 mg film-coated tablet	2,886.43	4,057.80
52	40 mg film-coated tablet	2,817.63	3,961.49
53	Bevacizumab	100 mg, 4 mL vial	16,735.07	23,445.90
54	400 mg, 16 mL vial	57,621.55	80,686.97
55	Cetuximab	5 mg/mL, 20 mL vial	12,182.70	17,072.58
56	Denosumab	60 mg/mL, 1 mL pre-filled syringe (SC)	9,676.00	13,563.20
57	Erlotinib	150 mg film-coated tablet	1,500.01	2,116.81
58	Goserelin	10.8 mg pre-filled syringe (SC)	14,077.89	19,725.85
59	3.6 mg pre-filled syringe (SC)	4,118.80	5,783.12
60	Lapatinib	250 mg film-coated tablet	377.34	545.08
61	Panitumumab	20 mg/mL, 5 mL vial	20,652.24	28,929.94
62	Pertuzumab	30 mg/mL, 14 mL vial	124,356.34	174,115.67
63	Regorafenib	40 mg film-coated tablet	2,026.30	2,853.62
64	Rituximab	100 mg/10 mL, 10 mL vial	9,783.74	13,714.04
65	500 mg/50 mL, 50 mL vial	47,673.39	66,759.55
66	Trastuzumab	150 mg vial	26,025.24	36,452.14
67	Trastuzumab Emtansine	100 mg vial	65,318.33	91,462.46
68	160 mg vial	104,908.18	146,888.25

Immunosuppressant

69	Azathioprine	50 mg tablet+	34.30	42.58
70	Basiliximab	20 mg vial	53,969.49	75,574.09
71	Ciclosporin	100 mg/mL, 50 mL oral solution	6,634.84	9,305.57
72	Etanercept	25 mg/0.5 mL, 0.5 mL pre-filled syringe (SC)	5,316.17	7,459.44
73	Golimumab	50 mg/0.5 mL, 0.5 mL pre-filled autoinjector	44,022.64	61,648.50
74	Immunoglobulin Anti-Thymocyte	25 mg vial+	11,704.12	16,402.57
75	Mycophenolic Acid	360 mg enteric coated tablet	58.71	94.36
76	Secukinumab	150 mg vial	17,004.26	23,822.77
77	Sirolimus	0.5 mg tablet	136.97	208.55
78	1 mg tablet	185.72	276.81
79	Tacrolimus	0.5 mg prolonged-release capsule	46.34	75.26
80	1 mg prolonged-release capsule	83.18	131.36
81	Tocilizumab	200 mg/10 mL, 10 mL vial	10,392.98	14,566.97
82	400 mg/20 mL, 20 mL vial	20,581.45	28,830.84
83	Tofacitinib	5 mg film-coated tablet	569.61	814.26
84	Ustekinumab	45 mg/0.5 mL, 0.5 mL pre-filled syringe	114,933.59	160,923.83

Analgesics

85	Morphine	10 mg modified-release tablet+	10.08	16.00
86	30 mg modified-release tablet+	26.18	41.58
87	60 mg modified-release tablet+	69.67	108.69
88	Naloxone + Oxycodone	10 mg + 20 mg prolonged-release tablet+	143.80	214.00
89	2.5 mg + 5 mg prolonged-release tablet+	80.10	124.13
90	20 mg + 40 mg prolonged-release tablet+	243.54	351.00
91	5 mg + 10 mg prolonged-release tablet+	72.92	113.50
92	Oxycodone	10 mg controlled-release tablet+	115.69	175.39
93	10 mg/mL, 1 mL vial+	552.40	775.23
94	10 mg/mL, 2 mL vial+	923.50	1,284.96
95	Parecoxib	40 mg ampule	329.44	478.01

Antiasthmatic & Chronic Obstructive Pulmonary Disease (COPD) Preparation

96	Fluticasone	500 mcg/2 mL, 2 mL nebules	59.02	85.00
97	Formoterol	12 mcg dry powder for inhalation, capsule	15.32	24.88
98	Indacaterol	150 mg inhalation powder, capsule	48.71	79.11
99	300 mcg inhalation powder, capsule	47.54	77.21
100	Procaterol	10 mcg/dose, 200 doses lung metered dose inhaler	589.99	842.78
101	Roflumilast	500 mcg film-coated tablet	54.95	88.69
102	Tiotropium Bromide	18 mcg powder for inhalation, capsule	57.33	92.28
103	2.5 mcg per dose, 60 doses (4 mL)+	2,420.34	2,988.26

Anticoagulant

104	Apixaban	2.5 mg film-coated tablet	56.59	91.17
105	5 mg film-coated tablet	56.47	90.98
106	Ticagrelor	90 mg film-coated tablet	54.70	80.25
107	Tinzaparin	10,000 anti-XA IU 2 mL vial (SC)	711.57	1,013.00
108	4500 anti-XA IU, 0.45 mL pre-filled syringe	238.31	350.44
109	Tirofiban	250 mcg/mL, 50 mL	8,570.94	12,016.12
110	Triflusal	300 mg capsule	28.06	45.57

Anti-Angina

111	Isosorbide Dinitrate	0.1%, 10 mL ampule+	485.72	696.81
112	Ivabradine	5 mg film-coated tablet	23.31	37.86
113	7.5 mg film-coated tablet	23.52	38.19

Agents affecting bone metabolism

114	Calcitonin (Salmon)	100 IU/mL, 1 mL ampule	321.42	466.79
115	200 IU nasal spray, 14 doses	3,041.56	4,274.99
116	Ibandronic Acid	6 mg/6 mL, 6 mL vial	7,675.33	10,762.26

Antiemetic

117	Palonosetron	75 mcg/1.5 mL, 1.5 mL vial	902.47	1,280.26
118	Ramosetron	100 mcg oral disintegrating tablet	659.95	940.73
119	300 mcg/2 mL, 2 mL ampule	1,002.32	1,420.05

Psoriasis, Seborrhea & Ichthyosis Preparation

120	Betamethasone + Calcipotriol	500 mcg + 50 mcg/g, 30 g gel	1,221.36	1,726.70
121	Betamethasone + Salicylic Acid	0.5 mg + 30 mg/g, 5 g ointment	151.84	229.38

Antidepressant

122	Vortioxetine	10 mg film-coated tablet	61.66	98.83
123	20 mg film-coated tablet	61.83	99.08
124	5 mg film-coated tablet	32.99	53.57

Iron Chelating Agent

125

Deferoxamine

500 mg, 7.5 mL vial

163.68

245.96

Growth Hormone Inhibitor

126

Octreotide

20 mg vial

48,457.96

67,857.95

Antiviral

127

Ganciclovir

500 mg vial

1,630.78

2,299.90

Fibrinolytic

128

Alteplase

50 mg, 50 mL vial

27,264.30

38,186.81

Hematopoietic Agent

129

Lenograstim

263 mcg/mL, 1 mL vial

3,987.48

5,599.27

Mucolytic

130

Erdosteine

175 mg/5 mL, 60 mL suspension

120.92

186.09

Parenteral Nutritional Product

131

Alanyl-Glutamine

200 mg/mL, 100 mL solution for infusion

1,766.04

2,489.26

Phosphate Binder

132

Sevelamer

800 mg film-coated tablet

34.63

56.24

Surfactant

133

Beractant

25 mg/mL, 8 mL vial+

14,086.19

19,600.27

MRP refers to the maximum price given by retailers to consumers. Prices reflected, by default, are value-added tax (VAT) inclusive.

MWP refers to the maximum price to be given by the manufacturer/wholesales/trader/distributor and the like to retailer.

Special discounts such as Senior Citizen and Persons with Disability shall continue to be honored.

*MRPs reflected are VAT-exclusive.

+Voluntary price reduction from pharmaceutical companies which the government approved.

Published in the Official Gazette, Vol. 116, No. 8, p. 1164 on February 24, 2020.