The Philippine government has achieved milestones when it comes to the campaign for integrity in the healthcare community. In 2011, the Mexico City Principles for Voluntary Codes of Business Ethics for the Biopharmaceutical Sector was endorsed by Asia-Pacific Economic Cooperation (APEC) member economies, including the Philippines.
The Philippine Food and Drug Administration also adopted and implemented the Mexico City Principles in September 2013. The Department of Health (DoH), meanwhile, created a Committee for the Creation and Adoption of the Mexico City Principles (MCP) and Kuala Lumpur Principles for Medical Device Sector Codes of Business Ethics. In enforcing the MCP, the DoH has put in effect Administrative Order No. 2015-0053 relating to the Implementing Guidelines on the Promotion and Marketing of Prescription Pharmaceutical Products and Medical Devices.
All these have been put in place due to the recognition that ethical interactions between the pharmaceutical industry and the healthcare community benefit the patients as well as propel the advancement of science and medical information.
Prior to the adoption of the APEC Mexico City Principles, the Pharmaceutical and Healthcare Association of the Philippines (PHAP) adopted its own Code of Practice in the early 1990s. As a member of the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA), PHAP fully subscribes to the rigid international code.
The Code is a requirement for PHAP membership, a non-negotiable component to be part of our roster. Previous members who could not comply with the Code for various reasons, including their failure to understand the importance of being bound by a stringent code of conduct, left the association. Our current members, composed of 40 pharmaceutical companies, are those that have been at the forefront of the research and development of medicines and vaccines for COVID-19, among others.
Among the principles that the Code espouses are trust, care, quality, innovation, quality, fairness, and integrity.
Specifically, “trust” is where all PHAP members are expected to act with integrity and honesty to improve patient care and build trust with those they serve. Also crucial in promoting this principle is respecting the independence of healthcare providers, patients, and other stakeholders.
Another principle is “care” where PHAP members must protect the safety of those who use their medicines and vaccines — from the conduct of clinical trials and throughout the product life cycle. The next principle is “quality” which is about the commitment to providing high quality medicines and vaccines that have proven clinical efficacy and have a reliable safety profile. Also crucial is “fairness” which supports and respects fair trade practices and open competition.
“Integrity,” on the other hand, is acting responsibly, ethically, and professionally. This refers to not offering, promising, providing, or accepting anything of value in order to inappropriately influence a decision, or gain an unfair advantage.
These principles are backed by specific provisions and rigid enforcement mechanisms. The Code of Practice is implemented through an independent Ethics Committee comprised of leading ethicists and health luminaries.
For example, Section 11.2 of the Code states that venues that are considered as beach resorts as well as those that primarily offer leisure or recreational facilities and those that operate casino and or golf courses within their premises are considered inappropriate venues for events. The PHAP has time and again been asked to comment on a venue’s appropriateness by various groups, including medical societies, and our stance has always been to refer to said Section 11.2.
Meanwhile, Section 12 of the Code, titled “Independence of Healthcare Professionals,” states that PHAP member companies’ relationships with healthcare professionals and other stakeholders are intended to benefit patients and to enhance the practice of medicine. Interactions should be focused on informing healthcare professionals about medicines, providing scientific and educational information, and supporting medical research and education.
The said provision adds that no financial benefit or benefit-in-kind may be provided or offered to a healthcare professional in exchange for prescribing, recommending, purchasing, supplying, or administering products or for a commitment to continue to do so. Gifts of any kind for the personal benefit of healthcare professionals are not allowed, irrespective of value, kind, or occasion.
The Code is cascaded to PHAP members through a pioneering module called the Integrity and Proficiency Program for the Pharmaceutical Sector (IPPS). The IPPS, registered under the Professional Regulation Commission, offers not just science-related information. It also provides modules on various laws and codes that must guide all interactions with healthcare professionals, the government, and patients among others.
In the healthcare community, unethical behavior hurts not just businesses. It also brings harm to patients and deprives them of the quality and appropriate healthcare they deserve. Ethical interactions, meanwhile, help ensure that medical decisions are made in the best interests of patients. They also level the playing field and encourage robust competition in the industry.
Due to the unique role of ethical behavior in positively affecting the health and lives of patients, the pharmaceutical industry must always be committed to ethical behavior. For this reason, we are, we will, and we continue to stand for integrity.
Teodoro B. Padilla is the executive director of Pharmaceutical and Healthcare Association of the Philippines (PHAP). PHAP represents the biopharmaceutical medicines and vaccines industry in the country. Its members are in the forefront of research and development efforts for COVID-19 and other diseases that affect Filipinos.
