No Free Lunch

Posted on July 14, 2006. Filed under: Resources |

by Raoul A. Bermejo III, MD

I just received the degree of Doctor of Medicine and these days a new physician has many things to be bothered about –an eroding public image of the doctor, the crisis of health worker migration, and the lack of access of many Filipinos to health care. But while these issues have been often talked about, I would like to raise another that, because it is ingrained in our health care subculture, is often tolerated.

I am bothered by the fact that our class graduation party was largely paid by a drug company. They footed the bill of 150,000 pesos for dinner. Just to be clear about it. It was a party. It was not a scientific meeting. It was not a course of continuing medical education. People went there to eat, drink and be merry.

I am bothered that our class allowed it. It is patently a marketing scheme from the drug company and our class fell for it. Many feel that they are above the issue thinking that they can personally resist being swayed by all these marketing schemes. I think that is being quite naïve. Drug companies utilize these schemes because they work. Clear evidence has shown that physicians’ behaviour in prescribing medication is affected by these enticing efforts of drug companies.

And even if a doctor really can resist being swayed by these marketing schemes, where is the marketing money of drug companies coming from?  Do you really think that it is out of the goodness of their heart? Or their fondness of physicians? Marketing costs are passed on to the consumers and thus are shouldered by patients.  Costs from maintaining an army of cute and dapper medical representatives, and costs from cups of coffee, rounds of golf, lunches, tours, and various freebies that physicians accept contribute to the high prices of medications in the country. All these enjoyable freebies come from the pockets of patients, many of them poor and could hardly afford the complete course of medications their doctors prescribe.

Drug prices in the country are as much as it is in Western Europe, the U.S. and Canada. Our country, having no real pharmaceutical industry of its own, is one of the favourite playgrounds of the three big pharmaceutical firms. They are now challenging even the band-aid effort of our government to make essential drugs accessible to poor Filipinos though parallel drug importation. Expensive marketing schemes compound the problem of unjust drug pricing.

Will making a stand now against an unethical practice really change the situation? Our small daily choices may seem minute to make a dent on what is a much-ingrained practice. But how do we expect the situation to change? Who will make that stand if not us? Our collective stand will matter and will make that change.

There is no such thing as a free lunch. Or a free graduation party.

Bermejo is 27 years old. He graduated from the University of the Philippines College of Medicine on May 21, 2006. For comments, email him at


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