Mister President, esteemed colleagues, ladies and gentlemen,
Today, I rise before you with a heavy heart and a sense of moral obligation to shed light on a matter of grave concern within the medical community. It saddens me to say that a significant conflict of interest and unethical behaviors have seeped into the medical profession, compromising their commitment to prioritize the well-being of their patients above all else.
Reports have come out that certain doctors have become entangled in the web of a pharmaceutical company that shamelessly peddles its products through a deplorable multi-level marketing scheme.
Mr. President, my dear colleagues, an all-Filipino-owned pharmaceutical company engaged in distributing anti-hypertensive, anti-diabetic, antibiotic products and health supplements nationwide, called Bell-Kenz Pharma Inc. is at the center of this issue.
Maliban sa iilan sa kanila, napag-alaman ko na ang kumpanyang ito ay binubuo halos ng mga doktor, mga espesyalistang doktor. Sa datos mula sa Securities and Exchange Commission, ang mga tumatayong directors o officers ay sina Luis Raymond T. Go bilang presidente, Alina Fatima M. Hojilla (vice president), Joseph Vincent T. Go (corporate secretary, a lawyer), Jaime F. Cayetano Jr. (treasurer) at limampu’t walong (58) iba pa na stockholders na pawang mga doktor mula sa iba’t ibang panig ng bansa.
Karaniwan na nating naririnig ang mga insentibong ibinibigay sa mga doktor at nakasaad naman sa Philippine Medical Association Code of Ethics na maaari silang tumanggap ng mga regalo. Nakasaad sa Article 6 nito na “only gifts of reasonable value that primarily entail benefit to patient care or related to physicians’ work may be accepted by a physician from a health product company.”
Ganito rin ang nakasaad sa The Mexico City Principles, ang itinuturing na international code of business ethics sa biopharmaceutical industry na inindorso sa Asia-Pacific Economic Cooperation (APEC) noong 2011 at kung saan ay signatory ang Pilipinas at ipinatutupad ng Department of Health sa pamamagitan ng Administrative Order No. 2015-0053.[1]
Ang mga doktor ay pinagkatiwalaan ng isang sagradong tungkulin na itaguyod ang pinakamataas na pamantayang etikal na pag-uugali at pagbibigay prayoridad sa kalusugan at kapakanan ng mga taong nagtitiwala sa kanilang pangangalaga. Nakasaad ito sa Hippocratic Oath na kanilang sinumpaan.[2]
Sa kaso ng Bell-Kenz, mukhang nakalimutan ng mga doktor sa likod ng kumpanyang ito ang sinumpaang oath at iba ang pamantayan nila. Kung kadalasan na nating naririnig ang kaliwa’t kanan na sponsored na trips abroad sa mga doctor at stakeholders ng pharmaceutical companies, ang Bell-Kenz ay namimigay ng cash incentives na umaabot sa milyon, o kaya naman ay mga mamahaling sasakyan na nasa milyon-milyong halaga rin.
This company which has been in operation since 2006, shamelessly recruits doctors, not medical representatives, into its fold, enticing them with promises of exorbitant commissions and lavish incentives in exchange for prescribing their medicines – a blatant violation of their ethical principles, betrayal of trust bestowed upon them by their patients, and a flagrant disregard for the sacredness of their profession.
Under the guise of advancing medical science and improving patient outcomes, these doctors-turned-entrepreneurs exploit their positions of authority to promote and prescribe medications that may not necessarily be in the best interest of their patients. They prioritize profits over patients, prioritizing their financial gains over the well-being of those they have sworn to serve and protect.
Mr. President, my dear colleagues, allow me to walk you through their business scheme.
Ang mga ni-recruit nilang mga doktor na bumubuo ng “core group” ay tinatawag na “Jedis.” Dahil mahilig sa “Star Wars” ang mga may-ari ng kumpany na sina Doctors Luis Go, Berwyn Flores at James Cayetano.
Not everybody can be part of this group. Only doctors who are recommended by a Jedi and all other Jedis will be accepted. If there’s one Jedi who disapproves of a particular doctor for whatever reason, that doctor cannot be a Jedi.
They do this approval process via the Jedi Viber group. The reason why a Jedi recommends a doctor is mostly based on friendship, practice, and influence.
Bell-Kenz started predominantly with a group of cardiologists. Gradually, they tapped endocrinologists/ diabetologists, pulmonologists, neurologists, internists, and family physicians.
The recommended Jedis go through the nurturing lecture conducted by Dr. Luis Go. The objective of this lecture is to teach doctors financial freedom and that Bell-Kenz is the only pharmaceutical company that can make it possible.
Their productivity is regularly monitored and once they reach the target productivity, they level up to Jedihood. Once already a Jedi, they can enjoy all the benefits of a Jedi and these are the following:
· Eight (8) percent rebates based on monthly productivity (usually around P2 million);
· Milestone point;
Under the milestone program points system, one (1) point is earned from the minimum P2,700 worth of prescribed brand sales. Earned points can be used for redemption of items such as gadgets, household items, or foreign travel. One point is equivalent to one hundred pesos (P100).
· Yearly performance bonus based on the percentage of the total contributions of the sales of Jedis against all of the Jedis;
· Dividends and growth of sales which is based on the total number of shares the the doctor holds;
· And on top of that is what they call as the annual “Jedi star tour.” Depende kung na hit ng doktor ang kanyang 3.5 percent productivity target, maaari silang bigyan ng Asian, European o US tour package;
· Nanggagaling naman sa rebates ang mga cash or luxury items tulad ng “dream car” nila. Convertible sa mga cash, mamahaling kotse, Rolex at iba pa ang naipong rebates.
Para maging Jedi, kailangan nilang mag prescribe ng mga gamot ng Bell-Kenz, maging mga supplements na ibinibenta ng kumpanya, kailangan man o hindi ito ng pasyente. Nasa P250,000 hanggang P500,000 ang “entry” level ng investment nila.
The Jedis also earn from the prescription of the “down-line” doctors they recruit. If the down-line doctor is not an investor, the recruiting doctor earns a six (6) percent rebate from every prescription of company products made by the down-line doctor.
The company also has a category of “second investors” who are called “Padawans.” In the fictional universe of the Star Wars films, a Padawan is a Jedi apprentice.[3] They do not have downline doctors. Padawans are entitled to receive dividends, and rebates and earn milestone points.
Unlike other pharmaceutical companies, the Bell-Kenz model is different and doctors tend to stick with it because of its attractive benefits. Most of them are enticed by the leveling- up scheme.
Dahil madami silang na re-recruit, natural lamang na mabilis din ang paglago ng kumpanya. Mula sa isang bilyon na benta noong 2016, tumaas pa ito at umabot sa P3.2 bilyon noong 2018 at P5 bilyon noong 2019.
The scheme is not only about making money but also hurts the credibility and integrity of the medical profession. The doctors who engage in such unethical practices undermine public trust in healthcare professionals and cast a dark shadow over the noble work of dedicated physicians who strive to uphold the highest ethical standards.
We cannot allow this unethical conduct to continue. It is our responsibility to denounce and eradicate such practices.
Nakapanlulumong isipin na habang pinipilit natin na gawing abot-kaya para sa mga mahihirap nating kababayan ang presyo ng mga gamot, sa pamamagitan ng mga pagbibigay ng diskwento gaya ng Senior Citizens Act, RA 10754 o ang batas na nagpalawig ng mga benepisyo ng mga persons with disability o PWDs, at iba pa, ay may mga doktor na nagdadagdag ng mga pasanin sa kanilang mga gastusin.
Under the Generics Act of 1988, all medical, dental and veterinary practitioners, including private practitioners shall write prescriptions using the generic name. The brand name may be included if so desired.[4]
Nakasaad din sa batas na ang mga drugstores at iba pang mga kagaya nito ay may responsibilidad na ipaalam sa bumibili na maaari silang bumili ng ibang produkto na may kahintulad na generic name. Dapat binibigyan ng karapatan ang bumibili na makapamili at hindi matali sa brand na inirerekomenda ng mga doktor. Maaring masuspinde ang lisensya ng doktor kung hindi susunod sa kautusan ng batas na ito.
Mr. President, while it is not illegal for medical professionals to engage in business activities, it is highly unethical when a pharmaceutical company owned by doctors hires other doctors as agents and pays them commissions based on the prescriptions they give to patients.
This practice becomes even more concerning when these doctors are also required to meet a quota for the number of prescriptions they give out. This type of behavior is not only unethical but also prejudicial to the well-being of Filipino patients.
To prescribe drugs from doctors who are agents or distributors of Bell-Kenz is a clear conflict of interest under the Mexico City Principles and the Code of Ethics for doctors.
The trust and confidence that patients place in their physicians are paramount. To preserve this trust, medical practitioners must adhere to the highest ethical standards. This includes the strict prohibition on physicians benefiting financially from the medications they prescribe, as established by various international protocols. Such a measure ensures that patients’ welfare remains the top priority in all medical decisions, free from any financial bias.
In bringing to your attention this matter, I implore you, my dear colleagues, to condemn this reprehensible exploitation of some medical practitioners for personal gain. May I emphasize, Mr. President, that those allegedly involved represent only a fraction of our country’s more than 28,000 practicing doctors. Hindi ko po sila nilalahat. Naniniwala ako na mas nakakarami pa rin ang mga kababayan nating doktor ang nanatiling tapat sa kanilang sinumpaang tungkulin alinsunod sa kanilang Code of Ethics.
I move to have this issue investigated by the appropriate committee to enable us to craft the needed legislation. It’s probably high time that we come up with legislation similar to the United States, the Anti-Kickback Statute, a criminal law that prohibits the knowing and willful payment of “remuneration” to induce or reward patient referrals or the generation of business involving any item or service payable by the Federal health care programs.[5]
As I close, I urge our medical professionals to reaffirm their commitment to the Hippocratic Oath and reassert their dedication to the highest ethical standards of medical practice.
The Filipino people deserve nothing less than your unwavering devotion to their health and well-being, free from the influence of greed and self-interest.
Thank you, Mr. President.
[1] https://www.fda.gov.ph/wp-content/uploads/2024/01/A.O-2015-0053.pdf
[2] https://www.philippinemedicalassociation.org/wp-content/uploads/2017/10/HIPPOCRATIC-OATH.pdf
[3] https://www.oed.com/dictionary/padawan_n
[4] https://www.officialgazette.gov.ph/1988/09/13/republic-act-no-6675/
[5] https://www.law.cornell.edu/uscode/text/42/1320a-7b