REPUBLIC OF THE PHILIPPINES
HOUSE OF REPRESENTATIVES
Quezon City

NINETEENTH CONGRESS
Third Regular Session

House Bill No._ 16680

Introduced by ABONO Party-list Representative
HON. ROBERT RAYMUND M. ESTRELLA

EXPLANATORY NOTE

Access to affordable and quality healthcare remains a significant challenge for many Filipinos,
particularly those in geographically isolated and disadvantaged areas (GIDA.)' The timely availability
of essential medicines is a critical component of healthcare delivery and in many instances, the lack of
accessible pharmacies, steep drug prices, and the additional burden of transportation costs exacerbate the
difficulties faced by patients in obtaining their prescribed medications. These factors contribute to a
compliance gap in patients, which if left unaddressed, will ultimately render the Universal Healthcare
Act inutile

There are about 30,000 practicing pharmacists spread thinly and unevenly between local
pharmacies, private and public hospitals, and among other relevant institutions. Ilstratively, the public
healthcare system mandates the employ of an in-house pharmacist only up to the district level, meaning
in small local hospitals, health centers, and rural health units, an essential health professional is absent—
there even exists no available plantilla position for it, Add the fact that physicians are legally restricted
to dispense medicine to their patients, except for free samples, and we now discover a glring deficiency
in our healthcare delivery system. If pharmacists, who are health professionals tasked with dispensing
medicine and medication counseling are absent, while doctors are limited to writing prescriptions; the
sale or distribution of medicines often becomes the responsibility of untrained individuals. Such practice
is ahealth risk, and can only serve to increase the chances of mistreatment

In this scenario, it makes no sense that a physician that can prescribe not only what medicine to
take, but albo the exact dosage required for maximum efficacy, cannot dispense the appropriate drug to
their patients due to an antiquated restriction from a historical period when prescription drugs still had to
be compounded in pharmacies. Physicians, owing to their relations with their patients, are already quickly
able to gauge the efficacy of a given brand of medicine and/or the side effects that may arise from the
usage of particular brands. In addition, they are professionally trained to provide counsel and discuss
safeguards with regard to the medications they prescribe to their patients. The truth of the matter is,
instead of relying on unqualified individuals who have little to no background in the practice of medicine
and pharmacy, why not rely on our physicians who are better equipped to work with our pharmacists. in
effectively dispensing safe, affordable, and effective medicines.

The practice of allowing physicians to dispense medicines is not a groundbreaking policy
proposal. Advances in medicine meant what was once a compound of varying substances have now taken
a safer and more efficient form as capsules or tablets. Countries like the United States, Japan, and
Singapore, among others, have allowed their physicians to dispense medicines making the process of



healing and recovery easier on patients, especially in underserved areas. Practically speaking, without
the burden of overhead costs in establishing and operating a pharmacy, we can expect a reduction on the
price of medicine, bypassing the opaque vagaries of retail drug pricing.

It is for these reasons that this measured is proposed. Under this Act, physicians shall be
authorized to directly dispense medicines to their patients with the end goal of making medicines more
accessible and helping to drive down medicine costs.

In view of the foregoing, the approval of this bill is eamestly sought.

fep. Robert Rayfnund M. Estrella



ANNEX 1

2023 GIDA SUMMARY as per the Department of Health

MIMAROPA

RIZAL

|

CAR
ABRA 76 MARINDUQUE. 23
|APAYAO 43] [OCCIDENTAL MINDORO 4g
BENGUET 87] | ORIENTALMINDORO. 13
TFUGAO ios) [PALAWAN rr
KALINGA 90] | PUERTO PRINCESA 1g
MOUNTAIN PROVINCE ROMBLON. 55,
ILOCOS REGION BICOL REGION
ILOCOS NORTE 3} ~~ [ALBaY 154
ILOCOSSUR 80 | CAMARINES NORTE sq
UAUNION Sal | CAMARINES SUR 357,
PANGASINAN 18) | CATANDUANES ail
MASBATE 280
CAGAYAN VALLEY SORSOGON 234
BATANES 14)
CAGAYAN 34 WESTERN VISAYAS
ISABELA 1 AKLAN 64
NUEVA VIZCAYA 89) [ANTIQUE 104
QUIRINO 55] [CAPIZ 6
ae Sea [cumanas EI
CENTRAL LUZON ILOILO 25
[AURORA 33] | NEGROS OCCIDENTAL ud
BATAAN 4
BULACAN 1 CENTRAL VISAYAS
NUEVAECHIA 62| [BOHOL Ey
PAMPANGA 20 «= [ ceBu Gi
[ANGELES CITY 3] | NEGROS ORIENTAL E
TARLAC Fr
ZAMBALES 25 EASTERN VISAYAS
CALABARZON EASTERN SAMAR a
BATANGAS 35] [LEYTE 3g
(CAVITE 2] [NORTHERN SAMAR FEY
LAGUNA 3] _[ SAMAR (WESTERN SAMAR) 15q
[QUEZON 170| | SOUTHERN LEYTE 10
LUCENA CITY a



ZAMBOANGA PENINSULA

‘SOCCSKSARGEN

DAVAO OCCIDENTAL

DAVAO ORIENTAL Ee

(CITY OF ISABELA 17] [COTABATO (NORTH COTABATO) 08
ZAMBOANGA DEL NORTE 223| [SARANGANI 53)
[ZAMBOANGA DEL SUR 194] [SOUTH COTABATO
ZAMBOANGA CITY SULTAN KUDARAT
ZAMBOANGA IBUGAY Ee ————
NORTHERN MINDANAO BASILAN.

BUKIDNON 123] [LANAODELSUR 304
[CAMIGUIN a] [MAGUINDANAO, 215|
LANAO DEL NORTE aii] [suw 233
TUGAN CITY 2h] [TAWL-TAWI
MISAMIS OCCIDENTAL 75) feat eee
MISAMIS ORIENTAL e CARAGA
CAGAYAN DE ORO CITY 19] [AGUSAN DEL NORTE 3g

ee AGUSAN DEL SUR 122)

DAVAO REGION BUTUAN CITY 14
(COMPOSTELA VALLEY / DAVAO DE ORO 82) [DINAGATISLANDS FE}
DAVAO DEL NORTE 66] | SURIGAO DEL NORTE i
DAVAO DEL SUR 72] [SURIGAO DEL SUR
DAVAO CITY 33]
85



ANNEX 2

Respor ies of a Doctor of Medicit

As per R.A. 2382 or the Philippine Medical Act of 1959, a person is engaged in the practice of medicine
if

(a) for compensation, fe, salary or reward in any form, paid to him directly or through another, or
even without the same, physically examine any person, and diagnose, treat, operate or prescribe
any remedy for any human disease, injury, deformity, physical, mental or physical condition or
any ailment, real or imaginary, regardless of the nature of the remedy or treatment administered,
prescribed or recommended; or

(b) by means of signs, cards, advertisements, written or printed matter, or through the radio,
television or any other means of communication, either offer or undertake by any means or
method to, diagnose, treat, operate or prescribe any remedy for any human disease, injury,
deformity, physical, mental or psychical condition; or

(©) the individual uses the title M.D. after his or her name.
Scope of the Medical Board Exam:

“Section 21. Scope of examination. The examination for the registration of physicians
shall consist of the following subjects: (1) Anatomy and Histology, (2) Physiology, (3)
Biochemistry, (4) Microbiology and Parasitology, (5) Pharmacology and Therapeutics, (6)
Pathology, (7) Medicine, (8) Obstetrics and Gynecology, (9) Pediatrics and Nutrition, (10)
Surgery and Opthalmology, Otolaryngology and Rhinology, (11) Preventive Medicine and Public
Health, and (12) Legal Medicine, Ethics and Medical Jurisprudence: Provided, however, That
the examination questions in each subject or group of subject shall at least be ten in
number: Provided, further, That the examination questions in Medicine shall include at least
three from the following branches: Infectious diseases, Neurology, Dermatology, Allergy,
Endocrinology and Cardio-Vascular diseases: Provided, finally, That the examination questions
in Surgery shall include at least four questions from the following: Opthalmology, Otology,
Rhinology, Laryngology, Orthopedic Surgery and Anesthesiology”

Responsibilities of a Registered Pharmacist:
As per R.A. 10918 orthe Philippine Pharmacy Act, a person is engaged in the practice of pharmacy when
with or without a fee, salary, percentage or other rewards, paid or given directly or indirectly, shall:

a) Prepare, compound or manufacture, preserve, store, distribute, procure, sell, or dispense, or both,
any pharmaceutical product or its raw materials;* or

b) Render services, such as clinical pharmacy services, drug information services, regulatory
services, pharmaceutical marketing, medication management, or whenever the expertise and
technical knowledge of the pharmacist is required;* or



c) Engage in teaching scientific, technical, or professional pharmacy courses in a school or college
of pharmacy;* or

4) Dispense pharmaceutical products in situations where supervision of dispensing of pharmaceutical
products is required;* or

©) Chemical, biological or microbiological analyses and assay of pharmaceutical products,
food/dietary supplements, health supplements, and cosmetics; or

1) Physico-chemical analyses for medical devices used in aid of administration of pharmaceutical
products; or

g) Administration of adult vaccines as approved by the Food and Drug Administration (FDA):
Provided, That they shall undergo the training on the safe administration of adult vaccines and
management of adverse event following immunization (AEFI) for pharmacists and hold a certificate
of training issued by an institution duly accredited by the Professional Regulation Commission
(PRC): Provided, firther, That the safe administration of vaccines be part of the higher education
curriculum for pharmacists; or

hh) Conduct or undertake scientific research in all aspects involving pharmaceutical products and
health care; or

’) Provide other services where pharmaceutical knowledge is required.*

Legend:
*~ Activities under paragraphs (a), (b), (c), (4) and (9) are exchisive to licensed pharmacists.



Aauewn

oo

10
M1
12

13
14

15
16
7
18
19
20
21
22
23
24
25

REPUBLIC OF THE PHILIPPINES.
HOUSE OF REPRESENTATIVES
Quezon City

NINETEENTH CONGRESS
Third Regular Session

House Bill No._ 16680

Introduced by ABONO Party-list Representative
HON. ROBERT RAYMUND M. ESTRELLA

AN ACT AUTHORIZING LICENSED PHYSICIANS TO DIRECTLY DISPENSE MEDICINES
TO PATIENTS AND FOR OTHER PURPOSES

Be it enacted by the Senate and House of Representatives of the Philippines in Congress
assembled:

SECTION 1. Short Title.—This Act shall be known as the “Physician Dispensing Act”

SEC. 2. Declaration of Policy. — It is the policy of the State to protect and promote the right to
health of ll Filipinos and instill health consciousness among them. It likewise recognizes the essential
role of physicians in the healthcare delivery system, particularly in geographically isolated and
disadvantaged areas (GIDA,) and aims to authorize and regulate the direct dispensing of medicines by
physicians to enhance patient care and accessibility to medications, thereby promoting access to quality
healthcare and affordable medicines pursuant to the Universal Healthcare Act.

SEC. 3. Definition of Terms. — For the purposes of this Act, the following shall mean:

a. Dispensing refers to the distribution, procurement, or sale of prescription medicine to
patients;

b. Pharmacist refers to ahealth professional who has been registered and issued a valid
Certificate of Registration (COR) and Professional Identification Card (PIC) by the
PRC and the Professional Regulatory Board of Pharmacy;

c. Physician refers to a health professional who has been registered and issued a valid
Certificate of Registration (COR) and Professional Identification Card (PIC) by the
PRC and the Professional Regulatory Board of Medicine; and

SEC. 4. Licensing and Accreditation.- Physicians who elect to dispense medicines shall, at no
cost, register with the Department of Health for an authority to dispense. The Department of Health shall
at least require the following details from the physician prior to registration:

1. Physician Name;
2. PRC License Number;
3. Primary Practice/Dispensing Location;



26
27

28
29
30
31

32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49

50
51
52

33
54
55
56
57

58
59
60

61

62
63

65

4. Contact Numbers; and
5. Additional Practices/Dispensing Location’s

SEC. 5. Authority to Dispense. ~ Licensed dispensing physicians are hereby authorized to
dispense medicines, which are registered with and approved by the FDA, to their patients, subject to the
provisions of this Act and other applicable laws, rus, and regulations. In dispensing medicine,
physicians shall adhere to the following principles:

a. To avoid conflicts of interest and not exploit patients for financial gain by ensuring
compliance with the Maximum Retail Drug Prices (MRDP) and the Suggested Retail
Prices (SRP) of drugs and honoring legally mandated discounts, inchuding but not
limited to discounts for senior citizens and persons with disabilities;

b. To prescribe and dispense medications based on patient's best interest, considering
cflicacy, safety, and cost,

¢. To practice transparency with regard to patients’ treatment options, including the
availability of cheaper atemative medications, or their generic equivalent pursuant to
the provisions of Republic Act No. 6675 or the Generics Act of 1988;

4. To inform their patients, before the sale of any medicine, that they have the option to
buy the needed medicine from either the hospital or clinic pharmacy or in any other
retail drugstore or pharmacy;

€. To consistently issue a receipt of sale for every drug sold to patients and to allow for
refinds should patients wish to retum their purchase, regardless of reason;

£ To maintain, whenever dispensing takes place, appropriate records containing the
name of the patient, the name and strength of the drug dispensed, the quantity, the
dose, among other such details to be required by the Department of Health and the
Food and Drug Administration.

Physicians may dispense only to individuals with whom they have established a physician/patient
retionship. No physician shall be allowed to dispense medication at the order of any other physician
not registered to practice and dispense in a particular hospital, clinic, or location.

SEC. 6. Drug Packaging and Labeling. Physicians licensed to dispense prescription medicine
must comply with the regulations goveming the types of container that may be used to repackage
prescription drugs as specified in Sec. 36 of Republic Act No. 10918 or the Philippine Pharmacy Act,
unless the patient to whom the drug is dispensed gives written authorization for the container to be
otherwise.

SEC. 7. Implementing Rules and Regulations. — The Department of Health, together with the
Food and Drug Administration shall issue the necessary rules and regulations for the effective
implementation of this Act.

SEC. 8. Penal Provisions. - Any physician authorized to dispense found to be in violation of the
provisions of this Act or the guidelines issued pursuant hereto shall be subject to the appropriate penalties
under Philippine laws, including suspension or revocation of their license to practice medicine.

SEC. 9. Repealing Clause. — All laws, executive orders, rules and regulations, or parts thereof
which are inconsistent with this Act are hereby repealed or modified accordingly.



66
67

68
69

SEC. 10. Separability Clause. — If any part or provision of this Act is decked invalid or
unconstitutional, the other parts not otherwise affected shall remain in full effect and force.

SEC. 11. Effectivity. This Act shall take effect fifleen (15) days fiom the date of its publication
in the Official Gazette or in at least two (2) newspapers of general circulation,

Approved,