MANILA, Philippines – While Bell-Kenz Pharma, Inc. dismissed allegations that its business model resembles a pyramid scheme, its executives admitted that it does give out incentives to its shareholder-doctors.

In a Senate hearing on Tuesday, April 30, Bell-Kenz Pharma chief executive officer Luis Raymond Go repeatedly denied that doctors receive commission from their company.

“There is no doctor that is earning from another doctor in Bell-Kenz Pharma,” said Go, a cardiologist who also sits as the company’s chairperson.

The hearing comes after reports surfaced that some doctors would prescribe their patients with a certain medical brand that they can profit from, with a scheme similar to that of multi-level marketing.

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While Go denied this, he admitted they do give “incentives” to doctors who include their brand in the generic prescriptions for their patients. These include supporting them in programs for continuing medical education here and abroad. Go also said that they also sometimes provide their doctors clinic equipment and trips overseas.

“We also gave out watches,” Go said in Filipino. “But not Rolex watches.”

‘Traditional’ pharma

The goal of the 17-year-old company is to make medicine more affordable for Filipinos, with products sourced from Bangladesh, Korea, India, and Vietnam. The Food and Drug Administration (FDA) has confirmed that their products are registered and some are also awaiting FDA approval.

Senators said they received information that Bell-Kenz has two levels of investors – the Jedis, who are apparently officials at the top of the scheme, and the “second-level investors,” who are called Padawans. However, Go emphasized that Bell-Kenz Pharma is a “traditional pharma company.”

“We have med reps, they see the doctors, they explain the content indications of the drug, and the doctors prescribe the drugs and these are being purchased at the drug store,” Go said.

“Hindi po kami nagbibili ng gamot sa ahente (We don’t buy medicine from agents).”

He also denied that their doctors have to reach a certain quota for prescriptions.

Go, a visiting cardiologist at state-run Philippine Heart Center, admitted that 90% of what he prescribes to his patients are from Bell-Kenz.

When asked by Senator Jinggoy Estrada if he believes that a conflict of interest arises when the doctor prescribes medicine from a company which they are invested in, Go said: “I think when the doctor is already an investor of a pharma company, whether or not he or she will prescribe the medicine, there’s already conflict of interest, but the remedy is disclosure.”

Is this allowed?

Under the country’s Generics Act, medical, dental, and even veterinary practitioners are supposed to prescribe the generic name of the drug.

Private doctors are also allowed to put their preferred brand name. Physicians in government hospitals, however, are required to only use generic brand names in prescribing drugs and medicine to patients.

“But in the implementation, the patient is given the choice at the pharmacy level, they are given the choice to ask for the generic brand they like and not the choice of the physicians,” Health Secretary Teodoro Herbosa said.

Those who do not abide by the law may face penalties such as suspension to revocation of their license and/or a fine of P5,000 to P10,000. Herbosa urged the Senate Committee on Health to look into updating this as “the penalties are now so small.”

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Meanwhile, the health secretary also pointed out that the Universal Healthcare Act that was passed in 2019 also mandates pharmaceutical companies and medical suppliers to disclose their grants and partnerships with hospitals to the DOH and the FDA.

The country is also a signatory to the Mexico City Principles, which provides ethical guidelines for companies in the Biopharmaceutical industry. Companies giving grants to physicians to attend conferences here and overseas must also disclose this to the FDA.

“If they do not report it, then it is unethical and probably even illegal,” Herbosa said.

When asked if they report the overseas trips they sponsor, Go said they are “already partially complying with this issue.”

What’s next?

Herbosa noted that he has already directed the FDA to start looking into pharmacies reported to be implementing the alleged scheme. He also spoke with the director of the hospital involved, urging them to start investigating the claims against their doctors.

The Philippine Medical Association (PMA) committed to work with the Board of Medicine at the Philippine Regulatory Commission (PRC) to straighten the issue.

The PMA, in a joint statement with the Philippine Hospital Association, the Private Hospitals Association of the Philippines, and the Philippine College of Hospital Administrators, also asked for a copy of the list of doctors allegedly involved with Bell-Kenz Pharma for their own investigation.

“The associations would like to invite the so-called whistleblowers for us to substantiate these allegations against the allegedly erring doctors in accordance to our rules of our administrative investigations, which will also serve as a venue for these allegedly involved to clear their names,” their statement read.

The PRC, on the other hand, noted that if a complaint is filed against those who invested in Bell-Kenz Pharma, they may be charged with unethical practice. – Rappler.com