P3.5B for dengue vaccination program 'too big' – economist

MANILA, Philippines – An economist belonging to the expert panel that did not recommend the mass use of the controversial dengue vaccine in the Philippines said the budget allotted for it was too much.

Hilton Lam was among the members of the Formulary Executive Council (FEC) who testified during the Senate investigation into the controversy hounding Sanofi Pasteur's Dengvaxia vaccine on Monday, December 11.

The vaccine was used in the now-suspended dengue immunization program for public school students in Metro Manila, Central Luzon, and Calabarzon, launched by ex-Department of Health (DOH) secretary Janette Garin in April 2016. (READ: New vaccines shouldn't be introduced during an election year – Ubial)

Sanofi recently announced Dengvaxia could lead to a more severe case of dengue if given to a person who had not been infected by the virus before, prompting the Senate to reopen its probe. (READ: TIMELINE: Dengue immunization program for public school students

During the hearing, Senate blue ribbon committee chairperson Richard Gordon asked Lam to answer this question: "[Sinasabi mo bang] sumosobra 'yung amount for something that has not been actually adequately tested? Or even if it was, sobra 'yung amount because the extent, the expansion of the test is so huge [at] one million [children]?"

(Are you saying the amount was too much for something that has not been actually adequately tested? Or even if it was tested, the amount was too much because the extent, the expansion of the test is so huge at one million children?) 

Lam replied: "That amount is huge... In that sense, I would agree." (READ: PCMC director grilled for P3-B dengue vaccine purchase)

Gordon then proceeded to ask FEC members Dr Cecilia Lazarte and John Wong, lawyer Froilan Bagabaldo, and FEC secretariat Dr Melissa Guerrero if the "rollout of this drug [was premature]."

All 4 of them said yes.  

"I think the minutes would show that we did object to the vaccine. So I would say yes. It seems to be premature," said Lazarte.

No backing from experts

The FEC is composed of experts in the fields of pharmacology, toxicology, clinical epidemiology, pharmacy, clinical medicine, public health, health economics, health social science, and law and medicine.

The FEC, according to Executive Order No. 49, is the body mandated to determine which drugs should be part of the National Formulary, a list of drugs that the government can buy and use. Any drug not listed in the formulary cannot be purchased by the government.

From January to February 2016, the FEC met to assess the safety, efficacy, and cost effectiveness of Dengvaxia, which was sold to the government at P1,000 per dose.  

Minutes of the meetings showed the FEC members were against using Dengvaxia on a nationwide scale, as clinical studies at the time had not guaranteed the vaccine was safe for mass use.

Lam had even conducted an economic evaluation study on Dengvaxia, where he calculated that the vaccine is only cost-effective from the public payer's perspective if it costs $13 or P654.25.

The FEC was told, however, that the Department of Budget and Management already issued a special allotment release order for the vaccination program, which got a P3.5-billion budget taken from sin tax funds. 

Given these restrictions, the FEC then recommended to the DOH an exemption for Dengvaxia for only a year, with certain conditions. Any purchases beyond that period were supposed to be subject to another study. 

Under that one-year purchasing period, the FEC also recommended "staged procurement" of the vaccine.

But Garin did not follow the experts' recommendation and instead pushed through with administering the vaccine to hundreds of thousands of children in Metro Manila, Central Luzon, and Calabarzon.  

Garin maintains the vaccination program was "not a midnight deal," but Gordon suspects there was a "conspiracy" to have the dengue vaccine approved given the speed of the whole process.

Read copies of the minutes of the FEC meetings on January 7 and 25, 2016 and February 1, 2016 below:

https://www.scribd.com/embeds/366703740/content?start_page=1&view_mode=scroll&access_key=key-F890qjjnta6rGTL9GUTQ&show_recommendations=true" data-auto-height="false" data-aspect-ratio="0.7061128526645768" scrolling="no" id="doc_55823" width="100%" height="600" frameborder="0">

https://www.scribd.com/embeds/366699430/content?start_page=1&view_mode=scroll&access_key=key-9rPKpCqHSJUBaIscyBfP&show_recommendations=true" data-auto-height="false" data-aspect-ratio="0.7074509803921568" scrolling="no" id="doc_47973" width="100%" height="600" frameborder="0">

https://www.scribd.com/embeds/366699769/content?start_page=1&view_mode=scroll&access_key=key-Ao7CPGXatqPQ102YX4J9&show_recommendations=true" data-auto-height="false" data-aspect-ratio="0.7074509803921568" scrolling="no" id="doc_88409" width="100%" height="600" frameborder="0">

– Rappler.com

P50.35 = $1

Mara Cepeda

Mara Cepeda writes about politics and women’s rights for Rappler. She covers the House of Representatives and the Office of the Vice President. Got tips? Send her an email at mara.cepeda@rappler.com or shoot her a tweet @maracepeda.