Republic of the Philippines

SUPREME COURT
Manila
EN BANC
G.R. No. 88265 December 21, 1989
SANTIAGO A. DEL ROSARIO, GEORGE G. GACULA, EDGARDO G. SANTOS, ALBANO S.
SIBAL, ALBERTO C. REES, NONITO P. ARROO, EMMANUEL !. TERENCIO, DOMINGO S. DE
LEON, MODESTO O. LLAMAS, !ARIDA U. ALONTO, "ENAIDA A. !LOIRENDO, ISABEL A.
ME#IA, LU" P. MABANAG, RAMON $. RABAGO, #R., SAMUEL D. TROCIO %&' OSCAR M.
BRION, petitioners,
vs.
$ON. AL!REDO R. BENG"ON, (& )(* c%+%c(,- %* Secre,%r- o. ,)e De+%r,me&, o.
$e%/,), respondent.
Facundo T. Bautista for petitioners.

GRI0O1A2UINO, J.:
This is a class suit filed by officers of the Philippine Medical Association, the national organiation of
!edical doctors in the Philippines, on behalf of their professional brethren "ho are of #indred
persuasion, "herein this Court is as#ed to declare as unconstitutional, hence, null and void, so!e
provisions of the $enerics Act of %&'' (Rep. Act No. ))*+,, and of the i!ple!enting Ad!inistrative
-rder No. ). issued pursuant thereto, specifically/
(a, 0ection ), Pars. (a, and (b, of the $enerics Act "hich provide/
a, All govern!ent health agencies and their personnel as "ell as other govern!ent
agencies shall use generic ter!inology or generic na!es in all transactions related to
purchasing, prescribing, dispensing and ad!inistering of drugs and !edicines.
b, All !edical, dental and veterinary practitioners, including private practitioners, shall
"rite prescriptions using the generic na!e. The brand na!e !ay be included if so
desired. (p. ), Rollo.,
(b, 0ection %., Pars. (b,, (c, and (d, of the sa!e la" "hich provide/
b, 1or the second conviction, the penalty of file in the a!ount of not less than t"o
thousand pesos (P.,222.22, but not e3ceeding five thousand pesos (P+,222.22, at
the discretion of the court.
c, 1or the third conviction, the penalty of fine in the a!ount of not less than five
thousand pesos (P+,222.22, but not e3ceeding ten thousand pesos (P%2,222.22,
and suspension of his license to practice his profession for thirty (42, days at the
discretion of the court.
d, 1or the fourth and subse5uent convictions, the penalty of fine of not less than ten
thousand pesos (P%2,222.22, and suspension of his license to practice his
profession for one year or longer at the discretion of the court. (pp. )6*, Rollo., and
(c, 0ections 7 and *, Phase 4 of Ad!inistrative -rder No. )., 0eries of %&'& dated March &, %&'&,
of the respondent 0ecretary of 8ealth, "hich read as follo"s/
0ection 7. Violative Erroneous, and Impossible Prescriptions.
7.%. 9iolative Prescriptions/
7.%.% :here the generic na!e is not "ritten;
7.%.. :here the generic na!e is not legible and a brand na!e "hich is legible is
"ritten;
7.%.4 :here the brand na!e is indicated and instructions added, such as the phase
<No 0ubstitution< "hich tend to obstruct, hinder or prevent proper generic dispensing.
7.. :hat to do "ith 9iolative Prescriptions.
9iolative prescriptions shall not be filled. They shall be #ept and reported by the
phar!acist of the drug outlet or any other interested party to the nearest =-8 -fficer
for appropriate action. The phar!acist shall advise the prescriber of the proble!
and>or instruct the custo!er to get the proper prescription.
7.4 Erroneous Prescriptions/
7.4.% :hen the brand na!e precedes the generic na!e.
7.4.. :here the generic na!e is the one in parenthesis.
7.4.4 :here the brand na!e in (sic, not in parenthesis.
7.4.7 :here !ore than one drug product is prescribed in one prescription for!.
7.7 :hat to do "ith erroneous prescriptions.
Erroneous prescriptions shall be filled. 0uch prescriptions shall also be #ept and
reported by the phar!acist of the drug outlet or any other interested party to the
nearest =-8 -ffice for appropriate action.
333 333 333
0ection *. Timetable of Implementation.
?n order to give all affected parties ade5uate ti!e for learning and ad@ust!ent, the
i!ple!entation of these Rules and Regulations shall be in three phases, as follo"s/
Phase % Education =rive ...
Phase . Monitoring of Co!pliance
333 333 333
Phase 4 ?!ple!entation.
Beginning 0epte!ber %, %&'& the =-8 and the other relevant agencies of
govern!ent shall !onitor co!pliance "ith these Rules and Regulations and all
violations shall be sub@ect to the appropriate sanctions and penalties provided for
under these Rules and Regulations and the $enerics Act of %&''. (pp. *6&, Rollo.,
-n March %+, %&'&, the full te3t of Republic Act No. ))*+ "as published in t"o ne"spapers of
general circulation in the Philippines. The la" too# effect on March 42, %&'&, fifteen (%+, days after
its publication, as provided in 0ection %+ thereof.
0ection *, Phase 4 of Ad!inistrative -rder No. ). "as a!ended by Ad!inistrative -rder No. *)
dated August .', %&'& by postponing to Aanuary %, %&&2 the effectivity of the sanctions and
penalties for violations of the la", provided in 0ections ) and %. of the $enerics Act and 0ections 7
and * of the Ad!inistrative -rder.
The petitioners allege that Bas of this date, there is no breach or violation yetB of the la" (p. &, Rollo,,
"hich too# effect on March 42, %&'&. 8o"ever, as the penal provisions "ill only ta#e effect on
Aanuary %, %&&2, it "ould have been !ore accurate to state that Bas of this date, no breaches or
violations of the la" have been punished yetB (p. &, Rollo,.
The petition is captioned as an action for declaratory relief, over "hich this Court does not e3ercise
@urisdiction. Nevertheless, in vie" of the public interest involved, "e decided to treat it as a petition
for prohibition instead.
The petitioner<s !ain argu!ent against paragraphs (a, and (b,, 0ection ) of the la", is the alleged
une5ual treat!ent of govern!ent physicians, dentists, and veterinarians, on one hand, and those in
private practice on the other hand, in the !anner of prescribing generic drugs, for, "hile the for!er
are allegedly re5uired to use only generic ter!inology in their prescriptions, the latter !ay "rite the
brand na!e of the drug in parenthesis belo" the generic na!e. The favored treat!ent of private
doctors, dentists and veterinarians under the la" is allegedly a specie of invalid class legislation.
There is no !erit in that argu!ent for it proceeds fro! a !isreading and !isinterpretation of the
letter and intent of paragraphs (a, and (b,, 0ection ) of the $enerics Act. ?ndeed, as e3plained by the
public respondent/
... "hile paragraph (a, enu!erates the govern!ent transactions (<Purchasing,
prescribing, dispensing and ad!inistering of drugs and !edicines<, "here the sole
use of generic ter!inology has been re5uired, the <prescription< of drugs is further
governed by paragraph (b,. And the use of the word 'all' in the latter provision
emphasies the absence of an! distinction between "overnment and private
ph!sicians. ?n other "ords, in prescribing drugs, physicians, "hether in govern!ent
service or in private practice, are both governed by e3actly the sa!e rules, and thus,
are both authoried to include the brand na!e in their respective prescriptions. (p.
77, Rollo.,
1urther!ore, it !ay be observed that "hile paragraph (a, refers to Ball govern!ent health agencies,
and their personnel as "ell as other govern!ent agenciesB (not necessarily physicians, dentists and
veterinarians,, paragraph (b, refers to #all medical, dental and veterinar! practitioners, includin"
private practitioners.#
Petitioners concede that the re5uire!ent for doctors, dentists, and veterinarians to use the generic
ter!inology in "riting their prescriptions, follo"ed by the brand na!e in parenthesis, is B"ell and
goodB (p. %., Rollo,. 8o"ever, they co!plain that under paragraph (d, of the la" "hich reads/
(d, =rug outlets, including drugstores, hospital and non6hospital phar!acies and
non6traditional outlets such as super!ar#ets and stores, shall infor! any buyer about
any and all other drug products having the sa!e generic na!e, together "ith their
corresponding prices so that the buyer !ay ade5uately e3ercise his option. :ithin
one (%, year after approval of this Act, the drug outlets referred to herein, shall post in
conspicuous places in their establish!ents, a list of drug products "ith the sa!e
generic na!e and their corresponding prices. (Anne3 A, p. .4, Rollo.,
the salesgirl at the drugstore counter is authoried to Bsubstitute the prescribed !edicine "ith
another !edicine belonging to the sa!e generic group.B 0ince doctors are not allo"ed to instruct the
druggist not to substitute the prescription, or to B=ispense only as PrescribedB (per 0ec. 7, Ad!.
-rder No. ).,, the petitioners argue that Bthe act of prescribing the correct !edicine for the patient
beco!es the act of the salesgirl at the drugstore counter, no longer the act of the physician, dentist,
or veterinarianB (p. %., Rollo,.
8ere again, the petitioners have distorted the clear provisions of the la" and the i!ple!enting
ad!inistrative order. 1or it is plain to see that neither paragraph (d, of 0ection ) of the $enerics Act,
nor 0ection 7 of Ad!inistrative -rder No. )., gives the salesgirl and>or druggist the discretion to
substitute the doctor<s prescription.
-n the contrary, 0ection 7, par. 7.%, of Ad!inistrative -rder No. ). directs the phar!acist not to
fill Bviolative prescriptionsB ("here the generic na!e is not "ritten, or illegibly "ritten, and the
prescription of a brand na!e is acco!panied by the doctor<s instruction not to substitute it,, as "ell
as #impossible prescriptions# (par. 7.+,. Even a doctor<s BerroneousB prescriptions Bshall be filled,B
not substituted (par. 7.4, Ad!. -rder No. ).,. And, 0ections 4 and + of Ad!. -rder No. )4 en@oin the
drug outlets not (to, favor or suggestB or Bi!poseB a particular brand or product on the custo!er. The
ad!inistrative older provides/
?n order to ensure the infor!ed choice and use of drugs by the patient> buyer, the
dru" outlet is re$uired to%
4.%.% ?nfor! the patient>buyer of all available drug products
generically e5uivalent to the one prescribed "ith their corresponding
prices. ?n so doing, the dru" outlet shall not favor or su""est an!
particular product so that the patient&bu!er ma! full! and ade$uatel!
e'ercise his option to choose (0ec. 4, Ad!. -rder No. )4 s. %&'&,.
333 333 333
The followin" acts or omissions are considered violations of these rules and
re"ulations%
+.% Imposin" a particular brand or product on the bu!er. ... (pp. 7)67*, Rollo.,
The salesgirl at the drugstore counter, !erely informs the custo!er, but does not deter!ine (for she
is inco!petent to do so, all the other drug products or brands that have the sa!e generic na!e, and
their corresponding prices. That infor!ation she !ay obtain fro! the list of drug products
deter!ined by the Bureau of 1ood and =rugs to have the sa!e generic na!e, or "hich are the
che!ical, biological, and therapeutic e5uivalent of the generic drug. All drugstores or drug outlets
are re5uired by the la" to post such list in a conspicuous place in their pre!ises for the infor!ation
of the custo!ers, for the choice of "hether to buy the e3pensive brand na!e drug, or the less
e3pensive generic, should be e3ercised by the custo!er alone.
The purpose of the $enerics Act is to carry out the policy of the 0tate/
To pro!ote, encourage and re5uire the use of generic ter!inology in the i!portation,
!anufacture, distribution, !ar#eting, advertising and pro!otion, prescription and
dispensing of drugs;
To ensure the ade5uate supply of drugs "ith generic na!es at the lo"est possible
cost and endeavor to !a#e the! available for free to indigent patients;
To encourage the e3tensive use of drugs "ith generic na!es through a rational
syste! of procure!ent and distribution;
To e!phasie the scientific basis for the use of drugs, in order that health
professionals !ay beco!e !ore a"are and cogniant of their therapeutic
effectiveness; and
To pro!ote drug safety by !ini!iing duplication in !edications and>or use of drugs
"ith potentially adverse drug interactions. (pp. 4'4&, Rollo.,
or, as stated by the public respondent, Bto pro!ote and re5uire the use of generic drug products that
are therapeutically e5uivalent to their brand6na!e counter6partsB (p. 4&, Rollo, for #the therapeutic
effect of a dru" does not depend on its 'brand' but on the 'active in"redients' which it contains.# The
medicine that cures is the #active in"redient# of the dru", and not the brand name b! which it has
been baptied b! the manufacturer.
The public respondent points out that the institution of generics in the Philippines "ill co!pel
physicians to prescribe drugs based on their therapeutic or Bactive ingredient,B instead of their "ell6
#no"n brand na!es. Multiple !edications "hich !ay produce potentially adverse, even lethal,
che!ical reactions in the patient "ill thereby be avoided. Patients "ith li!ited !eans "ill be able to
buy generic drugs that cost less but possess the sa!e active ingredients, dosage for!, and strength
as brand na!es, !any of "hich are priced beyond the reach of the co!!on tao because the high
costs of advertising, pac#aging, royalties, and other inputs of production deter!ine their pricing for
the !ar#et.
The Court has been unable to find any constitutional infir!ity in the $enerics Act. ?t, on the contrary,
i!ple!ents the constitutional !andate for the 0tate Bto protect and pro!ote the right to health of the
peopleB and Bto !a#e essential goods, health and other social services available to all the people at
affordable cost# (0ection %+, Art. ?? and 0ection %%, Art. C???, %&'* Constitution,.
The prohibition against the use by doctors of Bno substitutionB and>or "ords of si!ilar i!port in their
prescription, is a valid regulation to prevent the circu!vention of the la". ?t secures to the patient the
right to choose bet"een the brand na!e and its generic e5uivalent since his doctor is allo"ed to
"rite both the generic and the brand na!e in his prescription for!. ?f a doctor is allo"ed to prescribe
a brand6na!e drug "ith Bno substitution,B the patient<s option to buy a lo"er6priced, but e5ually
effective, generic e5uivalent "ould thereby be curtailed. The la" ai!s to benefit the i!poverished
(and often sic#ly, !a@ority of the population in a still developing country li#e ours, not the affluent and
generally healthy !inority.
There is no !erit in the petitioners< theory that the $enerics Act i!pairs the obligation of contract
bet"een a physician and his patient, for no contract ever results fro! a consultation bet"een patient
and physician. A doctor !ay ta#e in or refuse a patient, @ust as the patient !ay ta#e or refuse the
doctor<s advice or prescription. As aptly observed by the public respondent, no doctor has ever filed
an action for breach of contract against a patient "ho refused to ta#e prescribed !edication,
undergo surgery, or follo" a reco!!ended course treat!ent by his doctor ( p. +4, Rollo,. ?n any
event, no private contract bet"een doctor and patient !ay be allo"ed to override the po"er of the
0tate to enact la"s that are reasonably necessary to secure the health, safety, good order, co!fort,
or general "elfare of the co!!unity. This po"er can neither be abdicated nor bargained a"ay. All
contractual and property rights are held sub@ect to its fair e3ercise (Anglo61il Trading Corporation vs.
Daaro, %.7 0CRA 7&+.,
Petitioners have also assailed 0ection %., paragraphs b, c and d, of the $enerics Act prescribing
graduated penalties (ranging fro! a repri!and to a fine of not less that P%2,222 and the suspension
of the physician<s license to practice his profession for one E%F, year or longer, at the discretion of the
court, for violations of its provisions. Petitioners< allegation that these penalties violate the
constitutional guarantee against e3cessive fines and cruel and degrading punish!ent, has no !erit.
Penal sanctions are indispensable if the la" is to be obeyed. They are the BteethB of the la". :ithout
the!, the la" "ould be toothless, not "orth the paper it is printed on, for physicians, dentists and
veterinarians !ay freely ignore its prescriptions and prohibitions. The penalty of suspension or
cancellation of the physician<s license is neither cruel, inhu!an, or degrading. ?t is no different fro!
the penalty of suspension or disbar!ent that this Court inflicts on la"yers and @udges "ho
!isbehave or violate the la"s and the Codes of Professional and Audicial Conduct.
:e hold that the $enerics Act and the i!ple!enting ad!inistrative orders of the 0ecretary of 8ealth
are constitutional. ?n light of its beneficial provisions, "e cannot heed the petitioners< plea to #ill it
aborning, i.e., before it has had a chance to prove its value to our people as envisioned by its
!a#ers.
:8ERE1-RE, the petition is dis!issed for lac# of !erit. Costs against the petitioners.
0- -R=ERE=.
Fernan, (.)., *arvasa, (ru, Paras, Feliciano, +anca!co, Padilla, Bidin, ,armiento, (ortes,
-edialdea and .e"alado, ))., concur.
-elencio/0errera, )., concurs in the result.



Se+%r%,e O+(&(o&*

G3,(erre4, #r., J., concurring/
? concur in the result only because of the failure to overco!e the presu!ption of constitutionality and
not because the respondent<s argu!ents are valid.

Se+%r%,e O+(&(o&*
G3,(erre4, #r., J., concurring/
? concur in the result only because of the failure to overco!e the presu!ption of constitutionality and
not because the respondent<s argu!ents are valid.