Consumer’s Perception and Preference Towards High-Cost Prescription

Drug

Marjorie Nicole D. Anonuevo, Hann Carlo P. Matorres ,

John Emmanuel B. Moreno
12 STEM Nicolaus Copernicus
Practical Research 2
St. Dominic College of Asia Senior High School
Emilio Aguinaldo Highway, Bacoor City, Cavite
marjorie.anonuevo@sdca.edu.ph / hanncarlo.matorres@sdca.edu.ph /
johnemmanuel.moreno@sdca.edu.ph
January 25, 2023

Abstract
The objective of this study is to determine the outcomes of having high-cost drugs and what is the
perception of consumers regarding this matter, According to the results of our research study,
parents prefer to take both branded and generic medications since they both have the same
physiological effects; the only difference is that branded medications cost more because the
producer is well-known.
Drug price increases result in significantly higher outpatient expenditures and a reduction in
adequate drug treatment because most patients will not buy the exact amount of prescription they
need, and if they don't take their medication as prescribed by their doctor or pharmacist, their
illness may worsen and they may end up in the hospital. High-cost drugs make the lives of others
difficult.
Keywords: branded drugs, generic drugs, prescription,high-cost

Introduction

Drugs are substances that change an individual's psychological or actual state. They can

influence the way the cerebrum works, how an individual feel and acts, their comprehension,

and their faculties. This makes them eccentric and risky, particularly for youngsters. The drug

medication' refers to an assortment of prescriptions used to forestall, analyze, treat or fix illness.
Background of the Study

In many non-industrial nations, destitute individuals cannot bear the cost of even
fundamental drugs. Imported brand-name drugs are excessively costly, and nonexclusive
prescriptions are not accessible all over the place. Some individuals go to fake
medications that are incapable, however, might be unsafe.

As stated by the World Health Organization (WHO), “essential medicines” are

those that meet an individual's needs. But the problem is that these drugs are not available
to everyone who needs them.“People in need deserve quality prescriptions,” says WHO's
Lembit Rego.In this mood, he emphasizes, bowel and other tropical diseases are not the
only areas in need of high-quality medicines. As he states, 70% of patients with mental
health problems in low-income countries do not have access to appropriate medication. A
moderate dose of medicine is urgently needed for the body and brain.

Statement of the Problem

The major goal to this research was to explore and aimed to make the consumers
understand why drugs cost to much and how can it change the perception of people
when it comes to expensive drugs.

Pharmacists. These people can benefit from this study and it will help them understand the
feelings of people in poverty, especially those who cannot afford high-cost prescription drug.
Consumers. This research might help the consumers like parents to have additional knowledge
on understanding why not everyone cannot afford the drugs prescribed by the doctors.
Future researchers. They can gain more knowledge and have additional information.

Research Questions

1. What are the common prescription drugs that participants buy?

2. How often do participants buy high-cost prescription drugs?

3. How does the price of high-cost prescription drug affects consumers?

Significance of the Study

The major goal to this research was to explore and aims to make the readers

understand why drugs cost to much and how can it change the perception of people

when it comes to expensive drugs

Pharmacist. These people can benefit from this study and it will help them understand the
feelings of the people in poverty, especially those who cannot afford prescription drugs.
Consumers. This research might help consumers to have additional knowledge on understanding
why not everyone cannot afford the prescribe drugs.
Future researchers. They can gain more knowledge through this study, implementing what has
been recorded in their works, and have additional information on where the research can improve.

Scope and Delimitations of the Study

This research is a qualitative study that tackles the difficulties of people that

cannot afford the high-cost prescription drugs that require their bodies.The researchers

will predominantly zero in on deciding on investigating and means to cause the perusers

to comprehend the reason why medications cost to a lot and how might it change the

impression of individuals with regards to costly medications

Conceptual/Theoretical Framework

There has been discussion about the superiority of branded medications over

generic versions for many years. Only licensed physicians are permitted to write prescriptions for

medications, and only registered pharmacists can dispense and sell medications under the

Philippine Medical Act, Republic Act 2382.

Pharmacy Law, or Republic Act 5921. In advance of the purchase of

medication, the patient must show the pharmacist the prescription

Any medication must first be approved by a pharmacist. This is done to protect the patient from

taking dangerous or, occasionally, incorrect medications. However, this arrangement restricted the

kinds of medicines that consumers could buy, whether they were branded or generic.

For decades, people have been debating whether or not branded medications are significantly

superior to their generic versions.

 Physicians are the only individuals permitted to practice medicine in accordance with

Republic Act 2382, also known as the Philippine Medical Act. When discussing the current state

of health, it was stated that poor health may be brought on by a lack of access to affordable health

care and inadequate nutrition. The use of generic drugs helps to improve human health by giving

a variety of people access to affordable medication for chronic illnesses, one of which is illness.

Medication compliance will be seen in the rising population survival rate.

Methodology

This study aims to help consumers explore and understand why medicines are priced too

high and how people's perceptions of expensive medicines can be changed. In our research

design, we used phenomenology-based qualitative research. In this research, gathering

information was really difficult for us so we used a survey via google Forms

Review Related Literature

More and more people ignore doctors' orders about how often and how many medications
to take.Overall, 28% of his pre-Medicine age adults report not adhering to their prescribed
medications because medications cost a lot of money.Overall, shoppers ask their GP for cheaper
medicines, delay ordering medicines, fail to take recommended measurements accurately, skip
dosages, and opt for options other than those prescribed by their doctor.The introduction of
generic versions of branded pharmaceuticals has resulted in the availability of alternative
products, which can typically be purchased for a price that is far lower than that of the original
branded version.Even if the original branded product is sold at a premium for an extended period
of time, in most cases consumers will go for the less expensive generic alternative.
It is possible, however, that the prices of a drug will not fall to the level that is considered
to be competitive if there is insufficient competition among the generic alternatives themselves.A
similar problem arises from the fact that the prices of medications in the United States are not
standardized across the board.To be more specific, makers and distributors of pharmaceuticals
begin with list pricing at the time of product introduction and frequently adjust these prices over
time.Manufacturers of biopharmaceutical products frequently argue that not enough attention is
paid to the actual cost of the drug to health plans and patients, rather than the list price of the
drug.The next sections will explore the effects of high list prices, with branded, generic, and other
drug goods covered independently from one another.
Despite the fact that branded medications only make up about 10 percent of all
prescriptions filled in the United States, they are responsible for about three-quarters of all money
spent on prescription drugs (GPhA, 2015).The pace of spending was 10.3 percent, and it
increased to 12.4 percent in the years 2014 and 2015 before falling to 5.8 percent in 2016—still
twice as fast as the rate of growth in 2013 of 2.5 percent (QuintilesIMS, 2015a, 2016a,
2017a).Launch prices are the prices that are set by the manufacturer for the new pharmaceuticals
when they are initially made available on the market.Subsequent annual increases in their list
prices also have an effect on the cost of branded drugs.According to the most recent findings on
anticancer medications, launch prices have climbed by around $8,500 year, on average, during the
past 15 years (Howard et al., 2015).According to the findings of other studies, the prices of cancer
medications rose similarly after their initial release (Bach, 2009; Bennette et al., 2016; Shih et al.,
2017).According to a report published by the United States Government Accountability Office
(GAO) in 2009, an estimated 416 brand-name pharmaceutical items exhibited "extraordinary"
price rises between the years 2000 and 2008.
 The 416 products represented 321 distinct medications, with some medications being
offered in a variety of drug strengths and dosage forms.For instance, the 416 products included
eight different drug strengths and dosage forms of the beta blocker Inderal.Some medications are
also available in different drug strengths and dosage forms.Price increases for branded
medications ranged anywhere from $0.001 per unit to treat a particularly, uncommon kind of
cancer rose from $390 to more than $3,000 per patient (GAO, 2009).
When the period of time during which branded pharmaceuticals enjoy patent exclusivity
ends, generic versions of such treatments may begin selling after receiving clearance to do so
from the Food and Drug Administration of the United States (FDA).The dosage, safety, strength,
chemical composition, mode of administration, quality, performance qualities, and intended
application of generic pharmaceuticals are identical to those of the branded "innovator" drugs
(FDA, 2017a).When a generic enters the market, its price will typically be set so that it is more
comparable to the marginal cost of production.This places a great deal of pressure on the
company that produces the branded drug to reduce the price of that drug in order to maintain its
position as the market leader (Berndt and Aitken, 2011; Frank, 2007; GPhA, 2015; Grabowski et
al., 2014; Greene et al., 2016; QuintilesIMS, 2016b).
Generic medications in the United States are typically sold at costs that are significantly
less expensive than those in other nations (Wouters et al., 2017).Up to 90 percent of all
prescriptions written in the United States are now filled with generic versions of the same
medicine (GPhA, 2015; Grabowski et al., 2016).In comparison, generics accounted for fewer than
20 percent of all prescriptions written in the early 1980s, and many profitable branded
pharmaceuticals with expired patents still did not have generic competition.Studies have shown
that the introduction of generic versions of a drug results in a decrease in market share for the
relevant brand name drug (Grabowski et al., 2014).When there is only one generic manufacturer
present on the market, there is no guarantee that costs will decrease as a result.In most cases, once
a drug has reached the end of its exclusive term, the price of the branded drug may remain
roughly the same or it may even creep upward during the period of exclusivity, but when the
prices of the generic drugs decrease, they grab a significant share of the market.In order for
medicine costs to drop to their minimum feasible level, which is mostly determined by the cost of
manufacture, it is probable that many competing generic drug businesses will need to enter the
market first.
It should not come as a surprise that the largest decreases in generic prices are seen in
markets where revenues were initially higher than average (Gupta et al., 2016; Olson and
Wendling, 2013).In the event that one company decides to stop producing generic
pharmaceuticals, the existence of multiple manufacturers helps prevent shortages.Mergers
between rival companies that produce identical or biosimilar products, whether they are generic
entrants or the original manufacturer of the branded product, are not a desirable occurrence from
the point of view of maintaining ongoing production and maintaining competition in the
market.The first of these studies discovered that the median and mean number of manufacturers
was approximately two and four, respectively, and that the number of suppliers has been
decreasing over the past few years due to both more exit and less entry of manufacturers.
Around forty percent of product markets were served exclusively by a single
manufacturer.These findings, when taken together, suggest that the conventional wisdom
regarding generic drugs in the United States—that competition among generic manufacturers,
facilitated by buying power consolidation among insurers and other purchasers, results in
increasing access to safe and effective treatments for chronic disease, offsetting at least to some
extent the higher prices of newly launched and existing branded drugs (Aitken et al., 2016;
Duggan et al., 2008)—may be less trite than previously believed.
When the GAO investigated the past price trends of 1,400 generic medications, it
discovered 351 instances of extreme price rises occurring within the span of a single year (GAO,
2016b) (see Figure 3-2).For instance, the price of a generic antidepressant that is used to treat the
symptoms of obsessive-compulsive disorder went from $0.34 per capsule in the first quarter of
2013 to $8.43 per capsule in the first quarter of 2014, representing an increase of more than 2,000
percent in only one year.Also, the price of a generic nonsteroidal antiinflammatory drug that can
be used to treat rheumatoid arthritis or osteoarthritis increased by more than 2,000 percent, going
from $0.09 per capsule in the first quarter of 2010 to $1.94 per capsule in the first quarter of
2011.In some instances, the increase in the cost of generic medications was caused by a lack of.
In recent years, there have been a number of publications that have received a great deal
of public attention concerning inadequate supplies of generic pharmaceuticals that have
functioned as the standard of care for a number of ailments.For instance, there have been reports
of shortages for two essential cancer medications, Doxil and Methotrexate, a medication that is
used as the backbone therapy to treat pediatric cancer (Harris, 2012); various antibiotics,
including doxycycline (Stone, 2015); and saline bags, which are used throughout the entirety of
inpatient and outpatient treatment (McGinley, 2017)Although the number of new drug shortages
has decreased since 2011, significant shortages still exist among generic injectables and other
drugs for cancer and cardiovascular conditions (ASHP, 2017a; GAO, 2014a; 2016a).
It is well known that drug shortages can result in adverse events and even increased
patient morbidity and mortality (Duke et al., 2011; Gu et al., 2011; Kaakeh et al., 2011; Kaiser,
2011; McKenna, 2011).The more limited supply of such treatments has also contributed to the
increase in the prices of such drugs (GAO, 2014; IOM, 2013).It is common for defects in
production quality to be the cause of shortages, both threatened and actual (Fox et al., 2014;
GAO, 2016a; Stomberg, 2016).For instance, the immediate precipitating factors behind the
shortages that have been reported since 2009 (primarily for infused and injectable drugs) include
a lack of high-quality manufacturing processes and facilities as well as a lack of necessary
compounds and raw materials.
The lapses in manufacturing quality and the shortages in the of necessary or adequately
manufactured raw materials that can lead to supply interruptions of certain drugs and other
products regulated by the FDA are not new, but they appear to be more frequently reported in
recent years than they were in previous years.This resulted in the removal of the product from the
market in the United States for a period of time, and as a consequence, there was not enough
supply to satisfy the demand in the United States.Drug shortages can be caused by a number of
factors, including unexpectedly high demand from customers or an epidemic of a rare disease
(ASPE, 2011; Fox et al., 2009; GAO, 2014; IOM, 2013; Pew, 2017).
In addition, a report from the federal government stated that widespread shortages in
2011 were probably caused by a sudden and large increase in the range of items produced as well
as the amount of products produced without a corresponding increase in overall manufacturing
capacity (ASPE, 2011).The limited supply of these medications, as well as the high costs of entry
for manufacturers who are willing and able to synthesize these compounds for sale on the market
in the United States, are both factors that contribute to the possibility of, as well as the occurrence
of, drug shortages (ASPE, 2011; Berndt et al., 2017a,b; Fox et al., 2009; IOM, 2013).The Food
and Medicine Administration`s approach to periodic drug shortages has primarily consisted of
either encouraging or coercing additional producers to meet the demand for these items in the
United States.Along with the highly publicized incident of adulterated heparin manufactured in
China that evaded inspection by a resource-constrained FDA (U.S. Congress, 2008), the growing
trend to outsource drug manufacturing and to source base ingredients from non-U.S.-based
manufacturing facilities led to key aspects of the Generic Drug User Fee Amendment (GDUFA),
which was first enacted in 2012.The GDUFA mandates that generic drug manufacturers must pay
a user fee for each prescription drug that they market (Conti and Berndt, 2017a).
In particular, the GDUFA Act provided funding for the FDA to restructure its inspection
program as well as the user fee schedule that went along with it in order to address these new
issues.More recently, the Food and Drug Administration (FDA) was required by the Safety and
Innovation Act of 2012 to require drug manufacturers to provide early notification of any changes
to production or interruptions in manufacturing that could lead to the discontinuation of a product
or a disruption in the supply of the product.Subsequently, the Food and Medication
Administration (FDA) enhanced its efforts to prevent shortages by accelerating application
reviews and inspections, exercising enforcement discretion in appropriate situations, and assisting
manufacturers in responding to quality control difficulties in drug manufacturing (Chen et al.,
2016; GAO, 2016a
Patients and health care organizations (such as retail pharmacies, hospitals, and nursing
homes) throw away medications every year that have a combined value of billions of dollars.By
way of illustration, vials of injected medications are frequently only offered in a single dose size
that is enough for the treatment of a patient who is physically huge.Because of this, any unused
portion of the medication must be thrown away whenever a smaller patient is being treated.As a
result of the fact that 18 of the top 20 infused cancer medications are only available in one or two
sizes of vials, the average amount of drug that is purchased is wasted at a rate of 10%.The FDA
only looks at the request in terms of safety concerns when it analyzes the dose amounts that the
manufacturers propose for marketing (FDA, 2015).

Research Design

This study will employ the phenomenology-based qualitative research design. It is a type

of qualitative research that looks at how a person interacts with the world on a daily basis.

Because it will make sense of the consumer’s presumptions and impressions of their experiences
as medication clients, this will be applied and used. This will successfully accomplish the

essential objectives of the research, which are to determine the perspective of a person who

switched from purchasing a high-priced drug to using a low-priced drug and how it affected their

general way of life.

Research Locale

The predetermined place where the researcher conducted the study is at the City of Bacoor, in the

province of Cavite, Philippines. The members based the respondents from Cavite on a survey

through Google Forms. It is the best spot for the members to respond to inquiries through Google

Forms because it is the nearest to the researcher.

Research Instrument

Gathering data is the most crucial part of a research study and decided to use the

open-ended survey method for us to easily approach consumers especially parents With this, it

will permit the members as far as possible their responses. For the analysts, it will

empower them to effectively dissect and look at information.

Data Gathering Procedure

We gather the primary questions of some consumers and decided to use Open-ended

survey and made a survey via google forms and was distributed to students for them to approach

their parents and answer the questions, but before that we make a consent for them to have a

signature

Data Analysis

In our data analysis, Generic and Branded drugs are most used by the consumer’s and consumer’s

finding way for them to have a better treatment despite of having a pricey prescription drugs
Results

Based on the result obtained from the question, "Should medication be free or cheaper for

those that live below the poverty line?" According to the respondents, "It should be free."

"Definitely as much as possible." and "Not all the time it will be free so by this time they will

patronize cheaper medication" are the repeated statements the respondents answered. Based on

the result, it is surprising that consumers prefer it to be cheaper or, at the very least, make it free

of any charges for people that live below the poverty line due to main factor affecting people in

poverty is proper health and money, so making it free of charge or affordable would make it a less

of a burden to people in poverty.

Table 1

Verbal
Behavioral Responses Weighted Mean
Interpretation
1. In favor of the questions 29 Very Apparent
2. Somewhat agree 5 Apparent
3. Neutral 15 Very Apparent
4. somewhat disagree 2 Apparent
Satisfactory
5. Against the questions 8
Apparent
Satisfactory
Average weighted mean 11.8
Apparent
This table was formed through the use of the Google form that was given to the
respondent to answer.

Table 1, entitled “Weighted Mean of the Behavioral Responses of the Respondents

Regarding the,” appears that most of the respondents answered are in favor of the given questions

on the given survey.

DISCUSSION

The respondents preferred to prescribe drugs to be affordable, stating, "Yes, so that

people who can't afford to buy expensive or branded medicine can also avail." and "yes, because

some sick people can't afford high drug prices." Among the answers given by the respondents
answering, the question, "Should the government do something to regulate high drug prices? If

so, why?. Stating that the reach of medicine will be accessible to everyone from different classes,

communities, and types of illnesses becomes another factor in considering the prices of

prescribed drugs, affecting how much you buy and how often you buy prescribed drugs. The

results show that consumers' situations can drastically change how consumers perceived when to

buy generic and branded prescribed drugs.

CONCLUSION

Summary

Based on the findings of our research, parents prefer to use both branded and generic

drugs because they have the same effect on the body, the only difference is that branded drugs are

more expensive because the manufacturer has a name.

Conclusions

The high-cost drug makes the life of others difficult and due to access concerns and

healthcare providers moving to subpar medicine, drug price hikes result in significantly higher

outpatient expenditures and a reduction in adequate drug treatment, so most of the patients will

not buy an exact amount of prescription they need, if they don't take their medication as directed

by their doctor or pharmacist, their sickness might grow worse, they could end up in the hospital

again or you could even die.

Limitation
During the conductivity of the research the researchers faced problems that were

uncontrollable to say the least. One of the most recurring themes in the problem is the time

required to complete the task at hand, and the actual research itself, from finding the necessary

participants to actually gathering the data, was influenced by time because it takes a long time to

complete. This was because of the time given to the researchers, given that they are students
attending to every needs of each subject that needed attention of the researchers. The lack of

participants is also factor on getting limited information that is needed for the researchers to

understand the study even more, however, because of the given time, the researchers were

subjected to gather the data from what they obtained from the participants they have found. For

minor inconvenience, the researchers also had to decide which design was best suited to the

study; changing the design can have a significant impact on the overall outcome of the study.

Implications
Consumers were affected by the medicine’s prices, as the prices of the needed drugs are

increasing, especially to those whose content of those prescription drugs are costly to make.

Because of that consumers will then exchange to a much more cheaper/ alternative drugs than to

buy a much more expensive drug providing the knowledge that it does the same thing, based on

the answer “Maybe ask my doctor for a cheaper medicine” and “Will look for an alternative

brander but cheap ones” given the question “How would you be affected if this happens?” In turn,

having a high-cost medicine can affect how the consumers will think to save money without

sacrificing the needed in take of materials they need.

Recommendations
Based on the study that was conducted, the researchers were faced with problems that

affected the study wildly, as a measurement using schedules, and trackers would be great as a way

to eliminate any situation that accommodates time. As said in the limitations, there are a lot of

thing to be improved upon. It is said upon that time is the most repeated problem, yet it is

advisable to also take into account the needed participants that the study needs to hold a strong

argument, for that to work finding the location of the participants that are needed can be helpful

and will serve as a guide to the participants needed, of course with that in mind knowing what

course to take is the best option that can help to find the participants.
REFERENCES

99% of Filipinos say medicines are expensive - September ULAT Ng BAYAN report |

Department of Health website. (2019, December 5). Welcome to Department of Health

website | Department of Health website.

https://doh.gov.ph/doh-press-release/99-percent-of-filipinos-say-medicines-are-expensiv

e-september-ulat-ng-bayan-report

Bunis D. (2019, August 21). People aren't taking prescription drugs due to costs. AARP.

https://www.aarp.org/politics-society/advocacy/info-2019/drug-prices-consumer-impact.

html

Focus, E. (2020, June 9). Prescriptions in the Philippines: What is available and how to

ensure you get the right level of care. Expat Focus.

https://www.expatfocus.com/philippines/health/prescriptions-in-the-philippines-what-is-

available-and-how-to-ensure-you-get-the-right-level-of-care-6295

Hamm, N. (2019, May 7). How high drug prices affect patients. Managed Healthcare

Executive.

https://www.managedhealthcareexecutive.com/view/how-high-drug-prices-affect-patient

Mysorekar, S. (2013, March 14). Medicines are too expensive for poor people in

developing countries, but local production could make a difference. D+C.

https://www.dandc.eu/en/article/medicines-are-too-expensive-poor-people-developing-c

ountries-local-production-could-make

Nass, J. S., Madhavan, G., & Augustine, R. N. (2017, November 30). Factors

influencing affordability - Making medicines affordable - NCBI bookshelf. National

Center for Biotechnology Information.

https://www.ncbi.nlm.nih.gov/books/NBK493090/

Pheage, T. (2016, December 13). Dying from lack of medicines. Africa Renewal.

https://www.un.org/africarenewal/magazine/december-2016-march-2017/dying-lack-me

dicines

Reno, J. (2015, December 16). Why Some Drugs Cost so Much and Others Don’t.

Healthline: Medical information and health advice you can trust.

https://www.healthline.com/health-news/why-some-drugs-cost-so-much-and-others-dont

-12171
 Appendix A

Communication Letter/s
 Appendix B

Consent Form/s
 Appendix C

Interview Schedule / Survey Questionnaire

 Appendix C

Interview Schedule / Survey Questionnaire

 Appendix C

Interview Schedule / Survey Questionnaire

 Appendix D

Raw Data/Coded Data

Patterns and Themes

 Appendix D

Raw Data/Coded Data

Patterns and Themes

 Appendix D

Raw Data/Coded Data

Patterns and Themes

 Appendix D

Raw Data/Coded Data

Patterns and Themes

 Appendix D

Raw Data/Coded Data

Patterns and Themes

 Appendix D

Raw Data/Coded Data

Patterns and Themes

 Appendix D

Raw Data/Coded Data

Patterns and Themes

 Appendix D

Raw Data/Coded Data

Patterns and Themes

 Appendix D

Raw Data/Coded Data

Patterns and Themes

 Appendix D

Raw Data/Coded Data

Patterns and Themes

 Appendix D

Raw Data/Coded Data

Patterns and Themes

 Appendix D

Raw Data/Coded Data

Patterns and Themes

 Appendix D

Raw Data/Coded Data

Patterns and Themes

 Appendix E

Turnitin Similarity Index Report and Certification

 Appendix F

Researcher’s Profile
 Appendix F

Researcher’s Profile
 Appendix F

Researcher’s Profile
 Appendix F

Researcher’s Profile
 Appendix F

Researcher’s Profile
 Appendix F

Researcher’s Profile
 Appendix G

Acknowledgements

First and foremost, the researchers would like to express their sincere gratitude to their

research adviser, Sir Mark P. Vacunawa, LPT, for giving them the opportunity to perform the

study and for his crucial assistance throughout it. We have been greatly inspired by his dynamism,

vision, genuineness, and motives. Working and studying under his supervision was an enormous

privilege and pleasure. We are really appreciative of what he has provided for us.

The researchers Marjorie Nicole Añonuevo, Hann Carlo Matorres and John Emmanuel

Moreno. Would like to thank Mr. Jasper P. Dailisan, who help them in finding the participant

needed in the research especially during times where the researchers lack the time needed to find

the participants, but he was there to support them and provide assistance and help, he also took

his time to listen and understand to the researchers problem.

Marjorie is very grateful; without the assistance of her research colleagues John

Emamanuel Moreno and Hann Carlo Matorres, she would not have been able to complete this

study. Marjorie is very grateful that they allowed her to direct their work during this research and

distribute the tasks evenly as well. And sharing and sacrificing their time is so meaningful to her.

Hann is extremely appreciative since he could not have finished this research without the

help of his research partners John Emamanuel Moreno and Marjorie Nicole Anonuevo. Hann is

quite appreciative that they gave him the freedom to oversee their work during this investigation

and distributed the jobs fairly. And it means the world to him when they share and give up their

time.
 Appendix H

Research Contributions
 Appendix H

Research Contributions
 Appendix H

Research Contributions