THE PHILIPPINE RESPONSE TO UNIVERSAL HEALTH CARE AND ACCESS TO MEDICINES 2013

Madeleine De Rosas-Valera, MD, MScIH (Heidelberg) Undersecretary for Health Policy, Finance and Research Development

Department of Health

Universal

Health Care Education

Housing Conditional Cash

Transfer

Investing in Filipinos,

especially the poor

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Able to use quality health services at affordable cost, by being enrolled in the National Health Insurance Program

Cared for in modern health care facilities

Prevented from falling ill by using preventive and promotive health care goods and services services to improve health outcomes and attain health-related MDGs;

What is Universal Health Care? Universal Health Care (UHC) is the Aquino administration’s

health agenda to ensure that Filipinos, particularly the poor, are:

UHC implementation will initially focus on the poor (Phase 1)

and progressively include all sectors (Phase 2), both formal and informal.

DOH INVESTMENTS FOR ESSENTIAL MEDICINES 2013

PROGRAMS FUNDS ALLOTED

Expanded Program on Immunization (EPI) 327,298,386.20

Family Health (including RH commodities) 1,307,772,696.00

ELIMINATION (Public Health Threat such as Malaria,

Schistosomiasis, Leprosy, Filariasis)

300,600,313.61

Rabies Control Program 106,000,000.00

TB Control 659,493,966.00

Other Infectious and Emerging Diseases 35,000,000.00

National Pharmaceutical Policy Devt. Including

provision of drugs and medicines

934,304,400.00

Health Emergency Preparedness and Response Prog 7,371,013.11

General Management & Supervision (GMS) 10,941,900.00

TOTAL 3,688,782,674.72

A COUNTRY OF BRANDED & EXPENSIVE MEDICINES

Medicines prices in the

Philippines have been

historically high

compared to other

countries.

65% of total out-of-

pocket expenditures

goes to medicines

putting more burden on

the poorest quintile of

the population (FIES,

2009).

Low Availability of medicines In the public sector

Establishment of a Baseline for the Performance Indicators of Health Sector Policy Support Programme Phase II – Ma. J.D. Dichosa, J. Sarol Jr, A.S. Mabulay, D.P. Domingo (2010)

* De facto market failure since public sector cannot mount an effective

competition with the large private sector

UNIVERSALLY ACCESSIBLE AND AFFORDABLE QUALITY

MEDICINES ACT OF 2008 (RA 9502)

NATIONAL CENTER FOR PHARMACEUTICAL ACCESS AND

MANAGEMENT (NCPAM)

In line with the efforts to strengthen the NCPAM towards Universal

Healthcare and to ensure its contribution in improving access to

essential medicines specifically:

(1) to improve the supply side access to quality essential

medicines;

(2) to ensure the rational use of medicines by prescribers,

dispensers and patients, and

(3) to institutionalize transparency and good governance in the

pricing and procurement of medicines.

MEDICINES ACCESS PROGRAMS (MAPS)

“The DOH, Philhealth and other relevant government agencies

shall employ strategies that will provide free medicines to the

poor or a population of patients that addresses priority diseases

(e.g. TB, HIV, malaria, NCDs, cancers).”

- Philippine Medicines Policy 2011

DOH-NCPAM

Since 2011, DOH has pursued free medicines

access programs to the poor as a strategy towards

UHC

Priority Areas:

1. Outpatient drugs for common infections,

hypertension and diabetes

2. Inpatient drugs for some catastrophic diseases

- Breast cancer

- Childhood acute lymphocytic leukemia (ALL)

MEDICINES ACCESS PROGRAMS (MAPS)

DOH COMPLETE TREATMENT PACKAGES

(COMPACKS) Free drug access program for poor families covered by the

Pantawid Pamilya introduced in 2011

25 complete treatment regimens for the most common

diseases: Infections, HPN, DM, asthma

Covers 1,980 CCT municipalities nationwide

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THE DOH COMPACK PROGRAM

For out-patient care (to be

interfaced with the PhilHealth

Primary Care Benefit Packages)

2013 :

• To cover all RHUs nationwide

• To include all Philhealth

sponsored members and

indigenous people (IP) as

beneficiaries

CANCER MEDICINES ACCESS PROGRAM

1. Breast Cancer Medicines Access Program (BCMAP)

- 1,356 patients enrolled in 6 DOH hospitals

2. Acute Lymphocytic Leukemia in Children (ALLMAP)

- 867 patients enrolled in 14 DOH hospitals

2013:

* To be interfaced with the Philhealth Z Benefit Packages

* Capacity-building of PHIC contracted hospitals in delivering cancer

care

OTHER MEDICINES ACCESS PROGRAMS (MAPS)

Geriatric Health Medicines Access Program (GHMAP)

Mental Health Medicines Access Program (MHMAP)

Rare Diseases Medicines Access Program (RDMAP)

Insulin Access Program

MANY MORE CANCER PATIENTS REACHED BECAUSE

OF LOWERING OF PRICES OF CANCER DRUGS

MANY MORE CANCER PATIENTS REACHED BECAUSE OF LOWERING OF PRICES OF CANCER DRUGS

THE PHILIPPINE NATIONAL FORMULARY

• “Essential medicines are those that satisfy the priority health care needs of the population.”

* Public health relevance

* Efficacy and safety

* Comparative cost-effectiveness

* Availability & affordability

* Equity / Ethics

* Sustainability

* Local context

- The Selection and Use of Essential Medicines. Report of the WHO Expert Committee, 2002. WHO Technical Report Series No. 914.

PNF: GOVERNANCE AND PROCESS FLOWS

Formulary Executive Council

Secretariat

(DOH-NCPAM)

Expert Panel

Evidence Review TWG

Doctors

Medical societies

Patient groups

Industry

BUILDING HTA SYSTEMS THROUGH PARTNERSHIPS

Executive Order to Combat AMR in the Philippines

To foster multi-sector

collaboration in

undertaking initiatives

to halt the spread

of AMR

CELEBRATING GENERICS@25 AND FDA@50

• Celebrate the gains of the Generics Law

implementation since 1988

• Recognize generic pioneers from both

the public and private sectors

• Further strengthen DOH initiatives to

promote the use of quality generics

UNIVERSAL ACCESS TO MEDICINES

EQUITABLE AND SUSTAINABLE ACCESS

GOOD QUALITY, GOOD RISK-BENEFIT

COST-EFFECTIVE USE OF RESOURCES

Provided with QUALITY INFORMATION

RATIONAL USE OF MEDICINES

Done through MULTI-APPROACH INTERVENTIONS

Involving the COLLABORATION OF STAKEHOLDERS