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Enabling Greater Private Sector

Participation Towards UHC:


Medicines in the Philippines
Beverly Lorraine C Ho MD MPH

Medicines account for


almost half of out-ofpocket payments.

(Ave) Four times more


expensive in retail

Na#onal
Reference Price

Intl Reference
Price

MPR (Retail)

Salbutamol

Php 215

Php 93.23

2.31 3mes

Omeprazole

Php 5.25

Php 0.80

6.5 3mes

Huge pricing difference


Government
Hospital

Price in Php

% Mark Up

Batanes General
Hospital

1.50

33%

East Avenue Medical


Center

0.29

20%

Philippine Heart
Center

4.00

43%

Cotabato Regional
Medical Center

1.50

33%

Zamboanga
Medical Center

0.32

2400%

Strong brand preferences & heavy marketing


Free pricing & market segmentation

Context

Many small devolved markets & minimal


government purchasing power
Information asymmetry between actors
Inefficient use of resources
System prone to corruption

Promote the use of generics


Consolidate procurement
Accept donations

Government
Interventions

Make information available


Provide medicines for free or lower cost
Include medicines in PhilHealth (SHI)

Platforms for Collaboration


with Private Sector
Medicine
Entitlement
Programs

Drug Price
Monitoring +
Advocacy

Drug Price
Reference
Index

Donate free

Share or crowd

Facilitate

medicines

source price

participation through

Supply in bulk at

information

fair competition &

lower prices
Expand access
points
Navigate Patients

transparency

Medicine
Entitlement
Programs
DOH-Pharmaceu#cal
Division

DOH-Center for Disease


Preven#on & Control

Stand-alone
Acute
Lymphocytic
Leukemia

EPI

Breast Cancer

Mental Health

Food & Water


Borne
Diseases

ComPack

Rare Disease

Insulin Access
Program

Filariasis

PHIC
Health
Insurance

Ver3cal Programs

Geriatric
Health

1.0

TB

PCB 1/2

HIV/STI

Rabies

Vaccine
Access
Program

Health & WellBeing of Older


Persons

Leprosy

Schistosomiasis

Micronutrient
Supp.

Malaria

SoilTransmitted
Helminths

Medicine
Entitlement
Programs
DOH-Pharmaceu#cal
Division

DOH-Center for Disease


Preven#on & Control

Stand-alone
Acute
Lymphocytic
Leukemia

EPI

Breast Cancer

Mental Health

Food & Water


Borne
Diseases

ComPack

Rare Disease

Insulin Access
Program

Filariasis

PHIC
Health
Insurance

Ver3cal Programs

Geriatric
Health

1.0

TB

PCB 1/2

HIV/STI

Rabies

Vaccine
Access
Program

Health & WellBeing of Older


Persons

Leprosy

Schistosomiasis

Micronutrient
Supp.

Malaria

SoilTransmitted
Helminths

Drug Price
Monitoring
+ Advocacy

2.0

All drug establishments regularly upload the prices of


medicines though an IT-based system
OBJECTIVES
Address information asymmetry
Allow patients to exercise intelligent choice
Serve as reference for DOH in its rule-making capacity
STATUS
average 65% compliance
largest retailer non-compliant

Drug Price
Reference
Index

3.0

DOH-Pharmaceutical Division collects data on


procurement prices of DOH Hospitals and
publishes these.
OBJECTIVE
guides hospital management on right price
provides Commission on Audit basis to make
procuring entities accountable for when they bid
higher than reference price
Help PhilHealth set reimbursement rates
EFFECT
Lessen avenues for corruption
Encourage private sector to bid
LIMITATIONS
Currently implemented only in DOH hospitals
(72 of 1800+ hospitals)

hPp://dpri.doh.gov.ph

Challenges
Business Sense
Premised on a supply driven
system with DOH as the single
bulk purchaser
Not necessarily applicable to
demand-driven social health
insurance based model
NEEDS change in perspective
with respect to:
who the client(s) is/are
revenue source
time horizon
defining bulk purchase

Trust
Expanding existing program (more
recipients, access points) hampered by
lack of trust for the private sector to
become implementing partners

Political Will
Full benefits of EDPMS and
DPRI have yet to be
harnessed, as participants are
still limited.
Expanding needs considerable
amount of POLITICAL WILL.

Key Takeaways

Enable.

Redefine.

Attract.

Government has to balance


regulation and enforcement
with TRUST, to come up
with mechanisms to enable
the private sector to become
partners in efforts towards
UHC.

The private sector has to


redefine how it does
business its timeframe,
what it considers as bulk,
and who the purchasers are.

To attract private sector


partners, government must
strive to be transparent &
credible. To

Insert photo here b/w medicines

Thank You
Beverly Lorraine C Ho MD MPH
bho1.consultant@adb.org