Capiz Integrated Health Services Development Program

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Capiz Integrated Health Services Development
Program
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Drug Management Reforms
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Drug Management Reforms

• Capiz is the pilot area for the Health Passport
  Program
• Universal health insurance coverage
• Weakness
• Medicine benefits of health insurance useless in
  a poorly stocked pharmacy

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Background

• Regional survey conducted by a point DOH-DTI Task
  force on Pharmaceutical Concerns found that
  Philippine drug prices, on average, are 30-35
  higher than other ASEAN countries
• Philippines is second only to Singapore among
  ASEAN countries with the highest drug prices

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Parallel Drug Importation

• Parallel Drug Importation
• Importation of affordable, high quality medicines

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Drug Management Reforms

• Capiz the first LGU in the country to avail of
  medicines under PDI in 2001
• Initial funding P1M
• Initial purchase of 4 drugs
• Currently, there are 43 drugs under this program
  the province imports 9 drugs under PDI

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Drug Management Reforms
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Drug Management Reforms

• Guidelines
• Sold only to those with valid prescriptions
• Maximum that can be bought is enough for a
  months supply for maintenance medicines OR a
  weeks full course for antibiotics

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Drug Management Reforms

• Guidelines
• Provincial Accountants Office created a separate
  book of accounts for the project sales are
  deposited in a trust fund
• Subsequent purchases charged against the trust
  fund

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Drug Management Reforms

• Medicines delivered to the hospital pharmacies at
  the center of the provinces five health zones
  for improved geographic access

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Drug Management Reforms

• Two critical options
• LGUs can purchase more medicines to give away at
  the health centers
• LGUs can sell medicines with the goal of lowering
  drug prices

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Drug Management Reforms

• Bulk procurement enabled province to access
  bigger discounts
• Successfully used to negotiate with local
  multinational pharmaceutical firms to lower their
  selling price of drugs
• Local multinational pharmaceutical lowered their
  selling price of drugs to compete with imports

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Drug Management Reforms

• For hypertension
• Amlodipine 10mg tab
• Atenolol 50mg tab
• Enalapril 20mg tab
• Felodipine 5mg tab
• Irbesartan 300mg tab
• Irbesartan hydrochlorothiazide 300mg tab
• Metoprolol 50mg tab
• Metoprolol 100mg tab
• Nifedipine 5mg tab
• Nifedipine 20mg tab
• Verapamil 240mg tab

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Drug Management Reforms

• Antibiotics
• Cefazolin 1g vial
• Ceftriaxone 1g vial
• Cefuroxime axetil 500mg tab
• Cefuroxime 750mg inj
• Ciprofloxacin 200 mg iv
• Ciprofloxacin 500mg tab
• Clarithromycin 500mg tab
• Co-amoxiclav 625mg tab
• Cotrimoxazole 800/160 tab
• Norfloxacin 400mg tab

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Drug Management Reforms

• For diabetes
• Glibenclamide 5mg tab
• Gliclazide 30mg tab
• Gliclazide 80mg tab
• Metformin 500mg tab

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Drug Management Reforms

• For gastrointestinal ailments
• Ranitidine 50mg inj
• Ranitidine 150mg tab
• Hyoscine ampule
• Oral Rehydration Salts

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Drug Management Reforms

• Anti-asthma
• Salbutamol 2mg tab
• Salbutamol inhaler
• Salbutamol 1 mg/ml nebule
• Anti-tetanus
• Tetanus toxoid inj
• Human Tetanus Immunoglobulin 250 iu vial

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Drug Management Reforms
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Drug Management Reforms

• Patient Savings (2006)
• P11,852,036.36
• Patient Savings (2001-2006)
• P60,320,818.60

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Drug Management Reforms

• Improved procurement efficiency appreciated by
  stakeholders
• According to QIDS study of PhilHealth, Capiz has
  the cheapest procurement prices for medicines in
  Western Visayas

Capiz Integrated Health Services
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Drug Management Reforms

• Project the 1st place winner of the 1st Best
  Public Sector Projects of the RDC IV for CY2005
  under the province category
• Project nominated in a competition to recognize
  the worlds most transformative government
  programs

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Drug Management Reforms

• Concerns
• PITC
• Recurrent problem of delayed deliveries
• Prices have become higher than local
  multinationals

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Drug Management Reforms

• Concerns
• BFAD regulations requiring project to be licensed
  as a drug distributor
• DOH A.O. 2005-0010 provides exemption only for
  DOH retained hospitals
• Coherence in policy
• Will cause project collapse