enabling greater private sector participation towards uhc: medicines in the philippines

7/25/2019 Enabling Greater Private Sector Participation Towards UHC: Medicines in the Philippines

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Enabling Greater Private Sector

Participation Towards UHC:

Medicines in the Philippines

Beverly Lorraine C Ho MD MPH


2/13

Medicines account foralmost half of out-of-pocket payments.


3/13

(Ave) Four times moreexpensive in retail

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Context

Strong brand preferences & heavy marketing Free pricing & market segmentation Many small devolved markets & minimalgovernment purchasing power Information asymmetry between actors Inefficient use of resources System prone to corruption

Promote the use of generics Consolidate procurement

Accept donations Make information available Provide medicines for free or lower cost Include medicines in PhilHealth (SHI)

Government

Interventions


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Platforms for Collaborationwith Private Sector

Share or crowdsource price

information

Drug PriceMonitoring +Advocacy

Facilitateparticipation through

fair competition &

transparency

Drug PriceReferenceIndex

MedicineEntitlementPrograms

Donate freemedicines

Supply in bulk at

lower prices

Expand accesspoints

Navigate Patients

1 2 3


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1.0Medicine

EntitlementPrograms

AcuteLymphocytic

LeukemiaGeriatricHealth EPI Filariasis TB PCB 1/2

Breast Cancer Mental HealthFood & Water

BorneDiseases

HIV/STI RabiesVaccineAccess

Program

ComPack Rare DiseaseHealth & Well-Being of Older

PersonsLeprosy Schisto-

somiasis

Insulin AccessProgram

MicronutrientSupp. Malaria

Soil-TransmittedHelminths

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1.0Medicine

EntitlementPrograms

AcuteLymphocytic

Leukemia

GeriatricHealth EPI Filariasis TB PCB 1/2

Breast Cancer Mental HealthFood & Water

BorneDiseases

HIV/STI RabiesVaccineAccess

Program

ComPack Rare DiseaseHealth & Well-Being of Older

PersonsLeprosy Schisto-

somiasis

Insulin AccessProgram

MicronutrientSupp. Malaria

Soil-TransmittedHelminths

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?@8AC)%0)+ *$+ ?.9)"9)-+)6)%#$% D C$%0+$&

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2.0Drug PriceMonitoring

+ Advocacy

All drug establishments regularly upload the prices ofmedicines though an IT-based system

OBJECTIVESAddress information asymmetryAllow patients to exercise intelligent choiceServe as reference for DOH in its rule-making capacity

STATUS average 65% compliance

largest retailer non-compliant


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3.0Drug PriceReference

Index

DOH-Pharmaceutical Division collects data onprocurement prices of DOH Hospitals andpublishes these.

OBJECTIVE guides hospital management on right price provides Commission on Audit basis to makeprocuring entities accountable for when they bidhigher 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)

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ChallengesBusiness Sense

Full benefits of EDPMS andDPRI have yet to beharnessed, as participants arestill limited.

Expanding needs considerableamount of POLITICAL WILL.

Premised on a supply drivensystem with DOH as the singlebulk purchaser

Not necessarily applicable todemand-driven social healthinsurance based model

NEEDS change in perspectivewith respect to:

who the client(s) is/are revenue source time horizon defining bulk purchase

Political Will

TrustExpanding existing program (morerecipients, access points) hampered bylack of trust for the private sector tobecome implementing partners


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Key Takeaways

Government has to balanceregulation and enforcement with TRUST, to come up with mechanisms to enablethe private sector to becomepartners in efforts towardsUHC.

Enable.

The private sector has toredefine how it does

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

Redefine.

To attract private sectorpartners, government muststrive to be transparent &credible. To

Attract.


13/13

Thank YouBeverly Lorraine C Ho MD MPH

bho1 consultant@adb org

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enabling greater private sector participation towards uhc: medicines in the philippines

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