enabling greater private sector participation towards uhc: medicines in the philippines
TRANSCRIPT
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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
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Medicines account foralmost half of out-of-pocket payments.
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(Ave) Four times moreexpensive in retail
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Huge pricing difference
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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
?@8A-;"+7",)B#,"&?.6.9.$%
?@8AC)%0)+ *$+ ?.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.
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Thank YouBeverly Lorraine C Ho MD MPH
bho1 consultant@adb org
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