DOH ComPack

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With the epidemiological shift that the Philippines is now experiencing where the top leading causes of deaths and diseases are both communicable and non- communicable diseases (NCDs), the availability and affordability of needed maintenance drugs to optimally control diseases like hypertension, diabetes, asthma and COPD bring the issue of access to medicines to focus as health facility surveys conducted by the DOH and WHO consistently show poor availability of these medicines in the public sector (WHO 2009).

Several issues contribute to the problem such as the lack of national and local financing for medicines, inefficient pharmaceutical procurement practices, poor management and the lack of human resources to prescribe and dispense medicines at the point of service delivery. As reflected in the survey of Sarol et al commissioned by DOH, the mean availability of essential medicines in public health facilities was found to be very low at only 25% in 2010.

To provide choice and to ensure access and availability of affordable quality generics to other segments of the population, the DOH Complete Treatment Packs was launched and initially allotted only to patients under the 4Ps program of the national government. The program was then expanded to all indigent patients under the National Health Targeting System (NHTS). The later part of

2013, it was decided by the department to extend the coverage of the program to all Filipino and made DOH ComPack available to the general public.

Access sites and Beneficiaries

The DOH ComPack program was initially implemented in areas identified by the DSWD as part of the Conditional Cash Transfer (CCT) program and was also implemented in other LGUs as part of the Province-wide Investment Plan for Health (PIPH) of the DOH particularly those LGUs aiming to increase availability of essential medicines in their public health facilities.

In the first year of implementation, all DSWD identified 4Ps members enrolled under the CCT Program were identified as the initial beneficiaries of this program. An expansion of the program was then made to cover the Set 5 of CCTs on the 2nd year. It was then realized that not all poor patients are enrolled as 4Ps and so the DOH has decided to cover all patients and prioritizing NHTS- PR members, PhilHealth Sponsored members, Senior Citizens and persons with disabilities (PWDs).

Program Objectives and Goal

Program Objectives

Achieve universal access to quality essential medicines by addressing the needs of the population especially the poorest of the poor for essential medicines as part of primary and secondary prevention especially for chronic non-communicable diseases.

Goal

To increase patients’ access to quality essential medicines, taking into consideration rational drug use and availability up to the grassroots level.

Components

In the revised policy, the P100 Program shall now be branded as the DOH Complete Treatment Pack program, a medicines access program designed to reach the poorest of the poor with complete treatment regimens for the top most common diseases in the country which contribute to increasing morbidity and mortality and high out-of- pocket spending for medicines and health services to majority of Filipinos.

Year	Target Beneficiaries and Access Sites	Number of Access Sites
2011	DSWD CCT Areas Set 1-4	1,019
2012	DSWD CCT Areas Set 1-5	1,392
2013	All RHUs/Health Centers	2,453
2014	All RHUs/Health Centers	2,665

Where can this availed?

The Rural Health Units (RHUs) of the CCT municipalities be granted a medicines package for the most prevalent such as hypertension, diabetes and common infections to be given for free to the identified 4Ps members.

The said members can avail of the medicines under the following conditions:

Must have a DSWD ID No.
Must be registered in an RHU included in the CCT Program
Must be seen and diagnosed by an RHU physician
Must adhere to the treatment regimen and comply with the follow-up schedules as advised by the physician.

Program Updates/Milestones

During the 1st year of implementation only 24 molecules of drugs are included in the ComPack program, hence, there is a need to update the list and include new drugs that are needed in the Primary Health facilities.

The following are the initial 24 molecules included in the ComPack program:

Antibiotics

Amoxicillin, 500 mg, capsule (as trihydrate)
Amoxicillin 250mg/5ml granules/powder for suspension (as trihydrate) Cloxacillin, 500 mg, capsule (as sodium salt)
Cloxacillin, 125mg/5ml powder for suspension (as sodium salt) Cotrimoxazole, 800mg, tablet sulfamethoxazole + 160mg trimethoprim Cotrimoxazole, 200 mg, sulfamethoxazole + 40mg trimethoprim per 5ml suspension Cotrimoxazole, 400 mg, sulfamethoxazole + 80mg trimethoprim per 5ml suspension
Erythromycin, 500 mg, tablet (as stearate)
Ciprofloxacin, 500mg, tablet (as hydrochloride)
Doxycycline, 100mg, capsule
Metronidazole, 500 mg, tablet
Mebendazole suspension

Antidiabetics

Metformin, 500mg tablet (as hydrochloride)
Glibenclamide, 5mg, tablet
Gliclazide, 80 mg, tablet

Hypercholesterolemia Agent

Simvastatin, 20 mg tablet

Antihypertensives and Anti-Anginal Agents

Amlodipine, 10 mg tablet
Aspirin, 80mg tablet
Enalapril, 10 mg (as maleate) tablet
Hydrochlorothiazide, 25mg tablet
Losartan, 50mg (as potassium salt) tablet
Metoprolol, 50 mg (as tartrate) tablet

Bronchodilator

Lagundi 300 mg tablet

Diuretic

Sambong 250 mg tablet

In 2012, Mebendazole suspension was omitted from the list because the National Center for Disease Prevention and Control (NCDPC) has already initiated their deworming program. In 2013, Salbutamol (100mcg/inhalation) and Fluticasone + Salmeterol (50mcg/25mcg & 125mcg/25mcg) Inhaler was also added to the list. For 2014, Glibenclamide 5mg tablet was removed and Gliclazide 80mg tablet was changed to Gliclazide 30mg MR tablet as recommended by the Formulary Executive Council (FEC).

*** In 2015, new medicines will be included in the list. Also, DOH ComPack medicines will be available in the

Out-Patient Department (OPD) of DOH-Retained Hospitals.

Number of RHUs with available ComPack medicines
REGION	NUMBER OF RHUs THAT RECEIVED COMPACK
REGION	2011	2012	2013	2014
NCR	27	30	508	568
REGION I – ILOCOS	35	83	152	162
REGION II – CAGAYAN VALLEY	23	82	98	99
REGION III – CENTRAL LUZON	41	63	268	285
REGION IV-A – CALABARZON	70	90	195	212
REGION IV-B – MIMAROPA	62	70	79	81
REGION V – BICOL	93	109	125	135
REGION VI – WESTERN VISAYAS	86	108	136	146
REGION VII – CENTRAL VISAYAS	61	109	151	168
REGION VIII – EASTERN VISAYAS	95	135	150	160
REGION IX – ZAMBOANGA PENINSULA	67	71	94	100
REGION X – NORTHERN MINDANAO	80	93	98	99
REGION XI – DAVAO REGION	32	46	51	68
REGION XII – SOCCKSARGEN	34	49	54	55
CARAGA	69	73	80	81
CAR	42	76	93	97
ARMM	102	105	121	122
TOTAL	1,019	1,392	2,453	2,638

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