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Medicines Access Programs (MAPs)

The Medicines Access Programs or MAPs are public health programs that aims to improve drug availability in public sector health facilities. The MAPs are initially implemented by the Pharmaceutical Division (formerly the National Center for Pharmaceutical Access and Management) pursuant to Cheaper Medicines Act of 2008. Also, the MAPs was enshrined in the Philippine Medicines Policy: “The DOH, PhilHealth and other relevant government agencies shall employ strategies that will provide free medicines to the poor or a population of patients that addresses priority diseases (e.g. TB, HIV, malaria, NCDs, cancers).

 

The MAPs occupies the 90% of the budget allocated for the Pharmaceutical Division budget for the procurement of essential medicines for priority diseases.

 

Goals and Objectives of Medicines Access Programs (MAPs)

  1. To improve access to essential medicines in the public sector through innovative strategies which include the following but not limited to:

a. Pooled procurement
b. Consignment
c.
Price negotiation
d. Medicines Patent Pool (MPP)

e. Importation/parallel importation
f. Employing TRIPS flexibilities
g. Public-private partnerships

  1. To increase the percent availability of essential medicines addressing priority diseases in both the hospital and primary care setting
  2. To ensure the cost-effective and rational use of medicines and quality of care according to nationally accepted treatment guidelines
  3. To improve health outcomes of patients affected by priority diseases (i.e. MDGs, TB, HIV/AIDS, NCDs and other priority diseases of DOH)

Milestones of the Medicines Access Programs

      In recent years, several access programs have thus been created under the DOH-NCPAM utilizing the Php 1 billion annual appropriation to target drugs poorly available in public health facilities and which pose a significant cost burden to patients.   These drugs include basic essential drugs needed in primary care for both infectious and chronic conditions (i.e. ARI, pneumonia, UTI, hypertension, diabetes, asthma) procured in bulk and distributed in complete treatment regimens to all rural health units (RHUs) nationwide. Several access programs for in-patient and catastrophic care have also been created for breast and childhood cancers, mental health diseases and geriatric health.

 

     With the launching of MAPs, drug availability in primary health care facilities were shown to have improved according to the monitoring and drug availability studies commissioned by the DOH. Mean drug availability in rural health units increased from 24.8% to 53.5% from 2010 to 2012.  However, the percentage improvement in Level 2 to 4 hospitals was lower from 25.8% to 44.3% (See Table 11).

 

Mean availability of a basket of essential medicines in government health facilities

Facility Level

Mean availability

2010

(Mean, 95% CI)

Mean availability

2011

(Mean, 95% CI)

Mean availability

2012

(Mean, 95% CI)

Rural Health Units, Health Centers and Level I Public Hospitals

24.8 %

(21.0-28.5 %)

51.7%

(47.9-55.4%)

53.6%

(50.0-57.2%)

Level II to IV Public Hospitals

25.8%

(22.3 -29.4 %)

37.8%

(33.6-41.9%)

44.3%

(39.7-49.0%)

Drug Availability is defined as the percentage availability of a reduced list of essential drugs taken from the Philippine National Drug Formulary in samples of health facilities at the moment of the visit.

Sources:

Dichosa, M.J.,  Sarol, J., Mabulay, A.S., & Domingo, D.P.(2010) Establishment of a Baseline for the Performance Indicators of Health Sector Policy Support Program Phase II – Final Report. Philippines.

Sarol, J. (2012) Survey on Drug Availability in Public Health Facilities in the Philippines 2011. Philippines.

Sarol, J. (2013) Survey on Drug Availability in Public Health Facilities in the Philippines 2012. Philippines.