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Rationale

     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:

  1. Must have a DSWD ID No.
  2. Must be registered in an RHU included in the CCT Program
  3. Must be seen and diagnosed by an RHU physician
  4. 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

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