The Philippine Health Insurance Corporation (PhilHealth) has announced an increase in the package rate for hemodialysis sessions.
Effective immediately, the rate will rise from PHP 2,600 to PHP 4,000 per session. The PhilHealth board, chaired by Department of Health (DOH) Secretary Ted Herbosa, approved this decision.
Chronic Kidney Disease in the Philippines
The rise in chronic kidney disease (CKD) among Filipinos requiring dialysis is alarming, according to the Philippine Society of Nephrology (PSN). They stress the importance of prioritising kidney health. They noted that while CKD can be managed, it is not curable with medication. Data from the National Kidney and Transplant Institute (NKTI) indicates that about one Filipino develops chronic renal failure every hour. This amounts to approximately 120 cases per million people annually. Unfortunately, underdiagnosis remains a significant issue.
The Vital Role of Hemodialysis for CKD Patients
Hemodialysis is crucial for patients with chronic kidney disease (CKD), especially in the advanced stages. The treatment performs the essential functions of the kidneys by filtering waste, excess fluids, and toxins from the blood. This treatment helps manage symptoms and complications associated with kidney failure, improving patients’ quality of life and survival rates. Regular hemodialysis sessions are necessary to maintain overall health and prevent life-threatening conditions that arise from untreated renal failure.
Comprehensive Coverage Expansion
The board’s approval includes provisions for catheter insertion and blood transfusion payments. They can now be claimed separately from the main case rate for admission. This move is part of an overall strategy to enhance financial support for renal replacement therapy (RRT), which encompasses hemodialysis and peritoneal dialysis. By separating these payments, patients will have better access to essential procedures without exhausting their main hemodialysis benefits.
Annual Session Increase
In a significant move last year, PhilHealth extended its coverage from 90 to 156 hemodialysis sessions per year. This expansion has effectively increased the annual benefit for chronic kidney disease stage 5 patients to PHP 405,600, up from PHP 234,000. In 2023 alone, PhilHealth paid out PHP 17.43 billion for hemodialysis claims, highlighting the substantial financial support provided to patients. This increase reflects a growing recognition of the importance of continuous and sufficient dialysis treatment for CKD patients to maintain their health and well-being.
Enhanced Primary Care and Preventive Services
PhilHealth is also enhancing its primary care coverage through a new iteration of the nationwide “konsulta package,” which incentivises early disease detection and prevention services. This initiative is designed to encourage Filipinos to engage in regular health check-ups, potentially reducing the need for extensive treatments like dialysis. By focusing on early detection and preventive care, PhilHealth aims to mitigate the progression of chronic diseases and reduce the long-term healthcare costs associated with advanced conditions.
The Financial and Health Impact
The financial burden of CKD on patients and their families is immense. Dialysis treatments, medications, and related healthcare services can be prohibitively expensive, often leading to significant economic strain. The increase in PhilHealth’s hemodialysis package rate and session coverage is a crucial step in alleviating some of these financial pressures. Moreover, by covering more sessions, PhilHealth ensures that patients do not have to skip necessary treatments due to cost constraints, improving their health outcomes.
Broader Implications for Healthcare
The enhancements in PhilHealth’s coverage are beneficial for CKD patients and signify a broader commitment to improving healthcare accessibility and affordability in the Philippines. By investing in better coverage for chronic diseases and preventive care, PhilHealth is paving the way for a healthier population. This proactive approach can lead to earlier interventions, reduced disease complications, and overall better health statistics for the country.
Conclusion
The increase in the hemodialysis package rate and the expanded coverage by PhilHealth represent significant advancements in the support provided to CKD patients in the Philippines. These measures not only alleviate the financial burden on patients but also ensure they receive necessary treatments without interruption. As the prevalence of CKD continues to rise, such initiatives are essential in promoting kidney health and improving the quality of life for affected individuals. PhilHealth’s ongoing efforts to enhance primary care and preventive services further underscore the importance of early detection and management of chronic diseases, paving the way for a healthier future for all Filipinos.
Have a pressing question for a doctor? Medical Channel Asia has launched a community forum page where you can get questions answered by a medical specialist. Visit the community forum here.
