In many low- and middle-income countries (LMICs), limited public health resources often push healthcare costs onto households already struggling with tight budgets. In the Philippines, household out-of-pocket payments account for about 45% of total health expenditures.
Making medicines more accessible can ease this financial strain, sparing families the difficult choice between medical treatment and other basic needs such as food, education, and shelter. When people can afford medicines, they are more likely to seek care promptly, adhere to treatment, and avoid complications that lead to higher costs later on.
COLLABORATION AS THE CORNERSTONE
Despite notable progress in health reforms, no single sector can achieve equitable access to essential medicines on its own. Sustained progress depends on robust multistakeholder partnerships that bring together government, the private sector, and civil society. These partnerships not only combine resources and expertise but also foster accountability, transparency, and long-term sustainability that are all essential for achieving health equity.
“Healthcare can indeed be accessible, but only if the private and public sectors work together, bound by common goals and grounded on a strong ethical code of conduct. The tragedy of a Filipino dying simply because they don’t have money must end,” said Dr. Diana Edralin, president of the Pharmaceutical and Healthcare Association of the Philippines (PHAP), during a recent healthcare forum.
Dr. Edralin emphasized that meaningful progress in access to medicines will depend on stronger partnerships between government and industry in three key areas.
First is in the area of accelerating Health Technology Assessment (HTA). Delays in HTA processes hinder patient access to innovative, life-saving medicines that are already standard of care globally. Without timely HTA reviews, these medicines are often excluded from the Philippine National Formulary, making them unavailable in public health facilities and forcing patients to shoulder the cost.
A practical solution is to establish a reliance or expedited review mechanism that allows the Philippine HTA to leverage trusted international regulatory bodies such as the US Food and Drug Authority (FDA) and the European Medicines Agency (EMA). Additionally, fostering structured and consultative discussions between industry experts and regulators can ensure that HTA evaluations remain timely, evidence-based, and transparent.
Second is in the area of implementing innovative access models. Innovative access models such as volume-based pricing and risk-sharing agreements can help reduce costs while expanding availability. Under these models, the government can purchase large quantities of medicines at lower unit prices and pay in full only for treatments that deliver verified patient outcomes.
Similarly, pooled procurement and multi-year contracts can stabilize supply chains and bring down costs. International experience demonstrates that when governments increase health spending and implement effective access programs, out-of-pocket payments for medicines drop significantly to 47% in Australia, 46% in Malaysia, 42% in South Korea, 41% in the United Kingdom, 32% in New Zealand, and just 9% in Thailand.
The third is in the area of strengthening partnerships with PhilHealth. While PhilHealth — the Philippine Health Insurance Corp. — has introduced programs aimed at improving medicine access, significant opportunities remain to expand its coverage. Limited formulary inclusion in benefit packages, particularly under the Z Benefits program, means that patients with catastrophic diseases still bear heavy out-of-pocket costs for essential medicines.
With this, Dr. Edralin proposed the co-creation of a joint review team with PhilHealth to regularly evaluate and update Z Benefit packages, prioritizing high-burden diseases. Partnerships could also fast-track the accreditation of private retail pharmacies as distribution points, bringing medicines closer to patients, especially in underserved areas.
During the same forum, stakeholders signed a “Manifesto of Commitment to Build a Stronger Nation through Improved Access to Medicines.” Signatories included Maria Blanca Kim Lokin, president and CEO of Philippine Pharma Procurement, Inc., and PhilHealth Vice-President Walter Bacareza.
Aligned with the Universal Health Care (UHC) Act, the signatories pledged to strengthen initiatives that promote the affordability, availability, and accessibility of quality medicines. These include the development of new distribution channels in remote communities. They also committed to cultivate partnerships, build stakeholder capacity, and adapt to evolving technologies and market dynamics to ensure the sustainability of the Philippine healthcare system.
Teodoro B. Padilla is the executive director of Pharmaceutical and Healthcare Association of the Philippines, which represents the biopharmaceutical medicines and vaccines industry in the country. Its members are at the forefront of developing, investing and delivering innovative medicines, vaccines, and diagnostics for Filipinos to live healthier and more productive lives.
