COA: Over 4,000 indigent patients in QC compelled to finance medication

MANILA, Philippines – At least 4,147 patients classified as indigents in Quezon City were forced to finance their own medication and purchase the medicines outside the Novaliches District Hospital (NDH), the Commission on Audit (COA) said.

COA’s audit report of the Quezon City local government unit (LGU) released Friday showed that this was because the hospital was not able to procure medicines not included in the Philippine National Drug Formulary (PNDF) list.

“The report showed that 190 essentially prescribed non-PNDF medicines intended for 4,147 indigent patients were procured by patients outside of the hospital. The City did not procure non-PNDF medicines due to the limitation provided under Rule No. 36 of the Implementing Rules and Regulations (IRR) of RA No. 9502,” COA explained.

The IRR of RA 9502 or the Universally Accessible Cheaper and Quality Medicines Act of 2008, restricts government offices from purchasing medicines through the PNDF.

COA said, however, that the local government of Quezon City could have obtained the medicines if it sought an exception, as specified in Item number 4 of Executive Order 49, released in January 1993.

This practice of allowing patients to subsidize their own medicine supposedly violates several rules on health care for indigents — specifically the No Balance Billing policy in relation to Section 43 R.A. 10606 or National Insurance Act of 2013’s IRR and the Philippine Health Insurance Corporation (PhilHealth) circular in 2017.

The IRR states that “no other fee or expense shall be charged to the indigent in government health care institutions,” while they have the right to “all necessary services and complete quality care to attain the best possible health outcomes.”

Philhealth’s Circular No. 2017-006 also states that buying medicines should be the last resort for patients, and it is wrong to ask patients to purchase supplies with the promise to reimburse the amount later.

COA advised the NDH management to seek authority from the city mayor, request approval from the National Center for Pharmaceutical Access Management (NCPAM) , and the Department of Health (DOH) to procure items not prescribed by the PNDF.

It also instructed NDH to seek exemption for the purchase of non-PNDF medicines as it is vital to their operations, aside from including the supplies in their Annual Procurement Plan (APP).

NDH said they are already communicating with the DOH, as authorized by the office of the city mayor, and in the process of securing an exemption to procure non-PNDF medicines.

While the process is ongoing, NDH said a special disbursing officer was assigned to purchase drugs not available in their pharmacy. (Editor: Eden Estopace)