Medical alliance works to bring down cost of TB tests

An alliance of 20 hospitals and laboratories is working to substantially bring down the cost of testing for tuberculosis (TB) in the country, hoping it would help erase the social stigma attached to TB and also provide a clearer picture of its prevalence among Filipinos.

Launched in February 2020, the Philippine Private Sector Diagnostics Consortium has brought down the cost of TB testing using GeneXpert technology, from as high as P12,000 to about P2,300 today.

The GeneXpert Instrument System, which runs the Xpert MTB/RIF assay test, can determine the presence of the bacteria that causes TB in about two hours and whether the type of TB is drug-resistant.

It is much faster than the standard sputum culture test, which takes two to six weeks to produce results and requires a certain level of expertise to read.

Misconceptions

While the Department of Health’s (DOH) National Tuberculosis Control Program provides free testing and treatment of TB, there are patients who prefer the services of private laboratories, partly due to the stigma attached to the disease, according to Dr. Richmond Reyes, TB DOTS (directly observed therapy short course) physician and infection control chief of Chinese General Hospital (CGH).

“There are misconceptions in the diagnosis and treatment of TB. We see some patients who are executives, or who belong to upper economic brackets, who are disbelieving of their diagnosis,” Reyes said.

Such reactions, he said, were only due to lack of knowledge about the disease. “They are both embarrassed and afraid, most are anxious.”

With a reduced cost of private lab testing, more people may be encouraged to get a diagnosis and undergo treatment.

“I do understand why some prefer private physicians and private testing,” said Anthony Geronimo, laboratory manager of Tropical Disease Foundation (TDF), a nonstock, nonprofit group and a member of the consortium.

Prior to the standard pricing of the GeneXpert TB test at P2,268 among consortium members, TDF used to charge patients about P6,000 per test, which was then among the lowest rate in the country.

HMO, PhilHealth coverage

Consortium members managed to drastically cut the test cost because they were able to purchase the testing equipment and related products at concessionary prices under a pooled procurement system.

Reyes, however, said more had to be done to further bring it down. “Cost is still a problem considering that there are free services. The paid GeneXpert TB test is neither covered by all HMOs (health maintenance organizations) nor PhilHealth (Philippine Health Insurance Corp.) deductible,” he said.

He remained hopeful that increased need for TB testing in the country could convince HMOs to cover the test, even partially, especially at this time when the government had been forced to close some health centers to divert medical front-liners to the pandemic response. This has resulted in more people turning to private facilities.

Building trust

Once diagnosed positive for TB by both CGH and TDF, a patient can still opt to enroll in the National TB Control Program for access to free medication, check ups and X-rays.

Geronimo said he was hopeful the availability of the GeneXpert TB test at an affordable price would lead to more individuals getting tested and treated for TB.

“If we can build up the trust in the National TB program, then we can reach more people in need of treatment,” he said.

UN commitment

In 2018, the Philippine government, through the DOH, made a commitment at the United Nations high-level meeting on TB held in New York City to find and treat 2.5 million TB patients in the country by 2022. The coronavirus pandemic, however, has altered government priorities and stalled the department’s case-finding efforts related to TB.

(This story is in support of the #TBFreePH campaign of the DOH. With the help of the United States Agency for International Development, #TBFreePH aims to increase and improve conversations about TB and help address stigma and discrimination experienced by persons with TB.)