Stroke could cost Philippines ₱416.5B over 15 years
MANILA, Philippines — Acute ischemic stroke could impose an estimated ₱416.52 billion economic burden on the Philippines over 15 years, while the annual cost of managing survivors who need caregiver assistance could reach ₱739,000, according to an unpublished cost analysis cited by two organizations pushing for stronger stroke care in the country.
The estimated annual management cost is more than three times the ₱240,400 estimated for survivors who remain independent, with both figures covering rehabilitation expenses, according to the APAC Stroke Policy Alliance (ASPA) and the German-Philippine Chamber of Commerce and Industry (GPCCI).
Both groups said the estimates illustrate how the consequences of a stroke can extend beyond emergency treatment and hospitalization, potentially affecting a patient’s ability to work, perform daily activities and live independently while requiring family members to provide continuing care.
The figures, based on a cost-of-illness analysis titled “Cost of Thrombolyzed Acute Ischemic Stroke: A Cost-of-Illness Analysis,” were presented by ASPA and GPCCI during the “Dagok ng Stroke sa Pilipino” press briefing on Oct. 30 to mark World Stroke Day.
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The media briefing on the burden of stroke on Filipino patients and families, supported by Boehringer Ingelheim Philippines, brought together representatives from the World Stroke Organization (WSO), Stroke Society of the Philippines (SSP), Beyond Stroke PH of the Philippine Alliance of Patient Organizations (PAPO) and the ANGELS Initiative of Boehringer Ingelheim.
The organizations described stroke as an illness whose consequences can persist long after a patient leaves the hospital.
“Stroke can change a person’s life in an instant. Its impact can extend far beyond the hospital, affecting patients, families, and livelihoods,” ASPA, GPCCI and Boehringer Ingelheim Philippines said in a statement.
The analysis also estimated that expanding timely access to thrombolysis among eligible patients could generate approximately ₱687.58 million in potential savings over 15 years, largely by reducing long-term disability and productivity losses.
Thrombolysis is a treatment that uses medication to dissolve blood clots blocking blood flow to the brain. Because it must be administered within a limited period after symptoms begin, patients need to reach an appropriately equipped medical facility quickly.
The economic consequences of stroke come as the disease continues to affect a substantial number of Filipinos each year.
Data from the Philippine Academy of Vascular and Interventional Neurology (PAVIN) showed that more than 156,000 new stroke cases occur in the Philippines annually. More than 1.2 million Filipinos are living with the aftereffects of stroke, while more than 72,000 people die from it annually.
“That translates to more than 2 million years of healthy life lost to stroke every single year — a figure that captures not just death, but the years spent disabled, dependent, and unable to participate in daily life,” PAVIN said, citing data from the 2023 Global Burden of Disease study.
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In 2022, figures from the Philippine Statistics Authority placed stroke as the third-leading cause of death in the country, accounting for more than 63,000 recorded fatalities. Stroke mortality experienced a significant upward trend in 2021, culminating in 68,180 deaths during the height of the COVID-19 pandemic.
Official mortality statistics also underscore the country’s continuing burden of cerebrovascular diseases, a broader category that includes stroke.
PSA’s provisional data for January to December 2025 recorded 66,988 deaths from cerebrovascular diseases, equivalent to 9.7% of registered deaths nationwide. The category ranked third among the country’s leading causes of death, after ischemic heart diseases and neoplasms.
READ: Deadly grip of cardiovascular diseases on Filipino families
Globally, stroke remains a major cause of death and disability. According to the World Health Organization (WHO) and Global Burden of Disease data, an estimated 93.8 million people were living with stroke in 2021, alongside 11.9 million new cases that year.
That same year, WHO said stroke ranked as both the third-leading cause of death and the third-leading cause of combined mortality and disability, measured in disability-adjusted life years, or DALYs, worldwide. The lifetime risk of stroke increased by 50% over the preceding two decades, leaving one in four adults projected to experience a stroke in their lifetime.
For Filipino families, ASPA and GPCCI said the figures represent more than the number of patients admitted to hospitals. A stroke survivor may require continuing medical attention, rehabilitation, medication and assistance with basic activities, depending on the severity of the brain injury.
Some may eventually regain their independence, while others experience lasting physical or cognitive limitations that affect their capacity to return to work or manage daily responsibilities without assistance.
According to WHO, a stroke occurs when the blood supply to part of the brain is interrupted, either by a blocked blood vessel or a ruptured vessel that causes bleeding.
Without adequate blood flow, brain cells are deprived of oxygen and nutrients and can become damaged or die. The resulting effects depend on the part of the brain affected and the extent of the injury.
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According to WHO, strokes fall into three categories:
Regardless of the type, WHO emphasizes that a suspected stroke requires immediate medical attention, warning that “strokes can be fatal and need immediate treatment.”
Both ASPA and GPCCI stressed the need for people to recognize stroke symptoms and seek emergency medical attention without delay.
“Stroke can cause sudden changes in how a person moves, speaks, sees, or maintains balance. Recognizing the warning signs and seeking emergency care quickly can make a critical difference,” ASPA, GPCCI and Boehringer Ingelheim Philippines said.
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The organizations promoted the B.E. F.A.S.T. method, which identifies six possible warning signs:
WHO likewise identifies sudden dizziness, loss of balance, vision loss, facial drooping, arm weakness and speech difficulties as possible stroke symptoms.
Health experts stressed that not all patients experience the same combination of symptoms. However, the sudden appearance of any of these warning signs warrants immediate medical attention.
WHO recommends that suspected stroke cases undergo diagnostic imaging, such as a computed tomography (CT) scan or magnetic resonance imaging (MRI), as soon as possible. These examinations help determine whether a patient has experienced an ischemic or hemorrhagic stroke and guide the appropriate treatment.
“Stroke is a medical emergency. The longer blood flow to the brain is disrupted, the greater the risk of brain damage and lasting disability. From recognizing the warning signs and seeking emergency care to reaching an appropriate facility and receiving treatment, every step can affect outcomes,” ASPA, GPCCI and Boehringer Ingelheim Philippines said.
Surviving a stroke does not necessarily mean a patient can immediately return to their previous condition or resume normal activities. Depending on the extent of brain damage, some survivors may experience physical limitations, difficulty communicating, memory problems or changes in their emotional and psychological well-being.
WHO identifies a range of complications that may develop within days or weeks after a stroke. These include swelling of the brain, aphasia or other speech disorders, difficulty swallowing, aspiration pneumonia, seizures, depression, pressure ulcers, muscle stiffness and deep vein thrombosis.
Some complications can persist for months or years.
Among the long-term effects identified by WHO are continuing movement difficulties, abnormal walking patterns, chronic pain, muscle spasticity, cognitive impairment, memory loss, anxiety, depression, post-stroke epilepsy and urinary incontinence.
Some survivors also lose their independence and become unable to perform everyday activities without assistance.
These complications may require continuing treatment and rehabilitation, adding to the medical and financial responsibilities of patients and their families.
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For people who experience significant disabilities, family members may have to provide assistance with activities such as bathing, dressing, eating and moving around. The additional caregiving responsibilities can also affect their ability to maintain employment or attend to other household obligations.
The annual management estimates cited by ASPA and GPCCI reflect the differing needs of stroke survivors, with costs estimated at ₱240,400 for independent patients and ₱739,000 for those requiring caregiver support. Both amounts include rehabilitation expenses.
WHO describes rehabilitation as a critical component of stroke care designed to optimize recovery, restore functional independence and improve a survivor’s overall quality of life. WHO recommends initiating rehabilitation as soon as the patient is medically stable, ideally within the first 24 to 48 hours after a stroke.
Because the effects of a stroke vary widely, recovery requires an individualized, multidisciplinary approach delivered by a team of specialized health care professionals:
A leading Filipino insurance company estimates that the cost of managing an acute heart attack can reach approximately ₱1 million within the first 10 years. This estimate includes:
For stroke patients, the economic burden is also significant.
In the research article “The Real Stroke Burden in the Philippines,” neurologist Dr. Jose Navarro and his co-authors highlighted that stroke care in the country is largely privatized, with patients and their families shouldering most costs out of pocket.
Their findings estimated that approximately half a million Filipinos would be affected by stroke, with medical expenses ranging from $350 million to $1.2 billion, or about ₱19.6 billion to ₱67.3 billion.
A survey by the Stroke Society of the Philippines found that the cost of thrombolysis for acute ischemic stroke in private hospitals ranges from ₱136,688 to ₱228,678. In contrast, government hospitals offer lower treatment costs, ranging from ₱3,239 to ₱35,903.
Meanwhile, a separate study led by Dr. Jose Danilo Diestro, a clinical investigator and assistant professor at the University of Toronto’s Department of Medicine, found that the average cost of stroke-related hospitalization at a public tertiary hospital in the Philippines is ₱17,141.50.
For more complex cases, expenses can rise to as much as ₱95,693.50.
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“The expenses incurred in the private hospitals alone can cost several months of salary based on the average annual Filipino family income of […] P313,000. These costs can even become catastrophic, particularly in families belonging to the lower-income classes,” said Dr. Maria Epifania Collantes, who co-authored the study “Current State of Stroke Care in the Philippines” with eight other health experts.
In a previous interview with the Inquirer, Joel, a 59-year-old development consultant, content creator and stroke survivor, said his hospitalization in October 2024 cost him ₱36,000 for a five-day stay at a private hospital in Malolos, Bulacan, even after PhilHealth discounts.
These costs cover only medical-related expenses and do not account for lost income because of an inability to return to work, which can add another financial burden for patients.
READ: Breaking hearts and the bank: The cost of heart attack, stroke in PH
Joel’s projects continued during his hospitalization, allowing him to maintain financial stability despite the costs. However, many stroke survivors also face lost income during recovery.
“I resigned from work because of the stroke. I used to work, but I had to leave because I couldn’t write, I was slurring, constantly dizzy, and had difficulty walking,” said Noah, not his real name, in a Facebook group for Filipino stroke survivors.
The Philippines already has a national policy framework intended to improve stroke prevention, diagnosis, treatment and management.
The Department of Health (DOH) established the National Policy Framework on the Prevention, Control and Management of Acute Stroke in the Philippines through Administrative Order No. 2020-0059, issued in December 2020.
The framework calls for standardized stroke protocols, stronger referral pathways, trained health care workers, the development of Acute Stroke Ready Hospitals (ASRH) and coordination among different sectors of the health care system.
These measures are intended to improve the delivery of care from the onset of symptoms and emergency response through diagnosis, treatment and rehabilitation.
Under the framework, hospitals and health care facilities are expected to strengthen their capacity to assess and manage stroke cases, while referral systems should help patients reach facilities capable of providing the appropriate level of treatment.
ASPA and GPCCI identified several priorities under the policy:
“Strengthening stroke care requires coordination across government, healthcare professionals and medical societies, patient and civil society organizations, hospitals, communities, and the private sector. Together, these stakeholders can help strengthen early recognition, emergency response, referral pathways, stroke-ready hospitals, and continuity of care,” the organizations said.
“Ultimately, the policy becomes meaningful when it helps more patients reach appropriate stroke care faster and supports better outcomes for patients and families,” they added.
WHO has likewise called for countries to strengthen their systems for preventing, diagnosing, treating and rehabilitating patients with stroke.
In 2024, it published a framework for organizing care for stroke and acute coronary syndrome, providing guidance on timely diagnosis, effective treatment and rehabilitation.
The organization also promotes the integration of stroke services into broader health strategies and universal health coverage to help ensure that patients can access appropriate and sustainable care.
Its STEPwise approach to stroke surveillance provides guidance for countries to collect reliable information on stroke cases and outcomes, supporting the development of evidence-based policies.
WHO likewise included stroke in its broader work on neurological disorders, which seeks to improve access to health care and the quality of life of people living with neurological conditions.
While some risk factors cannot be changed, WHO identifies several that can be addressed through lifestyle changes, medical treatment and appropriate management of existing health conditions.
High blood pressure, or hypertension, is identified as the leading contributor to stroke.
“Individuals with hypertension have a nearly three times higher risk of stroke compared to those without hypertension,” WHO said.
Tobacco use is another major risk factor. WHO associates it with approximately two-fifths of stroke deaths among people younger than 65.
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Other modifiable risk factors include high blood cholesterol, diabetes, elevated low-density lipoprotein (LDL) cholesterol, overweight and obesity, physical inactivity, unhealthy diets, harmful alcohol consumption, illicit drug use, air pollution, high fasting blood glucose and kidney dysfunction.
READ: High bad cholesterol: The silent threat, how to fight it
Some factors cannot be modified, including age, a previous stroke, pre-existing cardiac conditions such as atrial fibrillation and heart failure, and chronic kidney disease.
To reduce the risk of stroke, WHO recommends controlling high blood pressure through a healthy lifestyle and appropriate medication, avoiding tobacco and limiting exposure to secondhand smoke, and maintaining a balanced diet.
Its recommendations include consuming at least five servings of fruits and vegetables daily while reducing salt, saturated fats and sugar intake. It also recommends at least 150 minutes of moderate-intensity physical activity every week, as well as appropriate management of diabetes, abnormal cholesterol levels and atrial fibrillation.
Limiting alcohol consumption and improving indoor and outdoor air quality are also among its recommended preventive measures.
For people at particular risk, WHO stressed that medical interventions may be necessary. These can include antiplatelet medication or anticoagulants to prevent recurrent strokes, cholesterol-lowering treatment for people at risk of atherosclerotic cardiovascular disease and assessment for carotid artery narrowing when clinically indicated.
“Every minute matters in stroke care because every patient has a life beyond emergency,” ASPA and GPCCI said. /dm
Tags: inqfocus, stroke, health