1. Medicines Transparency Alliance15/11/2015 1 MEDICINES AVAILABILITY - PHILIPPINES Alexander A. Padilla Undersecretary of Health Vice Chairman, MeTA Philippines

2. Medicines Transparency Alliance15/11/20152 Some Factors Affecting Availability Archipelago of over 7,000 islands Decentralized health care system under Local Government Code – wide variation & gaps in levels of LGU commitment to ensure availability of essential medicines: share of medicines ranges from 0.8 to 10% of total health budget – Compartmentalized procurement among 80 provinces, 1,500 municipalities, 42,000 barangays and 72 national hospitals  Bulk procurement not frequently practiced  Wide variation in medicines’ selection (essential medicine list not defined by level of health care)  Heavily dependent on procurement practices at local levels High purchase prices aggravate budgetary constraints

3. Medicines Transparency Alliance THOUGH ALL KEY MEDICINES CAN BE FOUND IN PRIVATE PHARMACIES, THE MEDIAN AVAILABILITY IS ONLY 53.3% IN PUBLIC FACILITIES. IN PRIVATE PHARMACIES, THE MEDIAN AVAILABILITY IS ONLY 53.3% IN PUBLIC FACILITIES. Availability of key medicines in public & private pharmacies 1Amoxicillin 500mg capsule 2 Cotrimoxazole 800mg/160mg tablet 3Metoprolol 50mg tablet 4Paracetamol 500mg tablet 5 Mefenamic 500mg capsule/tablet 6Ferrous sulfate tablet 7Glibenclamide 5mg tablet 8Metformin 500mg tablet 9Captopril 25mg tablet 10Loperamide 2mg capsule 11Salbutamol 2mg capsule 12Omeprazole 20mg capsule 13Ciprofloxacin 500mg tablet 14Cefalexin 500mg capsule 15Simvastatine 20mg National Median (%) Source: WHO Survey Level II and III 2008

4. Medicines Transparency Alliance Long stock-out of key medicines in public facilities National Median (# days) Source: WHO Survey Level II and III 2008 MEDIAN STOCK-OUT DURATION IS 4 MOS. IN PUBLIC FACILITIES, NEARLY 1.5 MOS. IN WAREHOUSE

5. Medicines Transparency Alliance Uncompleted dispensing/administration of prescriptions in public facilities National Median (%) ONLY 25% OF PUBLIC FACILITIES CAN PROVIDE MORE THAN 75% OF MEDICINES LISTED IN PRESCRIPTION. Source: WHO Survey Level II and III 2008

6. Medicines Transparency Alliance Successes  P100 Treatment Pack Scheme  Botika ng Barangay Program  Generics promotion  Electronic Drug Price Monitoring System (EDPMS)  Philippine National Drug Formulary (PNDF) system  Price regulation and other cost-containment measures under the Cheaper Medicines Act

7. Medicines Transparency Alliance Challenges Need to properly document and disseminate information on pricing and availability Instituting good pharmaceutical management processes in LGUs, public and private health facilities Training on pharmaceutical management, governance and best practices for LGU executives Providing incentives for transparency and good governance practices in the public and private sector Development of an e-procurement system for the public sector

8. Medicines Transparency Alliance15/11/20158 Thank you Alexander A. Padilla Email: alexdelasalaspadilla@gmail.com; alpaddy@yahoo.comalexdelasalaspadilla@gmail.com www.metaphilippines.org.ph