PhilHealth now covers breast cancer, leukemia treatments

by Aleta Nieva-Nishimori,

Posted at Jul 06 2012 02:56 PM | Updated as of Jul 07 2012 03:20 AM

PhilHealth now covers breast cancer, leukemia treatments 1MANILA, Philippines – A lump on the breast is a health concern for a woman and could become a financial problem for her and her family in the future.

Dr. Rachel Rosario, executive director of the Philippine Cancer Association, said a woman who finds out she has a lump on her breast will also most likely think about its financial aspects.

“Do I have the money for the biopsy? If the results come out positive, do I have the money for the operation? And after the operation, what then?” Dr. Rosario told ANC on Friday.

Lucky for women (and men as well), the Philippine Health Insurance Corp. (PhilHealth) has launched a new benefit package for members and qualified dependents.

Called "Package Z," it includes four kinds of serious illnesses:

  • breast cancer (stages 0 to III-A), P100,000;
  • prostate cancer (low to intermediate risk), P100,000;
  • acute lymphocyctic leukemia (all stages) in children (standard risk), P210,000; and
  • kidney disease (low risk and end-stage requiring transplant), P600,000

“There is always going to be out-of-pocket expenses in the old way we do things. But right now, if we do discover this and there’s that package already then we could say, 'Okay, I think I have something. I better go in. And if it’s early, I get this package,'” said Dr. Rosario.

Although launched only this month, PhilHealth's Package Z has been in effect since June 21.

“Only on the day that the policies are effective when newly diagnosed cases are actually given the benefits,” reminded Dr. Robert Louis So, PhilHealth's senior Manager for benefits and research development.

So then explained how they chose the four diseases for PhilHealth's new package.

“It’s really value for money. We want to make sure that our patients get the services that they actually need, that there's capacity for our local sciences to provide the service,” he said.

"One of the reasons that we chose the four diseases is there is some information that comes in, the technical capacity is here and they are one of the more common cancers that we have," he added.

Breast cancer is top cancer in PH

Currently, breast cancer is the "overall number one cancer in the Philippines," according to Rosario.

Although she admitted that P100,000 is not enough to treat the early stages of the disease, Rosario said the amount is a good start.

“A lot of doctors will be saying it might not be enough. But we're saying this is for early stages and standard risks. It can be done. The beauty of the package is that Philhealth is very open to study it. Like after three months, we sit down again and review. It’s going be a regular process,” she said.

Rosario is optimistic that thousands of patients will benefit from the new package. "For breast cancer, we're looking at around 12,000 plus (patients). These are the new cases which PhilHealth will help. We have to consider who among them will have membership with PhilHealth and then we have to also look at the social economic status of the women who would avail of the package,” she said.

Expanded coverage

So, for his part, is hopeful that PhilHealth will be able to cover more diseases under Package Z in the near future.

Among the health conditions that he wants to be part of Package Z are colorectal cancer, coronary artery bypass graft, congenital surgical conditions, and lung cancer.

“We're eyeing a list of conditions and our timeline is over the next two to three years. This is in line with the universal health care strategy of the government. We're trying to see if we can add more…not limited to cancer,” he said.

So said, however, that PhilHealth first needs to improve its premium base to add more into the package.

“Not everybody is paying the premium. The premium base is relatively thin to really come up with high reimbursement rates. Our intent is to improve that base, but at the same time, as we do it, keep on adding into the Z benefits, keep on adding into the benefits,” he said.