PhilHealth will now pay for kidney transplants

MANILA, Philippines—The Philippine Health Insurance Corp. (PhilHealth) will pay for kidney transplant procedures of members and their dependents suffering from end-stage renal disease.

“We are affording every member and dependent with kidney failure the chance to enjoy a superior quality of life. We are now subsidizing the full cost of a kidney transplant procedure up to P600,000,” said Dr. Eduardo Banzon, PhilHealth president and chief executive officer, in a statement.

The PhilHealth benefit can be availed of at specialized centers with proven capabilities for providing first-rate kidney transplant services and care. These are the National Kidney and Transplant Institute in Quezon City, Vicente Sotto Memorial Medical Center in Cebu City, Southern Philippines Medical Center in Davao City and Davao Regional Hospital in Tagum City.

“These centers have excellent track records of more than 98-percent survival rates for kidney transplant patients,” Banzon said.

He added: “We are balancing high-quality service with accessibility. We’re starting with only four centers where members can avail themselves of the benefit, but we have at least one facility each in Luzon and the Visayas plus two in Mindanao. We may add to the four later on.”

“The four centers will apply the ‘no balance billing policy’ with respect to kidney transplant patients from families earning P30,000 or less annually. Patients will not be charged extra expenses on top of what PhilHealth pays. The P600,000 benefit already covers everything, including medication, hospitalization and professional fees,” Banzon said.

“This is our way of giving every member considerably greater value for their money. They will be entitled to a P600,000 benefit in return for premium contributions of as low as P2,400 per annum, or less than P7 per day, by Jan. 1, 2013,” Banzon said, noting that the subsidy would be PhilHealth’s single largest benefit payout ever.

According to Banzon, PhilHealth has members as young as 23 years old with chronic kidney disease.

“While they have their whole lives ahead of them, they have to undergo constant dialysis. Some of them die young. Hopefully, not anymore with this new benefit,” he said.

Some 12,000 Filipinos, or 120 per one-million population, develop kidney failure every year. They have a mean age of 53 years, with six out of 10 of them male, according to the National Renal Disease Registry.

Despite being the “gold standard” of care for patients with end-stage renal disease, Banzon said less than a thousand kidney transplants are performed in the country every year, largely due to the steep cost of the procedure.

With the P600,000 benefit, Banzon sees a dramatic increase in life-saving kidney transplants.

PhilHealth previously covered only up to eight percent of the total medical bill for the procedure.

“With this new benefit, our members and dependents with kidney failure, especially those from poverty-stricken households, can readily avail of a transplant procedure and look forward to more productive and fuller lives,” Banzon said.

The leading causes of kidney failure among Filipinos are diabetes, inflammation of the kidneys and high blood pressure.

To stay alive, patients with end-stage renal disease have only two treatment options—lifetime dialysis or a one-time kidney replacement.