Experts in the field of health value assessment from both public and private sectors gathered in the Health for Juan and Juana Forum Series 2, to put spotlight on the value of innovation, dialogue, and multi-stakeholder participation as the way forward in the country's strategy to improve health outcomes.
More than 350 people attended the webinar with theme “Health as an Investment” to widen understanding on sound Health Technology Assessment (HTA) principles and models, and draw lessons from them as the Philippines crafts its own fit-for-purpose value assessment processes.
As the COVID-19 pandemic showed, investing in health not only saves lives but is also a crucial investment in the country’s economy.
The Pharmaceutical and Healthcare Association of the Philippines (PHAP) together with its partners, recently conducted the forum to gain perspectives from government, patients, healthcare professionals, and international value assessment groups to discuss shared values in HTA as well as models that put patients and multi-stakeholder engagement at the center of policies.
“We must keep in mind that value assessments should include all outcomes that matter to patients and families and the society. What matters to us is that we are given hope that there is a chance for a cure or that there will be major health improvement for our condition,” said Mr. Teodoro Padilla, PHAP Executive Director. “What matters is being able to treat a disease with very few options or even prevent outbreaks and pandemics.”
On May 27, the Health for Juan and Juana: The Innovation Imperative Forum tackled collaborations for innovative health technologies to address COVID-19 as well as the country’s aspirations, supportive policies, enabling environment, and patients’ needs and expectations towards building a resilient health system and ensuring access to desired health outcomes.
Continuing on with the narrative on the Innovation Imperative, the webinar focused on HTA as a tool for access to new vaccines, tests and treatments, evaluating their value beyond cost-effectiveness. The webinar provided opportunities for participants to share their understanding of HTA and its impact on them.
The forum was moderated by former health secretary Dr. Manuel Dayrit, adjunct professor at the Ateneo School of Medicine and Public Health, and Dr. Kenneth Hartigan-Go, head of the Stephen Zuellig School of Development Management at the Asian Institute of Management.
In the forum, Pharmaceutical Research Manufacturers of America (PhRMA) Vice President of International Advocacy Dr. Kevin Haninger highlighted the value of innovative medicines and key attributes of a well-functioning HTA system.
"Transparency, flexibility, stakeholder engagement, and patient access are key attributes of a well-functioning value assessment system," said Dr. Haninger.
Sound HTA is an integral component of an effective and efficient implementation of Universal Health Care. In the Philippines, HTA has been explicitly included in the National Health Insurance Law of 1995 and in the Universal Health Care Act signed by President Duterte in February 2019. The UHC Act is a landmark legislation enabling Filipinos to have access to preventive, promotive, curative, rehabilitative and palliative care for medical services.
The state of HTA in the Philippines
The UHC law prescribes the creation of an HTA council (HTAC) which will facilitate provisions for financing, converge recommendations on health technologies to be financed, coordinate the HTA process within the Department of Health (DOH) and PhilHealth, and review and assess existing packages.
"Filipinos who cannot afford treatment should not bear the heavy burden of paying medical services," emphasized Presidential Spokesperson Harry Roque. "Accessibility and quality healthcare should be made available to all."
"It is our aspiration and dream to see that every Juan and Juana will be able to access quality health care services even in the farthest area of the archipelago," shared Ms. Melanie Santillan, Senior Manager Benefits Development and Research Department at Philippine Health Insurance Corporation.
COVID-19 highlighted the importance of the implementation of UHC provisions, such as HTA, and a collaborative environment in order to innovate the public healthcare system.
"The pandemic challenged our health system and exposed its strengths and limitations," said Paul Perez, President of Cancer Coalition Philippines.
“We are in a situation where we need to prioritize healthcare spending and the time when we need new and innovative health technology,” noted former Health Undersecretary Dr. Madeleine Valera.
"HTA is the tool that will help the government meet its objective of equity in healthcare services through the National Healthcare System," reminded Dr. Maria Encarnita Limpin, Vice President of Philippine College of Physicians. "From the physician’s point of view, HTA should ensure that healthcare services provided are of good quality. Quality should not be compromised over quantity."
Learning from HTA pioneers
Admittedly, the Philippines can learn from countries who have successfully implemented HTA. At the global level, HTA has been in implementation since the 1990s. Dr. Alicia Granados, Head of Global Health Technology Assessment Scientific Strategies of Sanofi, said that in Europe, United States, Canada and Australia, the success of HTA is attributed to two factors – multi-disciplinary and multi-stakeholder approach.
In Asia, Taiwan's HTA development is remarkable. From its early beginnings in 2007, HTA became a model for other countries to look up to. Their success lies in collaboration, synergy, and transparency.
"We worked very hard and decided to fit the policy making structure. We tried to make it better,” remarked Dr. Jasmine Pwu, Director of the International Society for Pharmaeconomics and Outcomes Research (ISPOR). “We did not break down the old system to build a new one. We supported it to make better decisions.”
The role of patients in HTA
Both the CCPh and the Philippine Alliance of Patient Organizations believe that integral to the success of the HTA process is patient involvement.
“Patients have something to say about all aspects of HTA but the most important thing they can contribute is a description of the benefits or unwanted effects of a healthcare technology," stated Einstein Rojas, a board member of PAPO.
"In order for health technology to be appropriate, feasible and driven by public health goals, it should be designed in coordination with both public and private sector, and most importantly with the community, patients and healthcare providers," said former Health Secretary Dr. Esperanza Cabral during her closing remarks.
The Health for Juan and Juana: The Innovation Imperative Forum is being co-organized by the Asian Institute of Management, American Chamber of Commerce, Cancer Coalition Philippines, the Department of Health, Department of Science and Technology - Philippine Council for Health Research and Development, European Chamber of Commerce of the Philippines, German-Philippine Chamber of Commerce and Industry, ISPOR Philippines Regional Chapter, Philippine Alliance of Patient Organizations, Pharmaceutical and Healthcare Association of the Philippines, PHAPCares Foundation, University of the Philippines- Universal Healthcare Study Group, Embassy of Switzerland in the Philippines and Zuellig Family Foundation.