Law Summary
Reference to the Philippine National Drug Formulary (PNDF)
- The PNDF serves as the main reference for PhilHealth in determining which drugs are reimbursable.
- The 5th edition of the PNDF was recently revised and updated by the Department of Health.
- Newly included drugs in this edition are subject to reimbursement under PhilHealth schemes.
List of Additional Reimbursable Drugs
- Numerous drugs across various therapeutic categories are added for reimbursement, such as:
- Non-steroidal anti-inflammatory drugs (NSAIDs): Ibuprofen, Etodolac, Indometacin, Ketoprofen
- Antipsychotics and antidepressants: Risperidone, Fluoxetine, Sertraline
- Anticonvulsants and neurological agents: Carbamazepine, Gabapentin, Valproate disodium
- Immunosuppressants and chemotherapy agents: Azathioprine, Cyclophosphamide, Mycophenolate mofetil, Mitoxantrone
- Antibiotics and antimicrobials: Amoxicillin, Azithromycin, Cefepime, Metronidazole, Amikacin
- Cardiovascular drugs: Carvedilol, Amlodipine, Losartan, Irbesartan, Simvastatin
- Vaccines including combination vaccines (e.g., DTP + hepatitis B, DTP + Hib, DTP + IPV + Hib)
- Antiretroviral drugs: Zidovudine derivatives such as Zalcitabine, Lamivudine, Indinavir, Ritonavir, Saquinavir, Valaciclovir
- Others: Zolpidem, Rocuronium, Mivacurium, Cetirizine, Amphotericin B
Legal Effect and Implementation
- The circular formalizes the reimbursement eligibility of the listed drugs by PhilHealth.
- Healthcare providers and beneficiaries are to adhere to this updated coverage for claims and reimbursements.
- This aids in expanding access to essential and newly recognized drugs under PhilHealth’s health insurance benefits.
Administrative Authority and Issuance
- The circular was issued and adopted on June 15, 2000.
- It carries the signature and authority of Enrique M. Zalamea, President and CEO of PhilHealth at the time.
- It serves as a directive for all concerned health insurance and healthcare institutions under PhilHealth.
Absence of Penalty Provisions
- The circular does not explicitly state penalties or sanctions for non-compliance, focusing instead on the policy update and procedural guidance.