PNDF 6th Ed. List for PhilHealth Reimbursement

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PHIC PHILHEALTH CIRCULAR NO.08, S.2005: PNDF 6th Ed. List for PhilHealth Reimbursement

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Title Supreme Court: PNDF 6th Ed. List for PhilHealth Reimbursement

Law: Phic Philhealth Circular No.08, S.2005

Decision Date: Feb 21, 2005

The National Formulary Committee has officially updated the Philippine National Drug Formulary, adding new drugs in key therapeutic categories, which will be eligible for PhilHealth reimbursement starting March 1, 2005, while temporarily suspending denials for delisted drugs pending further review.

administrative law

drug regulation

A

Legal Basis and Implementation of Drug Reimbursement

Implementation relies on Section 37 of Republic Act 7875 and PhilHealth Board Resolution No. 265 s. 1999.
These laws mandate the use of the latest PNDF edition for reimbursement purposes by PhilHealth.
Newly listed drugs under the specified sections of the latest PNDF edition shall be reimbursable for claims with discharge dates from March 1, 2005, onward.

Treatment of Delisted Drugs and Reimbursement Denial

Claims denial for delisted drugs and drug preparations in the mentioned sections will be held in abeyance.
The suspension of denials is pending the completion of the entire PNDF list or the provision of reasons for deletion by the National Formulary Committee.

Repeal of Inconsistent Issuances

Any prior issuances inconsistent with this circular are repealed or modified accordingly.
This ensures the circular’s precedence in governing drug reimbursement policies related to PNDF listings.

Accessibility and Documentation

The text listing the newly added drugs is available at the Office of the National Administrative Register, U.P. Law Complex, Diliman, Quezon City.
This ensures transparency and official availability of the updated formulary for public and institutional reference.

END