Center for Health Market Innovations (CHMI)

Programs

Revolving Drug Insurance Fund

last updated May 2, 2012

Overview

Implementing organization: 
Sogod Bay ILHZ/LGUs within the ILHZ, PhilHealth, Department of Health, GTZ
Legal Status: 
State/government
Year Launched: 
2004
Stage: 
Existing/expansion stage
Income Level of Target Population: 
Bottom 20%

Funding

Primary Source of Funding: 
Government
Summary: 

The Revolving Drug Insurance Fund (RDIF) hopes to provide access to medicines to indigent members of PhilHealth and Organized Groups (OG) members by creating a mechanism through which qualified members can purchase their medicines from private pharmacies for a minimal co-payment. The private pharmacies are, in turn, reimbursed by the RDIF for the cost of medicines issued.

Program goals/rationale: 

One of the problems identified in the Sogod Bay health zone is inadequate access to medicines by indigent patients who are enrolled in PhilHealth, which in turn has resulted to low utilization of health services in the area. Additionally, as public health facilities do not have an adequate supply of medicines, doctors are often forced to issue prescriptions for patients to fill at private pharmacies. The high out-of-pocket expenses association with private pharmacy purchases has made health care seeking at health facilities unattractive for the poor.

Key program components: 

The RDIF aims to provide access to essential quality drugs to clients who are enrolled in PhilHealth's Indigent Program and ensure timely reimbursement of participating pharmacies through a secure cash flow. It also tries to encourage both patients and local government unit (LGU) officials to enroll individuals, especially the poor, into PhilHealth.

The RDIF issues payments to accredited pharmacies for drugs issued to qualified patients. RDIF revenues come form capitation contributions from LGUs, co-payments from the patients, PhilHealth reimbursement for inpatients, as well as a grant from the Department of Health (DOH).

Operations of the RDIF are managed by the LGUs in Sogod Bay ILHZ and are headed by Sogod Bay ILHZ Board. The Memorandum of Agreement for the RDIF creates provisions for the smooth operations of the fund, including a drug benefit ceiling for inpatients and outpatients, standard contributions from the LGUs, and procedures for the collection of co-payment and accreditation of private pharmacies, among others.

The RDIF is implemented through a cooperative agreement between the LGUs within the Sounthern Leyte Inter-local Health Zone and PhilHealth with the assistance of the DOH and GTZ. The DOH provided a seed grant of one million dollars to start the fund's implementation in 2004.

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