[ PHIC PHILHEALTH CIRCULAR NO. 05, S. 2004, January 21, 2004 ]

AMENDMENTS AND CLARIFICATIONS TO PHILHEALTH CIRCULAR NO. 34, S. 2003



Please be guided by the following amendments and clarifications to PhilHealth Circular No. 34 s. 2003 titled Reimbursement of Claims for Drugs Listed in the PNDF Vol. 1 6th Edition and PhilHealth List of Reimbursable Drugs (Positive List):

1.    In October 2003, the Department of Health furnished us with the partial list of drugs included in the latest edition of the Philippine National Drug Formulary (PNDF) which is the 6th edition.  The annexes of Circular No. 34 provide a summary of the similarities and differences between the 5th edition and 6th edition of the PNDF.  The drugs and drug preparations could either be:

i.      delisted - listed in the 5th edition but removed in the 6th edition,
ii.     added - not found in the 5th edition but included in the 6th edition, or
iii.    retained - listed in both the 5th and 6th edition

It is possible though that only a certain drug preparation is delisted or added while the drug per se is retained.  Drugs and drug preparations so affected are listed in Annexes 1 and 2 of PhilHealth Circular No. 34, s. 2003.

2.    For the tables on annexes 1 and 2, the first column contains the drugs in their generic/international non-proprietary names (INN); the second column contains the drug's respective routes of administration; and the third column contains the preparations that specify the drug's dosage strength, dosage form and packaging.

3.    Section A of Annex 1 contains the drugs, in their generic name, that has been newly included in the 6th edition of the PNDF.  These drugs therefore are additional compensable drugs.

4.    Section B of Annex 1 contains the newly included preparations of retained drugs in the 6th edition of the PNDF.  These preparations therefore are additional compensable drug preparations.

5.    Section A of Annex 2 contains the drugs, in their generic names, that have been delisted in the 6th edition of the PNDF and are therefore no longer compensable.

6.    Section B of Annex 2 contains the delisted preparations of retained drugs in the 6th edition of the PNDF.  These preparations therefore are no longer compensable. The retained or newly included preparations of the drugs listed in this section are still compensable.

7.    Further, the following corrections and clarifications on Annexes 1 and 2 are hereby made for your guidance:

ANNEX 1 - New Drugs and Drug Preparations Included in the PNDF Vol. 1 6th Edition

A. Additional Compensable Drugs (by November 1, 2003)

Section 3.0 Anti-Infectives (page 1 of Annex 1)

  1. Didanoside should read as Didanosine.

Section 5.0 CARDIOVASCULAR DRUGS (page 1 of Annex 1)

  1. Add the following drugs, which are already included in the 5th Edition of the PNDF but are classified under a different category.  In the latest edition, they are newly listed under Section 5.0 Cardiovascular Drugs.
 
GENERIC NAME
ROUTE
PREPARATION
     
Atropine
Inj.:
 1 mg/ml, 1 ml ampul (IM, IV, SC) (as sulfate)
 
 
Enoxaparin
Inj.:
 20 mg/0.2 ml, 40 mg/0.4 ml,
 
60 mg/0.6 ml and 80 mg/0.8 ml pre-filled syringe (SC);
 
100 mg/ml, 1 ml vial (SC)
 
 
Unfractionated Heparin
Inj.:
 1,000 IU/ml and 5,000 IU/ml,
 
5 ml vial (IV, IV infusion, SC) (as sodium salt)
 
 
Warfarin
Oral:
 1 mg, 2.5 mg and 5 mg tablet

B. Additional Compensable Drug Preparations (by November 1, 2003)

Section 3.0 Anti-Infectives
(page 2 of Annex 1)

  1. Add to the list the following preparation of Chloroquine:
GENERIC NAME  
ROUTE
PREPARATION
      Chloroquine
Inj.:
50 mg/ml, 20 ml vial (IM, IV) (as diphosphate
  1. Delete from the list the following preparation of Clindamycin:
 
GENERIC NAME
ROUTE
PREPARATION
     
Clindamycin
Inj.:
 150 mg/ml, 4 ml vial (IM, IV) as phosphate)

Section 5.0 CARDIOVASCULAR DRUGS (page 3 of Annex 1)

  1. Add to the list the following preparation of metoprolol:
GENERIC NAME
ROUTE
PREPARATION
      Metoprolol
Oral:
10 mg tablet (as tartrate)

  1. Transfer the drug Enoxaparin to Annex 1.A Section 5.0
 
GENERIC NAME
ROUTE
PREPARATION
     
Enoxaparin
Inj.:
 100 mg/ml, 1 ml vial (SC)

ANNEX 2 - Drug and Drug Preparations Delisted from the PNDF
                  (Not Compensable by January 1, 2004)
A. DELISTED/NON-COMPENSABLE DRUGS:

  1. Delete the date November 1, 2003 in the subject heading
Section 3.0 ANTI-INFECTIVES (page 1 of Annex 2)

  1. Please note that in the 5th edition of the PNDF, Probenecid is also listed under Section 2.3 Anti-gout.
Section 5.0 CARDIOVASCULAR DRUGS (page 1 of Annex 2)

  1. Change preparation of Dipyridamole 20 mg tablet to:
    GENERIC NAME
    ROUTE
    PREPARATION
          Dipyridamole
    Oral:
    25 mg tablet

  2. The following should be included in the delisted drugs: 
     
    GENERIC NAME
    ROUTE
    PREPARATION
         
    Phenytoin
    Oral:
    		 30 mg and 100 mg capsule (as sodium salt)
        30 mg/5 ml suspension, 120 ml (as sodium salt)
        125 mg/5 ml suspension, 120 ml (as sodium salt)
     
    		 
     
    Inj.:
    		 50 mg/ml, 2 ml ampul (IV) (as sodium salt)
     
    		 
    Quinidine
    Oral:
    		 250 mg durules (as bisulfate) equivalent to 200 mg base

  3. Please note that in the 5th edition of the PNDF, Phenytoin is also listed under Section
    1.3 Anticonvulsants.

B. DELISTED/NON-COMPENSABLE DRUG PREPARATIONS:

  1. Delete the date November 1, 2003 in the subject heading.
Section 3.0 ANTI-INFECTIVES (page 2 of Annex 2)

  1. Delete from the list the following preparation of Quinine
 
GENERIC NAME
ROUTE
PREPARATION
     
Quinine
Inj.:
 300 mg/ml, 1 ml vial (IV) (as dihydrochloride)
    300 mg/ml, 2 ml vial (IV) (as dihydrochloride)

8.    We reiterate that the compensability of the drugs depends on their use, which should be as indicated in the 6th edition of the PNDF.

All other provisions of PhilHealth Circular No. 34, s. 2003 consistent herewith shall remain in full force and effect.

Adopted: 21 Jan. 2004


(SGD.) FRANCISCO T. DUQUE III, MD, MSc
President and CEO