[ PHILHEALTH CIRCULAR NO. 19, S. 2005, August 22, 2005 ]

REIMBURSEMENT OF CLAIMS FOR DRUGS LISTED IN THE PHILIPPINE NATIONAL DRUG FORMULARY (PNDF) VOLUME ONE, SIXTH EDITION



Pursuant to Section 37 of Republic Act No. 7875 and PhilHealth Board Resolution No. 265 s. 1999 which provides for the use of the latest edition of the PNDF for reimbursement, the said list of drugs shall be implemented as follows:

  1. Newly listed drugs and drug preparations that are now included in Section 16.0 Solutions Correcting Water, Electrolyte, Acid-base and Caloric Disturbances, 17.0 Diagnostic Agents, 18.0 Dermatological and Mucous Membrane Agents (Topical), 19.0 Ophthalmological Preparations, 20.0 Ear, Nose and Throat Preparations, 21.0 Vitamins and Minerals, and 22.0 Disinfectants of the PNDF, Volume 1, 6th edition (Annexes 1-7* ), shall be compensable for claims with discharge dates starting September 1, 2005.

  2. Denial of claims for delisted drugs and drug preparations in the above mentioned sections and the previous sections of the PNDF 5th edition (Sections 2.0, 7.0, 8.0, 13.0 to 15.0 as per Circular No. 26, s. 2004 and Sections 9.0 to 12.0 as per Circular No. 08, s. 2005) shall be deferred until December 31, 2005.

  3. Claims for drugs listed in the 5th edition of the PNDF (Sections 2.0, 7.0 to 22.0) shall remain compensable for claims with discharge dates until December 31, 2005.

  4. For claims with discharge dates starting January 1, 2006, reimbursement for drugs and medicines shall be based solely on the 6th edition of the PNDF, Volume 1.

All other issuances inconsistent with this circular are hereby repealed and modified accordingly.

Adopted: 22 August 2005

(SGD.) LORNA O. FAJARDO, CESO III
Officer-In-Charge
Office of the President and CEO


* Text Available at Office of the National Administrative Register, U.P. Law Complex, Diliman, Quezon City.