Background Orphan disorders (ODs) affect an estimate of 5,000 out of 100 million Filipinos -making a low disease prevalence of less than 1 out of 20,000. Most of these diseases are life threatening yet there have been very limited provisions for this sector, as it remains underserved. With the present-day goal of Universal Health Coverage (UHC), however, is the need for a greater initiative to address the needs of people suffering from ODs.
Objectives This study analyzed seven different financing strategies for patients with orphan disorders (PODs) in the Philippines for a prospective policy recommendation for the “Rare Diseases Act” Bill.
Methods Using a cross-sectional study design and the Health Policy Analysis Framework, this study analyzed and described the inter-relationships among the actors, context, content, and process variables affecting the different financing strategies. Two supporting frameworks -Functions-of-Health-Financing and the Universal Coverage Cube–were used (1) to describe the current health financing system for ODs and (2) to evaluate its progress towards achieving UHC, respectively, in relation to the different financing strategies.
Result Based on research and data gathered, financing for ODs remain largely out-of-pocket with substantial grants and subsidies mostly provided by private funding organizations. Government allocation remains low while a social health insurance benefit package for the OD sector is still lacking, thus, translating to poor delivery of health services for ODs.
Conclusion After a comprehensive analysis, social health insurance was determined as the most optimal financing strategy for ODs; PhilHealth Insurance Corporation provides the most efficient way to deliver services for PODs as it is already well established especially with many health providers across the nation. Its large member base and existing benefit packages for catastrophic illnesses also manifests an effective risk pooling system.
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