RDC-7 seeks to change the PhilHealth breast cancer coverage package.
The Central Visayas Regional Development Council (RDC) has asked the Philippine Health Insurance Corp. (PhilHealth) to change its Type Z Benefit Package rules, especially for patients with early-stage breast cancer.
The package is being provided to PhilHealth subscribers in order to address health issues that result in extended hospitalization and high-cost treatments.
In a statement on Tuesday, September 28, 2021, Evelyn Nacario-Castro, head of the RDC’s Social Development Committee, said the council had formally made the request via a resolution that it had previously approved.
According to current PhilHealth standards, the package rate for early-stage breast cancer is PHP100,000 for the full course of treatment, as per Board Resolution No.1629 (s.2012) and Circular No.029 (s.2012).
The first payment of PHP75,000 is provided 60 days after surgery, and the second tranche of PHP25,000 is given 60 days after the final chemotherapy cycle for Stage 1 to 3-A is completed.
As a result, Castro said, a patient who does not get chemotherapy forfeits the second tranche payment.
Furthermore, the recommendations indicate that only tamoxifen may be administered to breast cancer patients as part of a hormonotherapy treatment.
The RDC is working to change the rules so that all early-stage breast cancer patients may get the full benefits package, according to the official.
By not making chemotherapy a required treatment and expanding the filing timeline for tranche 2 claims of Stage 0 patients to additional early breast cancer patients who do not need chemotherapy, the change seeks to enable eligible patients to receive the maximum benefit package of PHP100,000.
The RDC also advised that aromatase inhibitors be considered as an alternative to hormone treatment.