EXECUTIVE BRIEFER

I. Subject Meeting on the Updating of Blood/Blood Products Costing

9 July 2018, 11:00 AM to 4:00 PM, UP NIH
II. Premise N/A
III. Requested For your information
Action
IV. Objective The forum aims to present the following:
 Costing for blood/blood products and other additional blood units testing
 Discussion of the 4 criteria as basis for Philhealth reimbursement
 Updating of Philhealth Circular No. 0035s. 2013
V. Background N/A
VI. Major Costing for blood/blood products and other additional blood units testing
Provisions  The final costing for blood and blood products has yet to be recomputed due to
TRAIN law.
 According to Dr. Bonifacio, there is an urgent need to review and adjust the costing
of blood products due to TRAIN law and increasing supply cost.
 We are currently looking into Philhealth as a possible source of funds to
subsidize/offset the increasing prices of blood products and services.
 Dr. Bonifacio emphasized the importance of NAAT during blood processing
though it is expensive (1,150) in order to detect possible TTI even when it is during
the window period of disease. NAAT is the only screening test that can determine
the presence of TTI during the window period (example:HIV).
 In a study, the author stated that without NAAT there could be 5 TTIs
(HIV/Hepatitis) that can be transmitted in every 500 blood units collected.
 They suggested to disaggregate the cost of the blood products/services during
payment.
 They suggested the Philhealth to create case rates on outpatient blood transfusion
packages based on the primary disease: Cancer, Thalassemia, Hemophilia, CKD etc
 Dr. Bonifacio stated that the PBC and Philippine Red Cross agreed that the
minimum blood staffing pattern at 6 persons but as the blood collection per center
increases the number of staffs also increase.
Philhealth RVS code: 36430
 Outpatient transfusion of blood or blood products
 Inpatient blood transfusion shall be covered by the medical case rates
 Applicable only in hospital, ASC, PCF and infirmary
 45 days allowable benefit per year
 1 session for each procedure regardless of the number of bags used=1 day deduction
 For a claim with a combination of case rates, the provider shall be paid the full case
rate amount for the first case rate plus 50% of the second case rate.
 The entire case rate amount plus the PF shall be paid directly to the HCI concerned.
The HCI shall act as withholding tax agent for the PF. The PF shall be distributed
by the HI within 30 calendar days from the date of receipt of reimbursement.
VII. Issues or Problems the proposal seeks to address: N/A
VIII. Resources needed (budget, logistics, HR): N/A
IX. Options or alternatives, cost-benefit analysis or cost-effectiveness analysis: N/A
X. Scope and Implications: N/A
XI. Recommendations: Next Steps
 The updated CPG on rational blood use will be updated/finalized by NVBSP and PSHBT
 The presentation on the recalculated costing will be done by Dr. Bonifacio after his consultation with
PRC, Private and Government Hospitals, representatives of different blood centers
 The final staffing pattern c/o HFSRB
XII. Annexes N/A
XIII. Prepared by John Allen E. Alcantara, MD

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Last Updated: 13-Aug-2018 7:13 Page 2 of 2