PhilHealth expands access to selected anti-TB drugs
MANILA, Philippines — The Philippine Health Insurance Corp. (PhilHealth) is expanding access to selected first-line antituberculosis (TB) medicines through its Guaranteed and Accessible Medications for Outpatient Treatment (Gamot) program.
The expanded benefit will take effect on Nov. 1, giving eligible patients additional access to prescribed TB medicines, according to PhilHealth Circular No. 2026-0018.
“Eligible patients with confirmed drug-susceptible tuberculosis (DS-TB) may obtain covered medicines from PhilHealth-accredited GAMOT facilities through prescriptions issued by YAKAP (Yaman ng Kalusugan) physicians,” PhilHealth said in a press release.
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READ: PhilHealth eyes faster benefit expansion to cut out-of-pocket costs
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The covered anti-TB medicines will not be deducted from the annual Gamot benefit limit of P20,000, preserving the allocation for other outpatient medicines, the state insurer added.
Under the policy, Yakap-accredited physicians must issue prescriptions through the Gamot app in line with the Department of Health’s National Tuberculosis Control Program treatment protocols.
Patients may receive up to a month’s supply of first-line anti-TB medicines per transaction. Accredited Gamot facilities must dispense the full prescribed quantity within two days of the issuance of the prescription.
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Patients who fail to claim their medicines within the prescribed period may still avail of these, although they will have to get an updated prescription or pay for the drugs themselves.
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Gamot facilities must also submit an updated certificate of availability to their designated PhilHealth regional office before dispensing anti-TB medicines.
PhilHealth will directly reimburse the facilities based on fixed fees.
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The expanded benefit allows eligible patients to obtain prescribed anti-TB medicines through accredited Gamot facilities, complementing the existing TB-DOTS (directly-observed therapy, short-course) package for comprehensive outpatient care.
TB-DOTS facilities will continue to provide comprehensive care and dispense anti-TB medicines, subject to available supplies. /cb
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