Philippines Financial Assistance Programs Market Analysis

Philippines Financial Assistance Programs Market Executive Summary

The Philippines Financial Assistance Programs Market is at around $62.3 Mn in 2023 and is projected to reach $166.9 Mn in 2030, exhibiting a CAGR of 15.1% during the forecast period 2023-2030.

The aim of drug manufacturers' patient financial support is to minimize or remove out-of-pocket cost sharing as an obstacle when patients choose medications, thereby keeping them on brand-name drugs for longer. Co-pay assistance, free drugs trails, bridge programs, sliding scale programme, Coupons, Bulk purchasing programs etc are some of the widely used financial assistance programme under patient assistance programs. Patients' out-of-pocket drug cost sharing is determined by their health plans or pharmacy benefit manager's (PBM's) formulary--a list of preferred and nonpreferred prescription drugs. Preferred status is based on a drug's effectiveness, price, and the level of rebate the payer receives from the manufacturer for giving the drug preference over its competitors. Generics and preferred brand drugs are generally assigned lower patient cost sharing than nonpreferred brand drugs. As drug prices have increased, so has patient cost sharing, causing some patients to stretch, forgo, or discontinue medication that is too expensive. Drug manufacturers often seek to mitigate these effects by providing or funding various forms of patient financial support.

There is an increasing prevalence of chronic diseases in Philippines, such as cardiovascular diseases, hypertension, diabetics, COPD, asthma and renal failure. Among all diabetics is most prevalent with prevalence rate around 7.5%. According to Internation Diabetics Federation as of 2021, In the Philippines, it was estimated that about 4.3 Mn Filipinos had been diagnosed with diabetes, and 2.8 Mn remained undiagnosed. Therefore, the market is predominately driven by factors such as rising drug cost, rising prevalence of chronic diseases, complex insurance landscape whereas sustainability concerns, limited awareness and budgetary concerns restrict the market

Pharmaceutical companies providing financial assistance to patient are such as Merck, GSK, Pfizer, Johnson & Johnson, Novartis among others.

Market Dynamics

Market Drivers

Rising cost of pharmaceutical products: The rising expense of pharmaceutical products: Specialty and innovative drugs, especially those for rare or complex conditions, are becoming more costly. This trend results in higher out-of-pocket costs for patients, including those with insurance. Consequently, more patients require financial aid to obtain their prescribed medications.

Complex insurance landscape: With the growing number of high-deductible health plans, patients often face substantial upfront costs before their insurance coverage applies. Rising co-pays and coinsurance rates increase the financial burden on patients. These insurance trends lead to a greater need for financial assistance programs.

Chronic disease prevalence: There is an increasing prevalence of chronic diseases in Philippines, such as cardiovascular diseases, hypertension, diabetics, COPD, asthma and renal failure. Among all diabetics is most prevalent with prevalence rate around 7.5%. According to Internation Diabetics Federation, In the Philippines, it was estimated that about 4.3 Mn Filipinos had been diagnosed with diabetes, and 2.8 Mn remained undiagnosed. This rise in prevalence rate of chronic diseases is driving the market of financial assistance in Indonesia.

Market Restraints

Sustainability concerns: The long-term feasibility of patient assistance programs may be in doubt, especially during economic downturns or shifting healthcare policies. Pharmaceutical companies and healthcare providers might be concerned about fostering dependence on these programs or setting unrealistic expectations. There is also worry about the impact on drug pricing, with fears that these programs could be used to justify higher medication prices.

Regulatory concerns: Financial assistance programs must navigate complex healthcare laws and regulations. Compliance with anti-kickback statutes, privacy laws, and other regulations can be difficult and might restrict the level of assistance provided. The potential risk of breaching these regulations could lead some organizations to be overly cautious in designing their programs.

Limited awareness: Many eligible patients are unaware of existing patient assistance programs, leading to missed opportunities for those who could benefit. Effective outreach and education are essential but can be expensive and challenging, especially when trying to reach vulnerable or isolated individuals.

Regulatory Landscape and Reimbursement Scenario

The regulatory body responsible for the pharmaceutical industry in the Philippines is the Food and Drug Administration (FDA). The FDA is responsible for ensuring the safety and efficacy of drugs and medical devices in the country. The FDA has implemented several regulations to facilitate the registration of new drugs, including the Abridged and Verification Review Pathways for New Drug Applications. This allows for a more efficient and streamlined process for drug registration, which can help reduce the time and cost associated with the process.

The reimbursement system in the Philippines is managed by the Department of Health (DOH) and the Philippine Health Insurance Corporation (PhilHealth). The DOH is responsible for setting the prices of medicines and medical services, while PhilHealth is responsible for providing health insurance coverage to eligible individuals. The reimbursement process involves several steps, including the submission of claims by healthcare providers and the review and approval of those claims by PhilHealth.

Competitive Landscape

Key Players

Here are some of the major key players in the Philippines Financial Assistance Programs Market:

• GSK
• Novartis
• Roche
• Pfizer
• Bayer
• Sanofi
• Merck
• Johnson & Johnson
• AbbVie
• AstraZeneca