Cancer kills four Filipinos every hour. But with early diagnosis, and access to quality treatment and care, this disease can be better managed. Beyond its impact on the patient’s life, it also affects their families, friends and communities.
This is the reason why Hope From Within focused its cancer conversation series, Tita Hope Talks, on #UsapangCancerCareFunding. For its fourth episode, national leaders and health experts gathered to talk about the financial burden and challenges faced by cancer patients, and the opportunities to alleviate the financial burden to help Filipino patients better cope with the disease.
With the passage of the National Integrated Cancer Control Act (NICCA) and the Universal Health Care Law (UHC), all cancer patients and cancer survivors regardless of cancer stage, age, ethnicity, gender, or religion can look forward to more meaningful, hopeful tomorrows. However, access to funding remains elusive to patients. Out of pocket expenses remain high.
Most cancers have a long-term nature that causes repeated financial hardships for families, intensifying the poverty-illness cycle. Diseases not properly treated deepen poverty by leading to loss of health, non-treatment of disease, higher morbidity, lost income, and further impoverishment.
The financial burden of cancer care in the Philippines
“Cancer care is catastrophic. If you get hit, not only does it devastate you because of the possibility of dying sooner, it devastates you financially. You would want to catch it early and you do everything possible to do so, but that’s going to eat up a lot of your money, your livelihood,” shared Dr. Marife Yap, Sr. Technical Advisor of Thinkwell, an international research organization focused on health financing.
In her discussion of a recent Thinkwell report, commissioned by MSD on cancer spending in six countries, Dr. Yap highlighted that to achieve an effective response to cancer, health system functions must be strengthened – stewardship, financing, service delivery, and resource generation, across the health system’s six components – prevention and secondary prevention, diagnosis, treatment, survivorship, rehabilitation, and palliative care.
When one of the components is not adequately managed, the entire response is at risk, resulting in premature deaths, unnecessary pain, and wasted resources. Although addressing all aspects of the continuum is a daunting task, the Philippine government has made the first step in this direction by including cancer care in recent reforms designed to achieve universal health coverage.
The report also pointed out the low utilization of the Philhealth Z-benefit package due to “tedious requirements, slow reimbursement, limited and restrictive coverage.”
“This is a good impetus to look at cancer in the entire continuum so that we will really be able to achieve our desire, which will be fewer people dying of cancer. For those who develop cancer,
they get treated not because they have the money but because the government and private sector come together to provide the ability and capacity to make life easier for them. Most importantly, we hope that these numbers keep going down because less and less people will develop cancer. Those who do get cancer can be diagnosed earlier, and have higher recovery rates,” Yap added.
Access to quality cancer care and funding for all Filipinos
Government leaders play an important role in prioritizing health care services for Filipinos. As legislators and implementers, they hold key roles in the implementation of the full benefit of existing health care laws like NICCA and UHC.
In his message, Senator Panfilo Lacson promised that “in an effort to aid our people, especially our poor countrymen who cannot afford nuclear PET-CT scans, I prioritize our programs to make this medical intervention affordable, available and accessible. This representation commits to ensuring that the lives and safety of our countrymen remain on top of our priority.”
Senator Christopher Lawrence Go, lead proponent of the Malasakit Center Act, highlighted that the Malasakit Center is a one-stop-shop for all financial assistance provided by different government agencies such as the Department of Health (DOH), Philippine Charity Sweepstakes Office (PCSO), Philippine Amusement Gaming Corporation (PAGCOR), and Department of Social Welfare and Development (DSWD) to serve the indigent patients for their treatment or hospitalization.
“Cancer always takes a toll not only on the patient’s health but ultimately the financial situation of the individual and their family. The aim of the Malasakit Center is to help our fellow Filipinos in their hospital needs. Since this is signed into law, the services it offers will remain,” noted Senator Go.
Asked about his recommendation to improve access to care and treatment, Senator Richard Gordon said, “The government should ensure that we have good coverage, good preventive suggestions, good stress-relieving measures such as parks and playgrounds. Providing access to medical experts and early detection are important. It is important to provide access to medicine; people should know where to go. There should be a 24/7 center to direct patients to the right hospital.”
In her short address, Senator Risa Hontiveros expressed her commitment to support the funding of NICCA.
“Cancer care must remain a national priority. As part of our push and support for the NICCA, we will monitor the establishment and rollout of cancer care centers as well as budgetary requirement of the program during the senate deliberation. With proper laws and funding, cancer is a battle that thousands of Filipinos can win,” Senator Hontiveros said.
As one of the proponents of NICCA, the House of Representative Committee on Health Chairperson Congresswoman Angelina Tan echoed, “the burden of cancer is real and adequate funding is the key. We badly need health champions in government, particularly those who will champion the cause of scaling up essential programs and increasing investments for robust prevention of cancer, better screening, prompt and accurate diagnosis, timely and optimal treatment, responsive palliative care and pain management, effective survivorship and late effects
management and rehabilitation as well as making cancer treatment and care more equitable and affordable for all, especially for the underprivileged, poor and marginalized Filipinos.”
Recalling their family’s first-hand experience in dealing with pancreatic cancer, senatorial aspirant Dr. Minguita Padilla noted that “patients and their families will do almost everything to avail themselves of a cure for cancer. But financial constraints almost always dash their hopes. Cancer is the one illness that can change a life of comfort to a life of difficulty and uncertainty. To be able to fund cancer care, we need to think out-of-the-box. 2022 is a year of hope. And that hope is in our hands.”
The Department of Health (DOH) has taken measures to materialize provisions of the two-year- old cancer law and UHC. According to Dr. Clarito Cairo, DOH Cancer Division Program Manager, existing cancer care funding and support for patients include the Philhealth Z-benefit package,148 Malasakit Centers, 27 DOH access hospitals, and the cancer assistance fund.
“We have a cancer control program continuum and scope. In the end-to-end continuum, we have access to the right information. This will help our patients get the right information regarding their disease, the agencies to approach, and the multidisciplinary team. Many think that all they need is an oncologist when in fact, cancer is a multidisciplinary team approach,” explained Dr. Cairo.
Dr. Cairo also noted that aside from providing free medicines, the cancer assistance fund has been recently expanded to include screening and diagnostics services for cancer patients.
Championing better navigation and access to funding for patients
Patient groups have been at the forefront in pushing cancer care reforms. After NICCA passed, a new era of lobbying began.
Mr. Paul Perez of Cancer Coalition Philippines lauded the passage of health-related laws. He said, “it is a beautiful law. It encompasses everything. There are also so many moving parts. We just hope it will move faster. Cancer cannot wait. We are very determined to see the patients benefit from the law.”
For his part, Mr. Jose Ramon Albert, policy researcher, and colorectal cancer patient, could not help but air his frustration over the slow progress in implementation. “Let’s do it with speed. We don’t have a sense of urgency. Even for processes for getting assistance, it is unclear for patients. Make processes simple. You will expect outcomes to be fast,” he emphasized.
Cancer is a complex disease that challenges a country’s health care system and the pathways to progressive inclusion. A defining characteristic of most cancers and many other chronic diseases is the need for a series of interventions along the treatment continuum and in the course of illness.
Speaking on behalf of fellow medical oncologists, Dr. Bil Ramos, immediate past president of the of the Philippines Society of Medical Oncologists, shared the commitment highlighted of the medical community to continue that they will continue advocating for awareness “lobby and adequate for adequate funding through the implementation of for the implementation of NICCA. “We join the literacy and cancer awareness campaign towards primary and secondary prevention of cancer knowing that detecting early-stage lesions will result in more prolonged survival.”
“We can win this battle against cancer. Kailangan natin ng champions sa LGU. Bahagi po iyan ng UHC, bubuhayin ang local health board. Iparinig ang ating boses para sa paggawa ng plano ng LGU, kasama na po ang cancer. Malaki ang puwersa at impluwensiya. Gamitin po natin ang pagkawala ng ating mahal sa buhay para lumaban. Let’s do it to honor their memory. Create new champions para ang pangako ng NICCA na affordable cancer care for all ay matupad na,” added Ms. Carmen Auste, Cancer Coalition Philippines.
When assessing the scope of effective interventions offered for specific cancers along the continuum, there is an insight gained into both the depth and breadth of the overall package, as well as the balance between prevention and treatment. Effective coverage requires both permanent revenue sources and capacity-building commitments. It is a long way to go and a race over time. Cancer care is a collective effort, and each Filipino has a role to play. Hope from Within (HFW) is a multi-stakeholder cancer advocacy campaign led by MSD in the Philippines, committed to renewing hope and reinforcing the fight for Filipino cancer patients. To know more about the advocacy visit www.hopefromwithin.org or follow Hope Frow Within’s official Facebook page https://www.facebook.com/Hopefromwithinph/.