VSMMC patient gets kidney transplant for free under Philhealth Z Package

Somewhere in the city of Cebu, a number of individuals were showing great acts of selflessness to save a life.

It was eight in the morning, and a team of medical experts had gathered in a room. The nurses had prepared all the necessary instruments and everyone's ready. Dr. Alvin Roxas asked his team to utter their prayers before performing a major surgery.

The patient, Herminia Terne, a 53-year-old woman from Lapu-Lapu City, was diagnosed with kidney failure in 1995. Her doctors felt that she needed to undergo renal replacement therapy (either via hemodialysis or kidney transplant).

Herminia believed that undergoing a kidney transplant is her best chance for a better and longer life. So she sought out a kidney transplant team to inquire. But her creatinine levels were very high, which necessitated a hemodialysis. So while she was waiting for her transplant, she started the dialysis three times a week.

''Patients suffering from kidney failure must undergo hemodialysis because this treatment filters out toxic wastes from our blood, (a function) which can no longer be performed by the kidneys. Hemodialysis can only be (preventive until) a new kidney can be transplanted in the patient'' explains Dr. Roxas.

In this treatment, a machine is attached to a patient, which allows blood ''to flow'' through a special filter that removes wastes and extra fluids. The clean blood is then returned to the body. Removing the harmful wastes and extra salt and fluids helps ''control blood pressure'' and keeps the proper balance of chemicals like potassium and sodium in the body.

Herminia has to endure four hours of hemodialysis three times a week and this routine can continue indefinitely. According to Dr. Roxas, ''The patient's doctor advised her to go and see me. So when we met, her worry was that she cannot afford a full-paying transplant procedure. Although she can shoulder some of the cost, there was no way she can raise the full amount. So she thought of just flying to Manila to get the procedure there.''

Upon hearing this, Dr. Roxas promised to help the patient, informing her too of the new benefit package of the Philippine Health Insurance Company (Philhealth).

Dr. Roxas is the Head of the Section of Kidney Transplantation of the Vicente Sotto Memorial Medical Center (VSMMC). It is the only government hospital in Cebu that is accredited by the Department of Health (DOH) to perform kidney transplants. Likewise, it has performed more kidney transplant operations than any other hospital in Cebu. VSMMC is one of the only four hospitals nationwide and the only one in the Visayas contracted by the Philhealth and DOH to provide the Type-Z Kidney Transplant package.

A patient's prayer

Despite her condition, Herminia tries to live a normal life. She goes to work every day and attends to her five children. She doesn't let her ordeal overwhelm her. She is full of hope that one day, the desire of her heart will be granted.

''When I saw Herminia, I told her that her case might be the first beneficiary of the Z benefits package of Philhealth for kidney transplantation in Cebu City. However, another obstacle presented itself before us -a living related donor is needed,'' Dr. Roxas notes.

''With the patient's permission, I talked to her family and discussed her situation. She was very concerned about her children donating a kidney for her, but I saw in her eyes how much she wanted the transplant. As if everything in the world conspired for that moment, three of her children expressed their willingness to help their mother,'' the young doctor continues.

Among the four children of Herminia, her eldest son Wyndel came out to be the most eligible donor for her.

A few months ago, Dr. Roxas started the work-up for both donor and the recipient. With a living related donor, Herminia can now contemplate about the cost of the procedure.

''Philhealth came up with the idea of universal health coverage that will not just cover hospital expenses, but also ensure totality of care and attainment of better health outcomes for its beneficiaries especially for those who are indigent or cannot afford to pay for medical treatments through Z Package,'' explains Dr. Roxas.

Included in the package are payment for hospital services such as hospital room and board fees, drugs and laboratory exams, operating room and professional fees for the entire course of treatment, including mandatory and other services required per illness. All eligible PhilHealth members under the Employed Sector, Individually Paying, Lifetime Member Program, Sponsored Program and Overseas Workers Program including their qualified dependents are entitled to avail of the said benefit.

Under the Z Package, Philhealth will subsidize P600,000 for kidney transplant. An indigent patient can qualify to get the transplant procedure, including the work-up, for the said amount. However, to avoid patients from claiming they are all indigents, simple rules have been set.

A patient is classified as indigent if he is only earning P30,000 or less in a month. For those who will fall under this classification, Philhealth changed the availment procedure. Philhealth must first pre-approve the application of an indigent patient before getting the procedure. ''Let's face it, many patients will claim they are indigent because many people don't want to spend money for their medication and treatments,'' Dr. Roxas says.

Following Philhealth's procedure in availing of the Z Package, VSMMC processed all the documents needed for the pre-approval of Herminia's case. It only took a day or two for Philhealth to release its approval.

A week ago, Herminia and her son were discharged from VSMMC and both of them are doing great now!

Addressing the challenges

Dr. Cyril Tolosa, Medico-Marketing Manager of Sanofi, talked about organizations helping transplant patients. Recently, Sanofi started a program called SPARK (Sanofi Partnership for Access and Resources to Kidney transplantation) to support Philhealth's universal healthcare program, specifically the Z package.

''Philhealth has already initiated great projects for better provision of healthcare. To show our support to Philhealth and its partners, we provide our medicines at the lowest cost possible. For kidney transplant, Sanofi's Thymoglobuline, which is one of the pioneers and leading medicines to prevent kidney rejection, is offered at an affordable price for patients of the Z Package,'' he explains.

Everybody's mission

Government institutions like Philhealth and VSMMC have already taken the first steps toward the realization of universal healthcare for Filipinos. On the side of the pharmaceutical companies like Sanofi, lowering the cost of medicines contributes a lot for the success of treatments, and medical professionals like Dr. Roxas play a very important role to make this procedure possible.

''I want to ask my colleagues to make themselves available for the Z Package. I believe that we all have a mission to fulfill and with everyone's aid - from the nurses, nephrologists, surgeons, and other medical experts, we can make a difference and by reaching out to our fellowmen who need our help the most, they will feel that they have worth in this society,'' Dr. Roxas says. At the same time, he exhorts: ''And to those who can afford payments for medical services, let's be honest in declaring our financial capabilities. Philhealth will readily contribute P600,000 and this is already a blessing that we didn't have in the past.''