Table 2 Summary and main challenges of healthcare systems in the Philippines, Thailand, and Vietnam
Philippines | Thailand | Vietnam |
Phenylephrine is not listed in the Philippine National Drug Formulary (PNDF) but is available in the Philippine market on the rationale of “compassionate use.” The Philippine National Health Insurance (Philhealth) reimburses only PNDF-listed medications used by patients. Non-PNDF medications are paid out-of-pocket by patients in public hospitals. Therefore, it remains an additional financial burden for the patient. The higher cost is an issue compared to that of ephedrine | Phenylephrine is new and recently included in Thailand's Diagnostic Related Group. However, anesthesiologists are concerned about the wasted cost of the unused drug when prepared in anticipation of use. The prefilled syringe can be cost-saving. Norepinephrine and epinephrine are used in some hospitals when phenylephrine is not available | Phenylephrine is registered but is limited to specialty hospitals. This deprives smaller community hospitals of medications like phenylephrine. On the other hand, ephedrine is cheap and widely available. Recently, Vietnamese health care insurance has inserted phenylephrine into the drug list. It means that insurers pay for this drug |