title: Outcomes of Kidney Transplantations Under the Philippine Health Insurance Corporation's Type Z Benefit Package at the National Kidney and Transplant Institute, Philippines.
abstract: BACKGROUND
  Under the Universal Health Care Program of the Department of Health, the Philippine Health Insurance Corporation (PHIC) launched the Case Type Z benefit package for kidney transplantation, providing the largest amount (USD $13,300.00) for any single medical procedure. The objective of this study was to describe under the PHIC Case Type Z Benefit Package for kidney transplantation at the National Kidney and Transplant Institute and kidney transplantation outcomes under this package.
  
  
  METHODS
  Included in the benefit were standard risk recipients between 10 and 70 years of age with at least 1 human leukocyte antigen (HLA) DR match with the donor, panel-reactive antibody (PRA) less than 20%, and absence of donor-specific antibody (DSA). Previous transplantations, malignancy, hepatitis B and C, human immunodeficiency virus (HIV) positivity, cytomegalovirus (CMV) R-/D+, congestive heart failure, and liver cirrhosis were exclusion criteria. Patients were evaluated by a medical social worker according to their family's financial status.
  
  
  RESULTS
  Since June 2012, a total of 261 patients have received the benefit, with 44 under service, 37 with fixed co-pay and 180 with variable co-pay. Of the living donor kidney transplants, 98% had immediate graft function, with 2.3% (6/261) acute rejection rates at 1 year. The total cost of hospitalization was within the benefit for living donor kidney transplants (less than USD 8000.00) but exceeded it in all cases of deceased donor kidney transplants.
  
  
  CONCLUSIONS
  The successful use of and excellent outcomes under the Case Type Z benefit demonstrated how collaboration among government agencies, health care providers, and pharmaceutical companies could result in a program that improved the access to health care for Filipino patients with end-stage renal disease.
authors.affiliation: Department of Adult Nephrology, National Kidney and Transplant Institute, Quezon City, Philippines.
authors.forename: G E P
authors.initials: GE
authors.lastname: Pamugas
authors.affiliation: Department of Adult Nephrology, National Kidney and Transplant Institute, Quezon City, Philippines.
authors.forename: M-H I
authors.initials: MH
authors.lastname: Arakama
authors.affiliation: Department of Adult Nephrology, National Kidney and Transplant Institute, Quezon City, Philippines. Electronic address: dr.radanguilan@gmail.com.
authors.forename: R A
authors.initials: RA
authors.lastname: Danguilan
authors.affiliation: Human Organ Preservation Effort, National Kidney and Transplant Institute, Quezon City, Philippines.
authors.forename: D
authors.initials: D
authors.lastname: Ledesma
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D003669:Deductibles and Coinsurance; D005260:Female; D006085:Graft Survival; D006760:Hospitalization / Q000191:economics; D006801:Humans; D016030:Kidney Transplantation / Q000191:economics*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D010679:Philippines; D012189:Retrospective Studies; D019472:Universal Health Insurance; D055815:Young Adult