Roux Prize awarded for expanding health insurance in the Philippines

WASHINGTON – A Filipino epidemiologist and professor has been awarded $100,000 for using health data to identify the most taxing health problems in the Philippines, helping his country expand health coverage and reduce the costs involved.

The award is part of the annual Roux Prize offered by the Institute for Health Metrics and Evaluation (IHME), an independent global health research organization at the University of Washington in Seattle. The recipient, Dr. John Wong, also identified and recommended specific, cost-effective interventions for Filipinos, including blood pressure measurement, breast examination, risk profiling for hypertension and diabetes, and smoking cessation.

“Until recently, simple mortality statistics and lobbying by stakeholders determined which benefit packages were chosen for government coverage,” explained Dr. Wong, an associate professor at Ateneo de Manila University. “With the burden of disease findings, we were able to show the areas that deserved the most attention. Now, the services included in the new guaranteed health benefits package will reflect what causes the most health loss of Filipinos.”

Although the Philippines began rolling out universal health coverage in 2010, nearly 8 million Filipinos still lack health insurance. Those who are covered still pay 60% of their health expenses out-of-pocket. As a result, many poor families cannot afford critical services. Under the new expanded benefits plan, patients will have to pay little or nothing.

UNICEF approached Dr. Wong to develop a new, evidence-driven process to be used by the Philippine Health Insurance Corporation (PhilHealth), the managing agency for the National Health Insurance Program, for selecting services to be included in the country’s universal health plan.

Looking to the disability-adjusted life year (DALY), the cornerstone metric for the Global Burden of Disease Study (GBD), Dr. Wong and his team identified the top 48 causes contributing to 80% of all health problems in the Philippines. This list is now the core of the new prioritization process driving the new health package that aims to cover 15 million Filipinos with the most need – the poor.

“There is a sizeable gap in the Philippines between those who can pay for health care and those who can’t,” said Dr. Wong. “If there is no help from government, if there is no push for universal health coverage, it will be very difficult to address the most pressing health problems, and families will continue to struggle to pull themselves out of poverty.”

In 2013, the top causes of health burden in the Philippines were heart disease, respiratory infections, tuberculosis, preterm birth complications, diabetes, stroke, low back pain, and iron-deficiency anemia.

Since the adoption of the new priority-setting procedure, two individual health plans focusing on maternal health and children with disabilities have been approved for the new guaranteed health benefits program.

“The Global Burden of Disease study estimates were what ultimately helped us clinch the approval of the maternal health package,” states Dr. Mianne Sylvestre, a former pediatrician and now a consultant tasked with designing the health plan. “Complications from preterm birth are the fourth top cause of disease burden in the Philippines, and once the new package is implemented, nearly all Filipino mothers will have access to essential services during pregnancy.”

The Roux Prize is presented annually by IHME, and is named for the founder of the award, David Roux and Barbara Roux. David Roux is one of IHME’s original board members and has been a longtime champion of using better evidence to improve decision-making in priority-setting and resource allocation.

“Dr. Wong has illuminated the power that health estimates have in driving sustainable change at the country level,” said IHME’s Director, Dr. Christopher Murray. “The push for universal health coverage by the Philippines is very salient right now when other countries are trying out how to expand coverage. He has played a critical role in ensuring health services for Filipino families.”

Dr. Wong, a collaborator in the Global Burden of Disease Study since 2013, has over 30 years of experience in epidemiology, biostatistics, community health, program management and evaluation, and health system management.

The Roux Prize is intended for anyone who has applied health data and evidence in innovative ways to improve population health. Nominees may come from anywhere in the world and could include, but are not limited to, staff in government agencies, researchers at academic institutions, volunteers in charitable organizations, or health providers working in the community.

Nominations for next year’s prize are due March 31, 2017, and the winner will be announced at an event in the fall of 2017. Details on the nomination process for the Roux Prize are available at www.rouxprize.org. Nominations and questions about the prize can be sent to [email protected]or mailed to:

Roux Prize 
c/o Institute for Health Metrics and Evaluation 
2301 Fifth Ave., Suite 600 
Seattle, WA 98121 
USA

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