Averting a health crisis: Yamsuan presses Philhealth to expand outpatient coverage for chronic kidney disease cases

Parañaque 2nd District Representative Brian Yamsuan wants the Philippine Health Insurance Corporation (Philhealth) to expand its outpatient coverage for dialysis and other means of renal replacement therapy (RRT) to make these life-supporting medical treatments easily accessible to the growing number of kidney disease patients.

Yamsuan issued the call amid the alarming rise in chronic kidney disease (CKD) among young Filipinos as shown by data from the Philippine Renal Disease Registry (PRDR), which recorded majority of this life-threatening ailment occurring among those aged 20 to 59 years old.

He has filed House Bill (HB) 6310 which aims to focus on the prevention and early detection of CKD and ensure that patients of this disease are fully covered by Philhealth, without the need to shoulder out-of-pocket medical expenses.

“Medical experts have long sounded the alarm about this silent epidemic afflicting many of our working-age kababayans. Huwag na nating hintayin na maging full-blown public health crisis ito. The Department of Health (DOH), all government hospitals with dialysis services and even stand-along dialysis facilities, should work together to educate the public about the risks of CKD and the importance of kidney health so that we can all continue leading productive lives,” said Yamsuan as the country marks National Kidney Month this June.

Based on the latest available PRDR data, 57.44 percent of patients diagnosed with kidney disease were between the ages of 20 and 59 years old. This means young adults had overtaken senior citizens — at 40.82 percent — as the majority of CKD patients.

Under HB 6310, Philhealth is mandated to cover all expenses of CKD patients for maintenance, dialysis treatments, including medicines, professional fees and hospital charges in accordance with the implementing rules and regulations of the Universal Health Care Act.

If the bill becomes law, the No Balance Billing policy shall be strictly applied to ensure that no out-of-pocket expenses are incurred by CKD patients.

“Recognizing that kidney transplantation provides the highest quality of life for End Stage Renal Disease (ESRD) patients, our measure also mandates Philhealth to shoulder all expenses for the procedure, including the costs for both the recipient and the donor, to make this life-saving treatment truly accessible,” Yamsuan said.

Hospitals are also required under the bill to provide facilities for peritoneal dialysis (PD), an outpatient and more cost-effective option, as opposed to hemodialysis (HD), which is an in-clinic and more expensive procedure. Overreliance on HD has cost PhilHealth
about P37.4 billion in 2020. This figure is projected to balloon to P213 billion by 2030 if current trends persist.

To support homebased PD, the bill emphasizes the training of medical and non-medical personnel, including barangay health workers, on this procedure.

The bill also focuses on prevention through early screening and heightening public awareness about CKD. Nephrologists have pointed out that early detection of possible kidney disease through laboratory tests could be managed by medication.

All RRT facilities are mandated under the measure to report the incidence and prevalence of patients receiving dialysis treatment and kidney transplants to the PRDR as a requirement for the renewal of their respective DOH licenses to operate.

The National Kidney and Transplant Institute (NKTI) and PhilHealth now rank kidney disease among the leading causes of death nationwide. In 2025, the burden has escalated to dire levels: over 30,000 new patients have begun dialysis that year alone.

This translates to one Filipino progressing to ESRD every hour. National prevalence of
CKD already stands at a daunting 35.94 percent, nearly triple the global average.###