Outcomes of Kidney Transplants Under the Philippine Health Insurance Corporation's Z Benefit Package at the University of the Philippines-Philippine General Hospital from 2015 to 2021

Abstract

End-stage renal disease is one of the most burdensome diseases, particularly in developing countries such as the Philippines, with dialysis and kidney transplant commonly being a source of out-of-pocket expenditure among patients. To address the burgeoning health inequity, the Philippine Health Insurance Corporation (Philhealth) launched in 2012 its Z Benefit Package for kidney transplantation providing a substantial amount to subsidize the transplant with the aim of increasing financial risk protection of its members, especially the marginalized sector. The University of the Philippines-Philippine General Hospital is a government hospital that was one of the contracted hospitals to provide this benefit package since 2015. Herein we report our initial experience with 29 primary, low immunologic risk, living donor kidney transplants. Recipients mostly had chronic glomerulonephritis with a median discharge creatinine of 1.04 mg/dL. One, 3-, and 5-year graft survival was 100%, 96%, and 85%, respectively, with a median graft survival of 65 months. Donors were mostly male with a median discharge creatinine of 1.0 mg/dL. One, 3-, and 5-year patient survival was 100%, 91%, and 81%, respectively. Complications were mostly urinary tract infections. In conclusion, the Philippine Health Insurance Corporation Z Benefit Package for transplant seems to be achieving its goals of providing quality care particularly for the poor with catastrophic diseases such as end-stage renal disease. Optimal patient selection and management are essential in attaining excellent graft and patient outcomes. Furthermore, it is hoped that with this program, there will be increased awareness of the at-risk population, transplanting them preemptively, ensuring a better overall survival.