To afford medicine, families in a low-income municipality often turn to alternative or cheaper treatments, borrow money, or use their savings

07 Jul 2026

The World Health Organization identifies non-communicable diseases (NCDs)—also referred to as chronic diseases—as the leading cause of global mortality, accounting for 74% of all annual deaths. These medical conditions are characterized by their long-term duration and characteristically slow progression.

This cross-sectional study assessed household out-of-pocket expenditures for NCDs in Ternate, Cavite, a 4th-class municipality in the Philippines. Surveying 200 households across all 10 barangays, the study found that hypertension, diabetes, heart disease, and asthma were the most common NCDs. Corresponding medications frequently included Losartan, Amlodipine, Metformin, and Glimepiride. Households often require laboratory tests like blood work and diagnostic services such as X-rays. While most had members with a single NCD, many had members taking medications for multiple conditions. To afford healthcare, families commonly turned to alternative treatments (61.0%), borrowed money (39.5%), or used savings (29.0%).

The median proportion of expenditures on NCD medicines over total health spending was 59.41%, and all medicines accounted for 77.57%. Catastrophic health expenditure (CHE), or the “proportion of the population with large household expenditures on health as a share of total household expenditure or income,” was experienced by 74.0% of households using a 10% income threshold and 30.5% using a 25% threshold. Households with one NCD member had significantly lower odds of CHE, while those with two or more showed increasing odds, especially at higher thresholds.

The study provides critical evidence on the financial burden that NCDs impose on households in a low-income municipality, highlighting how the high cost of medicines and limited access to affordable healthcare services lead to CHE. Findings underscore the limited financial protection against medicine-related costs and highlight gaps in primary healthcare accessibility and affordability, especially for those not enrolled in government benefit packages. The exclusion of households under Primary Care Benefit Packages may overestimate CHE prevalence, suggesting a need for broader insurance coverage and enhanced government support for NCD care.

By identifying these challenges, the study underscores the urgent need for policy interventions to improve access to essential medicines and strengthen primary healthcare systems. Ultimately, the research contributes valuable, locally relevant insights to support efforts toward achieving equitable and sustainable healthcare for NCD patients, particularly in underserved communities.

Authors: Marivie R. Magana (Department of Clinical, Social and Administrative Pharmacy, College of Pharmacy, University of the Philippines Manila), Gwyneth Allyson B. Ibarra (Department of Clinical, Social and Administrative Pharmacy, College of Pharmacy, University of the Philippines Manila), Charlene C. Laggui (Department of Clinical, Social and Administrative Pharmacy, College of Pharmacy, University of the Philippines Manila), and Frances Lois U. Ngo (Department of Clinical, Social and Administrative Pharmacy, College of Pharmacy, University of the Philippines Manila)

Read the full paper: https://actamedicaphilippina.upm.edu.ph/index.php/acta/article/view/10606

Image by Tima Miroshnichenko from Pexels

To afford medicine, families in a low-income municipality often turn to alternative or cheaper treatments, borrow money, or use their savings

The World Health Organization identifies non-communicable diseases (NCDs)—also referred to as chronic diseases—as the leading cause of global mortality, accounting for 74% of all annual deaths. These medical conditions are characterized by their long-term duration and characteristically slow progression.

This cross-sectional study assessed household out-of-pocket expenditures for NCDs in Ternate, Cavite, a 4th-class municipality in the Philippines. Surveying 200 households across all 10 barangays, the study found that hypertension, diabetes, heart disease, and asthma were the most common NCDs. Corresponding medications frequently included Losartan, Amlodipine, Metformin, and Glimepiride. Households often require laboratory tests like blood work and diagnostic services such as X-rays. While most had members with a single NCD, many had members taking medications for multiple conditions. To afford healthcare, families commonly turned to alternative treatments (61.0%), borrowed money (39.5%), or used savings (29.0%).

The median proportion of expenditures on NCD medicines over total health spending was 59.41%, and all medicines accounted for 77.57%. Catastrophic health expenditure (CHE), or the “proportion of the population with large household expenditures on health as a share of total household expenditure or income,” was experienced by 74.0% of households using a 10% income threshold and 30.5% using a 25% threshold. Households with one NCD member had significantly lower odds of CHE, while those with two or more showed increasing odds, especially at higher thresholds.

The study provides critical evidence on the financial burden that NCDs impose on households in a low-income municipality, highlighting how the high cost of medicines and limited access to affordable healthcare services lead to CHE. Findings underscore the limited financial protection against medicine-related costs and highlight gaps in primary healthcare accessibility and affordability, especially for those not enrolled in government benefit packages. The exclusion of households under Primary Care Benefit Packages may overestimate CHE prevalence, suggesting a need for broader insurance coverage and enhanced government support for NCD care.

By identifying these challenges, the study underscores the urgent need for policy interventions to improve access to essential medicines and strengthen primary healthcare systems. Ultimately, the research contributes valuable, locally relevant insights to support efforts toward achieving equitable and sustainable healthcare for NCD patients, particularly in underserved communities.

Authors: Marivie R. Magana (Department of Clinical, Social and Administrative Pharmacy, College of Pharmacy, University of the Philippines Manila), Gwyneth Allyson B. Ibarra (Department of Clinical, Social and Administrative Pharmacy, College of Pharmacy, University of the Philippines Manila), Charlene C. Laggui (Department of Clinical, Social and Administrative Pharmacy, College of Pharmacy, University of the Philippines Manila), and Frances Lois U. Ngo (Department of Clinical, Social and Administrative Pharmacy, College of Pharmacy, University of the Philippines Manila)

Read the full paper: https://actamedicaphilippina.upm.edu.ph/index.php/acta/article/view/10606

Image by Tima Miroshnichenko from Pexels