Doctors are urging the government to include Critical Limb Ischemia (CLI) treatment in Philippine Health Insurance Corporation (PhilHealth) coverage, warning that the disease is as deadly as cancer but remains underfunded and overlooked.

During the Philippine Heart Association’s (PHA) Usapang Puso sa Puso webinar on August 29, cardiovascular experts said CLI treatment should be part of the PhilHealth Ischemic Heart Disease-Acute Myocardial Infarction STEMI Package to ease patients’ burden of cost.

“Kapag may nagtanong, ano ang alam mong mapanganib na sakit, ang sagot mo ‘cancer.’ Pero alam ninyo ba na ang Peripheral Artery Disease ay kasing mapanganib ng cancer, at ang critical limb ischemia ay mas mapanganib pa kaysa sa karamihang cancer (When someone asks you what’s the most dangerous disease, you’ll say cancer. But do you know that Peripheral Artery Disease is just as dangerous as cancer, and critical limb ischemia is even more dangerous than most cancers),” Dr. Ramon Ribu, a thoracic cardiovascular surgeon at the Philippine Heart Center, said.

Ribu stressed that CLI patients face a five-year mortality rate of up to 60 percent, with 30 percent risking major amputation within a year of diagnosis.

While CLI treatments such as angioplasty, stenting, and bypass surgery are available in the Philippines, expenses remain a barrier, per Dr. Renato Villanueva of the Philippine Heart Association. 

He noted that procedures in private hospitals are often prohibitive, while government facilities face long queues.

All four doctors at the forum—Ribu, Villanueva, Dr. Florimond Garcia, and Dr. Iris Garcia—called on PhilHealth to cover both in-patient and out-patient CLI management, including surgical interventions, wound care, and maintenance drugs.

This, they said, would reduce out-of-pocket spending and make life-saving procedures more accessible.

“Mahalin natin ang paa katulad ng pagmamahal natin sa paa natin (Let’s love our feet the same way we love our heart),” Garcia said, stressing CLI’s link to heart attacks and stroke.

Villanueva, a thoracic and cardiovascular surgeon, said that while the country has 17 regional heart centers, catheterization laboratories (cath labs) are limited and specialists are lacking.

“So sa mga regional heart centers, ang cath lab iisa lang, tapos ang mga gamit o instruments, available ba? At ang pinaka-importante ay ‘yung operator, at ‘yung kanyang support staff na tutulong sa kanya. So, we have regional heart centers na may mga cath lab pero medyo kulang pa tayo sa tao pagdating sa mga tusok, but pagdating naman sa open surgery, ay kaya naman (In regional heart centers, there’s usually only one cath lab, and equipment availability is an issue. Most importantly, there’s the question of the operator and support staff. We have cath labs, but we lack personnel for catheter-based procedures. For open surgery, we can manage since it doesn’t need sophisticated equipment),” he explained.

Villanueva said the Philippine Association of Thoracic and Cardiovascular Surgeons, Inc. (PATACSI) has 198 members nationwide, but only 86 are capable of performing bypass surgery. 

He added that the country has just about four medical vascular interventionists and six surgical vascular interventionists.

Experts underscored that beyond PhilHealth coverage, greater awareness of CLI is crucial. 

They advised patients to stop smoking, manage diabetes, cholesterol, and blood pressure, and maintain a heart-healthy lifestyle.

“Magbabago ang lifestyle pati ang sitwasyon sa bahay kung kayo ay mawawalan ng paa. Magbabago ang buhay kung mayroong disabled sa pamilya. That’s why doctors are here for limb salvage(Life and the household will change if you lose a leg. Life changes when a family has a disabled member. That’s why doctors are here for limb salvage),” said Ribu.

“Magpakonsulta sa tamang doctor, hindi sa kapitbahay o kung sino-sino. At dapat, tama ang specialty ng doctor na pinagpatingnan. Kami sa PHA ang aming advocacy ay huwag kayong maputulan ng paa, para hindi pumangit ang inyong buhay (Consult the right doctor, not neighbors or random people. And make sure the doctor is the right specialist. At PHA, our advocacy is to prevent amputations, so your life won’t be diminished),” he added.