MANILA, Philippines — For many low-income families in Cavite, having a chronic illness is becoming more than a health problem—it is a financial struggle that can force households to borrow money, dip into savings and even choose cheaper treatment just to make ends meet.
A University of the Philippines study of 200 households in Ternate, Cavite found that 61% turned to cheaper or alternative treatments, while 39.5% borrowed money to cover medicines and other healthcare expenses. Another 29% relied on existing funds or savings.
The findings come from a cross-sectional study by researchers from the UP Manila College of Pharmacy, published in Acta Medica Philippina in 2025. The research examined how much households in a fourth-class municipality were paying out of pocket for noncommunicable diseases, or NCDs.
Medicines are taking the biggest bite
The study found that medicines accounted for the largest share of household health spending.
NCD medicines represented a median 59.41% of total household health expenditures, while medicines of all types accounted for a median 77.57% of health spending. Median monthly out-of-pocket spending specifically for NCD medicines was ₱1,140, although individual household expenses ranged from as little as ₱70 to as much as ₱35,000.
Nearly 6 in 10 households—59.5%—spent more than ₱1,000 a month on NCD medicines.
The most frequently reported medicines included losartan and amlodipine for hypertension, metformin for diabetes, and atorvastatin for high cholesterol. Hypertension, diabetes, heart disease and asthma were among the most commonly reported chronic conditions.
And the financial pressure increased as more family members required treatment. Researchers estimated that household health spending increased by about ₱1,576.68 for every additional household member taking medicine for an NCD.
The bigger problem: paying for care when medicine is unavailable
The researchers pointed to another issue beyond the price of medicine: access.
Essential medicines for common chronic illnesses are supposed to be available through public primary-care facilities such as rural health units and barangay health stations. But the study noted that supplies were not always guaranteed.
When medicines were unavailable locally, families could be forced to purchase them from private pharmacies or travel outside the municipality to obtain medicines and healthcare services.
That means the actual cost of staying healthy can include much more than the medicine itself—transportation, consultations, laboratory tests, diagnostic procedures and other expenses can add to the household burden.
3 in 4 households crossed the study’s catastrophic-spending threshold
Perhaps the most striking finding was the prevalence of catastrophic health expenditure.
Using a 10% threshold for household spending on health, 74% of the 200 households were classified as having catastrophic health expenditure. At the higher 25% threshold, 30.5% still fell into that category.
However, the researchers stressed that these figures should not be interpreted as representative of every household in Ternate. Households covered by Primary Care Benefit Packages were excluded, meaning the study’s estimates may overstate the true prevalence of catastrophic spending in the municipality.
That limitation is important—but it does not erase the underlying warning: chronic disease can impose a sustained financial burden on households that need medicines and treatment month after month.
When the money runs out, families change how they live
The study showed that families did not simply absorb the additional expenses.
Some borrowed money. Others used savings or searched for cheaper medicines and alternative treatments.
Among households experiencing catastrophic health spending, seeking cheaper or alternative treatment was particularly common. Some families also reported reducing household expenditures, while others delayed or stopped treatment altogether.
Researchers documented even more serious coping strategies, including cutting spending on food and education and relying on relatives or neighbors for medicines.
Such decisions may provide short-term relief, but they can create longer-term consequences for both health and household finances.
This is not only a Cavite problem
The Ternate findings reflect a broader issue in the Philippine healthcare system: Filipino households continue to shoulder a substantial portion of healthcare costs themselves.
According to the Philippine Statistics Authority’s 2024 National Health Accounts, household out-of-pocket payments represented 42.7% of current health expenditure in the Philippines. Government schemes and compulsory contributory health financing accounted for 44.7%. Total health expenditure reached ₱1.56 trillion in 2024, up 17.1% from the previous year.
The Philippine Institute for Development Studies has likewise highlighted the continuing burden of out-of-pocket healthcare payments, particularly among vulnerable groups including poorer and rural Filipinos.
The country’s healthcare spending has since continued to rise. PSA data show that total health expenditure reached ₱1.87 trillion in 2025, up 15.1% from 2024.
Why chronic disease creates a different kind of financial pressure
Unlike a one-time medical emergency, chronic diseases often require years of monitoring, consultations and medication.
The World Health Organization identifies cardiovascular diseases, cancers, chronic respiratory diseases and diabetes as the four major groups of NCDs. Globally, NCDs killed at least 43 million people in 2021, representing about 75% of non-pandemic-related deaths.
For families with limited income, the challenge is therefore not simply paying one medical bill.
It is finding the money every month.
That is what makes the Ternate study significant. Its findings suggest that when chronic disease collides with limited household income and gaps in medicine availability, families may be forced to make painful choices between healthcare and other basic needs.
The warning behind the numbers
The researchers ultimately emphasized the need to address access to essential NCD medicines and healthcare services, particularly in lower-income communities.
The issue goes beyond the price printed on a medicine box.
When a family has to borrow money to buy maintenance medicine, switch to a cheaper alternative, use up savings or postpone treatment, the cost of illness can extend far beyond the hospital or pharmacy.
For these families, the question is no longer simply whether they can afford to get sick. It is whether they can afford to stay well.
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