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SEVENTEENTH CONGRESS ey, ——fi—.,

Third Regular Session

House Bill No.__9 353

Introduced by MAGDALO Party-List Representative
HON. GARY C. ALEJANO

EXPLANATORY NOTE

Section 15, Article II of the Constitution provides that:

“The State shall protect and promote the right to health of the people and instill

health consciousness among them.”

Moreover, Section 11, Article XIII expressly mandates that:

“The State shall adopt an integrated and comprehensive approach to health
development, which shall endeavor to make essential goods, health, and other social
services available to all the people at affordable cost. There shall be priority for the
needs of the underprivileged sick, elderly, disabled, women, and children. The State
shall endeavor to provide free medical care to paupers.”

A bleeding disorder is a condition that affects the way your blood normally clots. The
clotting process, also known as coagulation, changes blood from a liquid to a solid. When you're
injured, your blood normally begins to clot to prevent a massive loss of blood. Sometimes, certain
conditions prevent blood from clotting properly, which can result in heavy or prolonged bleeding,

Bleeding disorders can cause abnormal bleeding both outside and inside the body. Some
disorders can drastically increase the amount of blood leaving your body. Others cause bleeding to
occur under the skin or in vital organs, such as the brain.

Bleeding disorders can be inherited or acquired. Inherited disorders are passed down through
genetics. Acquired disorders can develop or spontaneously occur later in life. Some bleeding



disorders can result in severe bleeding following an accident or injury. In other disorders, heavy
bleeding can happen suddenly and for no reason

‘There are numerous different bleeding disorders, but the following are the most common ones:

+ Hemophilia A and B are conditions that occur when there are low levels of clotting factors
in your blood. It causes heavy or unusual bleeding into the joints. Though hemophilia is
rare, it can have life-threatening complications.

+ Factor Il, V, VII, X, or XII deficiencies are bleeding disorders related to blood clotting
problems or abnormal bleeding problems.

+ Von Willebrand's disease is the most common inherited bleeding disorder. It develops when
the blood lacks von Willebrand factor, which helps the blood to clot.

In the Philippines, about 10,000 Filipinos are affected with hemophilia and approximately a
million suffering from von Willebrand disease, among other bleeding disorders. Despite this fact,
the government still has a lot to do in addressing the harms of bleeding disorders. There is also a
lack of awareness by patients regarding the disease and the costly treatment required.

In faithful observance to the provisions of our basic law and recognizing that bleeding
disorders are health concerns of many Filipinos, this bill is proposed. It shall provide for the
establishment of hemophilia treatment facilities in key cities and regions nationwide in designated
hospitals with Cancer and Hematology Departments. Furthermore, this bill also seeks to provide
free blood clotting products, exclusive rooms for hemophilia patients, and clinical coagulation
laboratory.

In view of the foregoing, approval of this bill is earnestly sought.

Ref Gary C. Alejano


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REPUBLIC OF THE PHILIPPINES
HOUSE OF REPRESENTATIVES
Quezon City

SEVENTEENTH CONGRESS
Third Regular Session

House BillNo._8353

Introduced by MAGDALO Party-List Representative
HON. GARY C. ALEJANO

AN ACT
PROVIDING A STANDARD OF CARE FOR THE TREATMENT OF PERSONS WITH
BLEEDING DISORDERS, ESTABLISHING TREATMENT CENTERS AND
APPROPRIATING FUNDS THEREFOR

Be it enacted by the Senate and House of Representatives of the Philippines in Congress
assembled,

SECTION 1. Short Title.This Act shall be known as the “Bleeding Disorder Standards
Act.”

SEC. 2. Declaration of Policy.—It is hereby declared the policy of the State:

a. To ensure the adequate treatment of hemophilia at the lowest possible cost and

endeavor to make them available for free to indigent patients;
b. To ensure the establishment of treatment centers in public hospitals; and

c. To establish a standard of care so that patients with severe bleeding disorders can
receive necessary and appropriate medical care.

SEC. 3. Definition of Terms.—For the purposes of this Act:

a. Bleeding disorder is a medical condition characterized by a severe deficiency or absence
of one or more essential blood clotting proteins in the human blood, often called factors, including
all forms of hemophilia, von Willebrand disease, and other bleeding disorders which result in
uncontrolled bleeding or abnormal blood clotting.

b. Blood clotting product is an intravenously administered medicine manufactured from
human plasm, recombinant biotechnology techniques, and other processes, approved by the FDA
and which is used for the treatment and prevention of symptoms associated with bleeding disorders.

The term includes, but is not limited to:


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1. Factor Vila, Factor VIII, and Factor IX products;
2. Von Willebrand factor products;

3. Prothrombin complex concentrates;

4. Activated prothrombin complex concentrates; and

5. Other products approved by the FDA for the treatment of bleeding disorders and
associated inhibitors.

¢. Indigent Patient is any patient unable to pay for services and/or medical treatment,
laboratory testing of blood and/or coagulation studies or blood coagulating product and/or ancillary
infusion equipment.

d. Hemophilia is a human bleeding disorder caused by a hereditary deficiency or
abnormality of the Factor VIII or Factor XI blood clotting protein in human blood.

¢. von Willebrand disease is a human bleeding disorder caused by a hereditary deficiency
or abnormality of the von Willebrand factor in human blood.

SEC. 4. State Treatment Facilities.—The State shall establish hemophilia treatment facilities
in key cities and regions nationwide in designated hospitals with Cancer and Hematology

Departments.
Each hemophilia treatment facilities shall provide to all hemophilia patients:

a. Care by qualified hematologists and medical doctors and shall also provide free of charge
the necessary blood clotting products and ancillary infusion equipment necessary for the infusion of
such blood clotting products;

b. A room exclusively for hemophilia patients; and

c. A clinical coagulation laboratory for the screening, diagnosis, provisional diagnosis and
treatment of bleeding disorders and such services shall be provided free of charge to all indigent
patients.


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SEC. 5. Funding.—The amount necessary for the initial implementation of this Act shall be
sourced from the current budget of the Department of Health. Thereafter, the funds necessary for
the continuous implementation of this Act in ensuing years shall be included in the General
Appropriations Act.

The treatment facilities are allowed to use five percent (5%) of the amount given to it for the
maintenance of the rooms that will be used exclusively for hemophilia patients. However, ninety
percent (90%) of the amount shall be used exclusively for necessary blood clotting products and
ancillary infusion equipment necessary for the infusion of such blood clotting products to
hemophilia patients. The remaining five percent (5%) shall be used for blood screening of
hemophilia patients.

Each treatment facility shall submit an annual report to the DOH on how the amount given
to it is used.

SEC. 6. Implementing Rules and Regulations.—Within sixty (60) days from the approval of
this Act, the Department of Health (DOH) shall, in consultation with hemophilia groups,
promulgate the Implementing Rules and Regulations to carry out the provisions of this Act.

SEC. 7. Repealing Clause.—Alll laws, decrees, executive orders or parts thereof inconsistent
with the provisions of this Act is hereby repealed or modified accordingly.

SEC. 8. Separability Clause.—If any part or provision of this Act is declared invalid or
unconstitutional, the other parts not otherwise affected shall remain in full effect and force.

SEC. 9. Effectivity.—This Act shall take effect fifteen days after its complete publication in
at least two newspapers of general publication.

Approved,