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SOH approves the HTAC recommendation on tocilizumab for COVID-19 in the Philippine National Formulary (PNF)

The Secretary of Health (SOH) approved the HTAC recommendation on the addition of tocilizumab for COVID-19 in the Philippine National Formulary (PNF) on 11 May 2022. 

On 15 March 2022, the Philippine FDA issued the CPR of tocilizumab for the treatment of COVID-19 in adults who are receiving systemic corticosteroids and require supplemental oxygenation or mechanical ventilation. The approved formulations are tocilizumab 80mg/4mL (20mg/mL), 200mg/10mL (20mg/mL), and 400mg/20mL (20mg/mL) Concentrate for Solution for IV Infusion.

In developing  its recommendation for tocilizumab for COVID-19, the HTAC considered the following:

  • Positively recommended by the LCPG for COVID-19 patients showing respiratory deterioration and/or requiring oxygen supplementation
  • While there were six new studies in the updated review of the Philippine COVID-19 Living CPG recommendations, there are no changes in its latest recommendations. Tocilizumab, in addition to systemic steroids, is recommended for patients showing respiratory deterioration and/or requiring high doses of oxygen and with elevated markers of inflammation but is not recommended for patients with COVID-19 infection who do not require oxygen supplementation.
  • Strongly recommended by WHO for patients with severe or critical COVID-19
  • WHO Guidelines on Therapeutics and COVID-19 (March 2022) focused on intravenous (administration of medicine through the veins) administration of tocilizumab. It is currently being strongly recommended for patients with severe or critical COVID-19. 
  • Decreased drug regimen costsincurred per patient from 2021 to 2022
    • For the 80mg/4mL (20mg/mL), 200mg/10mL (20mg/mL), and 400mg/20mL (20mg/mL), 200mg/10mL (20mg/mL) formulations, the cost decreased in 2021 to 2022 from Php 67,405.00 to Php 41,162.50; Php 46,560.00 to Php 41,162.00; and Php 46,102.44 to Php 18,100.00 per patient per regimen, respectively. The sources of the unit cost were based on the DOH purchase request cost (for the 400mg/20mL stock dose) and government list price from the manufacturer (for the other stock doses). 

The recommendation of HTAC did not undergo an appeals process since it is classified under the expedited track with regard to the COVID-19 public health emergency.