MANILA, Philippines – The Department of Health (DOH) has directed the Philippine Health Insurance Corp. (PhilHealth) to come up with mechanisms to cover saliva-based RT-PCR tests for COVID-19.
The DOH issued the directive as it released guidelines on the use and administration of saliva-based RT-PCR testing on Tuesday.
Under a memorandum dated March 31, the DOH ordered the state insurer to “develop appropriate payment and provider engagement mechanisms” for the test.
“No payment shall be charged to patients beyond the PhilHealth coverage for the conduct of saliva-based RT-PCR testing,” read a document signed by Health Secretary Francisco Duque III.
In a statement on Tuesday, the DOH announced that the country is now officially allowing the use of saliva-based tests for COVID-19 “in pursuit of expanding the country’s testing capacity and ensuring immediate and efficient implementation of PDITR strategies.”
Under the DOH Department Memorandum (DM) No. 2021-0161, only licensed COVID-19 laboratories certified by the Research Institute for Tropical Medicine (RITM) are allowed to perform saliva-based RT-PCR.
“Furthermore, point-of-care clinics, specimen collecting facilities, and disease reporting units can perform saliva specimen collection, provided that the specimen collectors have undergone training from the referral licensed COVID-19 laboratory certified to perform saliva testing,” it said.
Only test kits validated by the RITM or other RITM-recognized laboratories can be used for saliva tests. These kits should also have a special certification from the Food and Drug Administration.
The DOH also reiterated that “only trained saliva specimen collectors” should administer the test and “only medical doctors should interpret the results of these tests.”
“Results need to be correlated with the overall clinical and epidemiological context of the patient,” it added.
The DOH said saliva tests should only be done on certain conditions and are deemed valid when such conditions are met.
“As stipulated in the guidelines, morning saliva is preferred as specimen due to higher viral load but this should not prevent specimen collection at any other time,” it said.
“Proper collection procedure should also be strictly observed where patients should not eat, drink, brush their teeth, use mouthwash or smoke for at least 30 minutes before sample collection,” it added.
The agency, however, maintained that nasopharyngeal and oropharyngeal swab specimens remain the standard specimen for the diagnosis of COVID-19 through RT-PCR testing.
The Philippine Red Cross (PRC) first rolled out saliva testing in January after securing government approval. The humanitarian organization offers the saliva test at P2,000 each.