Balancing control and care: impact of controlled medicines policy on accessibility and availability of methylphenidate in the Philippines

Purpose This study aims to examine how Philippine drug policies shape the availability and accessibility of methylphenidate for adults with attention deficit hyperactivity disorder. It maps national policies; traces implementation experience across government agencies, clinicians and civil society; identifies the intended and unintended effects; and provides a few key recommendations. Design/methodology/approach A qualitative case study drew from a document review of eight national policy issuances and 17 semi-structured key informant interviews with government officials, clinicians and civil society. Analysis followed a reflexive thematic approach, using a mix of inductive and deductive analysis against a conceptual framework developed for the study, sensitized against international frameworks and guidance on medicine access. Findings Four major themes were constructed: fragmented policy interpretation and leadership gaps; implementation bottlenecks affecting availability and forecasting; unequal and high-cost access; and weak feedback loops. Philippine policies strongly align with international commitments, but implementation remains compliance-driven with limited responsiveness to patient health needs. Recommendations are offered for reforms spanning governance restructuring, healthcare integration and strengthening lived experience in policy. Research limitations/implications Despite national scope of the policies reviewed, study participants all came from Greater Metro Manila. Perspectives from other regions, especially geographically isolated areas in an archipelagic country might surface deeper insights. The study relies on civil society rather than direct patient accounts. Future research should incorporate patient narratives to deepen equity analysis. Originality/value To the best of the authors’ knowledge, this is among the first studies to examine controlled medicine access in the Philippines through the lens of methylphenidate rather than opioids, extending a literature that has concentrated heavily on the latter. It surfaces structural tensions between drug control imperatives and health equity, grounding critique of international drug control frameworks on country experience.