Thailand Position Paper - Improving Affordable and Equitable Access to Medicine

Thailand position paper

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Country: Thailand

Delegate: Denisse Sugey Rodríguez Romero

Committe: World Health Organization

School: CIDEB

Topic: Improving affordable and equitable access to medicine.

Having considered the report on access to essential medicines; noting that WHO’s definition of an essential medicine contains the following elements: “Essential medicines are those that satisfy the priority health care needs of the population” and “Essential medicines are selected with due regard to their public health relevance, evidence of efficacy and safety, and comparative cost–effectiveness”. To improve national policies for selection of essential medicines, including critical medicines, particularly by using transparent, rigorous, evidence-based processes based on the methods of health technology assessment in selecting medicines for inclusion in the national essential medicines lists according to each country’s health needs and priorities.

As in most countries, high-cost specialty medicines pose a major challenge to the health system in Thailand. The government addressed this challenge in 2008 through a multipronged strategy known as the E2 access program. The program initially targeted ten very costly medicines for 21 relatively rare conditions, which require specific diagnostic and treatment monitoring approaches. The Thai E2 strategy illustrates aspects of a system-oriented approach to benefit policy design that combines government regulatory, managerial, and economic measures with stakeholder cooperation in order to balance equitable access to and appropriate use of medicines with their affordability – along with the development of viable markets for industry. The increasing availability of novel but expensive medicines and health technologies heightens some ethical decision-making dilemmas – particularly around priority setting and resource allocation in health policy and financing. These dilemmas affect countries at all income levels, although LMICs are likely to face greater constraints in re-allocating funds from other public needs to health financing. Health technology assessments – as implemented for example by NICE in the UK– can contribute technical information on cost-effectiveness but importantly do not ensure that a policy decision meets ethical goals. Political battles in many countries and legal challenges to reimbursement decisions, mostly in those Latin American countries with a constitutional right to health, are illustrative of contentions in rationing health care resources. Controversies among different stakeholders are likely to become more prevalent, given that most drugs in development pipelines are biotechnology-based, will come to market with high prices, and will need to be evaluated for potential coverage by expanding health insurance schemes.

Thailand said support is needed for the monitoring of medicines supply to identify causes of shortages. There could be many causes for shortages, including “limited production, neglected diseases, and temporary stock-outs due to epidemics and changes in production lines.” Monitoring would help develop necessary strategies for the mitigation of problems caused by shortages. Thailand also proposed strategies such as price negotiations, bulk purchasing and the full use of TRIPS flexibilities. It further suggested price control and promoting local production, generic production and supporting technology transfer.

DE RUYCK, J., FRASER, J., & NEW, W. (2014, May 24). World Health Assembly Approves Plan To Strengthen Access To Essential Medicines. Retrieved October 16, 2015, from http://www.ip-watch.org/2014/05/24/world-health-assembly-approves-plan-to-strhttp://www.ip-watch.org/2014/05/24/world-health-assembly-approves-plan-to-strengthen-access-to-essential-medicines/engthen-access-to-essential-medicines/