The overall purchasing price index for outpatient drugs declined by 6.8% from 2010 to 2012, while access to essential drugs for diabetes, hypertension, and dyslipidemia increased.
Observational (n=3,517,835)
Yes
Generic market competition and price negotiation by the Universal Coverage Scheme in Thailand successfully reduced prices and increased access to essential drugs for diabetes, hypertension, and dyslipidemia.
Under the Universal Coverage Scheme (UCS) with payment per capita for outpatient (OP) services, hospitals' financial risks will rise if access to essential drugs increases. This study examined trends in access to and price of essential drugs for noncommunicable diseases (NCDs) and an overall purchasing price index (PPI) for an OP drug basket from public hospitals. To examine drug access, OP prescription data from 2010-2012 were obtained from the UCS. Access to thirteen drugs for diabetes, hypertension, and dyslipidemia was examined for trend using a time-series analysis. To calculate the PPI, drugs in the same dataset in 2010 that each contributed at least 0.2% of the total OP drug expenditure (N = 118 items) were selected together with drugs expected for near future growth (N = 48 items). The PPI was constructed from purchasing prices in 16 hospitals using a standard method developed by the International Labour Organization. Based on 166 drug items accounting for 75% of OP drug expenditures, the overall PPI continually declined by 6.8% from 2010 to 2012. Access to the 13 selected NCD drugs, accounting for 22% of the total OP drug expenditure increased from 22 to 30 per 1,000 population for antidiabetics, 27 to 47 for antihypertensive agents, and 32 to 53 for antilipidemics from 2010-2012. Growth in the study drug recipients was relatively higher than that in the population and diagnosed patients. Due to generic market competition, metformin, glipizide, amlodipine, losartan, simvastatin, atorvastatin, and fenofibrate prices decreased by 6-22%. Antiretrovirals and risperidone prices decreased by more than 10% due to price negotiation by the UCS. Access to essential drugs for diabetes, hypertension and dyslipidemia has increased. A decline in the PPI could contain essential drug expenditure when the demand for the drugs increased. Generic market competition and price negotiation by the UCS led to price reduction.
Limwattananon et al. (Wed,) conducted a observational in Noncommunicable diseases (diabetes, hypertension, dyslipidemia) (n=3,517,835). Antidiabetic, antihypertensive, and antilipidemic drugs was evaluated on Change in overall purchasing price index (PPI) and access to essential NCD drugs. The overall purchasing price index for outpatient drugs declined by 6.8% from 2010 to 2012, while access to essential drugs for diabetes, hypertension, and dyslipidemia increased.
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