Revisiting Roles of Health Technology Assessment on Drug Policy in Universal Health Coverage in Thailand: Where Are We? And What Is Next?

Tanvejsilp, Pimwara; Taychakhoonavudh, Suthira; Chaikledkaew, Usa; Chaiyakunapruk, Nathorn; Ngorsuraches, Surachat

doi:10.1016/j.vhri.2018.11.004

Cited by 10 publications

(8 citation statements)

References 14 publications

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“…The probabilistic sensitivity analysis of 1,000 Monte Carlo simulations was shown in the incremental cost-effectiveness plane ( Figure 3 ). At a WTP of 160,000 THB/QALY, a WTP threshold in Thailand ( Tanvejsilp et al, 2019 ), addition of both crystalline glucosamine sulfate (before diclofenac plus PPI state) and etoricoxib had approximately a 98.8% chance of being cost-effective when compared to addition of crystalline glucosamine sulfate alone. When adding crystalline glucosamine sulfate (before diclofenac plus PPI state) into the standard care sequence, all 1,000 iterations of ICERs fell in the lower-right quadrant, demonstrating that crystalline glucosamine sulfate treatment incurred lower costs and improved QALYs.…”

Section: Resultsmentioning

confidence: 99%

An economic evaluation of knee osteoarthritis treatments in Thailand

2022

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Objective: The objective of this study is to evaluate the cost-effectiveness of different knee OA care sequences compared to standard treatment reimbursed by the major health insurance payer in Thailand.Method: We used decision analytical modeling to evaluate the effect of either adding etoricoxib or crystalline glucosamine sulfate compared to standard treatment from a societal perspective over patients’ lifetimes. Data were analyzed based on efficacy, whereas adverse events were considered as a substate. Model input data were retrieved from relevant published literature and the Standard Cost Lists for Health Technology Assessment, Thailand. All health outcomes were measured in a unit of quality-adjusted life-year (QALY). An incremental cost-effectiveness ratio (ICER) was applied to examine the costs and QALYs. Sensitivity analysis was performed to investigate the robustness of the model.Result: The results demonstrated that adding crystalline glucosamine sulfate (before diclofenac plus proton pump inhibitors, PPI) into the standard care sequence was a dominant strategy compared to the standard care sequence. Adding etoricoxib alone or including crystalline glucosamine sulfate (after diclofenac plus PPI) was dominated by adding crystalline glucosamine sulfate (before diclofenac plus PPI), whereas in a willingness-to-pay (WTP) threshold in Thailand, adding of both crystalline glucosamine sulfate (before diclofenac plus PPI) and etoricoxib were cost-effective when compared to adding crystalline glucosamine sulfate alone with ICER of 125,547 Thai baht/QALY (3,472 US dollars/QALY).Conclusion: The addition of crystalline glucosamine sulfate and etoricoxib into standard knee OA treatment were cost-effective at the WTP threshold in Thailand. In addition, early initiation of crystalline glucosamine sulfate would be less costly and more effective than delayed treatment or the use of standard treatment alone.

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Section: Resultsmentioning

confidence: 99%

An economic evaluation of knee osteoarthritis treatments in Thailand

2022

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“…A significant portion of its funding comes from user institutions (e.g., units and programs within the MoPH) that commission HTAs, and this can vary from year to year. HTA process guidelines have been designed to promote transparency, but the complex health policy process in Thailand and multiple stakeholders make this challenging (22). The overlap among stakeholders engaged in both the assessment and appraisal processes has faced criticism (23).…”

Section: Thailandmentioning

confidence: 99%

“…HITAP has a robust program with detailed process and methods guidelines for HTA (21). Its recommendations have significant influence on decisions made by the MoPH and its associated institutions (22;23). HITAP’s success has led to it becoming a regional capacity building resource for other countries in the region and globally (23).…”

Section: Country Summaries (In Alphabetical Order)mentioning

confidence: 99%

Assessing progression of health technology assessment implementation in Asia: a balanced scorecard for cross comparison of selected countries in Asia

Kumar

Suharlim

Amaris

et al. 2022

Int J Technol Assess Health Care

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Objective To provide an update on the use of health technology assessment (HTA) in Asia and lessons for countries seeking to advance HTA. Methods Build upon the research by Chootipongchaivat and the World Health Organization identifying eighteen “factors conducive to the development of HTA in Asia.” These factors were used to create a balanced scorecard to assess the progress of HTA, measuring progress against each factor in China, India, Indonesia, Malaysia, Philippines, South Korea, Taiwan, Thailand, and Vietnam. A scoring system was used wherein: 1, No progress; 2, milestone at early stages, ad hoc HTA use; 3, progress on milestone but limited impact; 4, significant progress but limited remit; and 5, significant progress on milestone, routine HTA informs decisions. Total scores indicated progress of HTA while milestone scores provided contextual insights within countries. Literature reviews and expert interviews were used to complete scorecards. Results South Korea and Thailand scored highest with seventy-three and seventy-one points, respectively, while Vietnam scored lowest at 28.5. Advanced HTA programs have independent HTA agencies with a broad remit, explicit process and methods, network of researchers, and routine use of HTA. Taiwan and Malaysia fall in a middle tier, with established HTA programs with limited remit. The final tier with China, India, Indonesia, Philippines, and Vietnam, emerging HTA processes. Conclusions Universal Health Coverage goals have catalyzed expansion of HTA. Political will, technical expertise, and sustained financing remain challenges for sustainable HTA programs. Legislation supporting HTA is helpful but political will is key. Recommendations for regional collaboration are provided.

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“…Nevertheless, East and Southeast Asian researchers have become more active in the HTA field, and economic evaluation has officially been introduced in the drug policies 16 of some Asian countries or regions, 17,18 including Korea, 19 Taiwan, 20 Thailand, 21,22 and Japan. 23 HTAsiaLink, 24 a collaborative network of Asian HTA agencies, has also been established in Asia.…”

Section: Introductionmentioning

confidence: 99%