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The Thai Journal of Pharmaceutical Sciences

Abstract

Background: Patient access to anti-cancer medicines is challenging in Thailand and worldwide. Objective: This study aimed to explain and quantify access to anti-cancer medicines in Thailand. Methods: Mixed methods of literature review and in-depth interview were conducted. Access to anticancer medicines was compared to the World Health Organization-Model List of Essential Medicines (WHO-EML), and recommendations of the National Comprehensive Cancer Network (NCCN). Results: Access to National List of Essential Medicines (NLEM) is indifferent among the three public schemes. Universal coverage scheme (UCS) and Social security scheme (SSS) limit access to non-NLEM anticancer medicines by reimbursement caps. Civil Servant Medical Benefit Scheme (CSMBS) provides broader access through Oncology Prior Authorization program. Non-NLEM, nonnegative listed medicines are reimbursable if physicians deem necessary. Patient access programs were offered by pharmaceutical companies to assist access to non-reimbursable medicines for self-paying patients. UCS-SSS and CSMBS had 89.7% and 100% of medicines in WHO-EML. However, UCS-SSS had 19.2–100% of NCCN medicines for early-stage and 5.9–52.6% for advanced-stage cancers, while CSMBS had more access (57.7–100% and 41.2–84.2%, respectively). Conclusion: Access inequity to anti-cancer medicine was confirmed. However, Thais have adequate access to first- and second-line medicines for both early- and advanced-stage cancers. All stakeholders should consider formulating innovative financial models for high-cost anticancer medicines.

DOI

10.56808/3027-7922.3048

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