Example of HITAP’s Work that Generate Impact at Societal, National and International Levels

Research for development of an optimal policy strategy for prevention and control of cervical cancer in Thailand

The results showed that cervical cancer screening was more cost-effective than Human Papilloma Virus (HPV) vaccinations. The findings led to vaccine price negotiations and the expansion of cervical cancer screening program at national level.

The Potential of Provider-initiated Voluntary HIV Counseling and Testing at Healthcare Settings in Thailand

HIV screening in every patient visiting a health facility was found to be cost-effective. Policy impact from the findings came in the form of free-of-charge HIV screening for all Thai population.

A study on cost of social, health and economic consequences of alcohol consumption in Thailand

Social costs from alcohol abuse in Thailand was estimated to be 0.15 trillion Thai Bahts per year. Health promotion organization used the information to plan their activities.

Assessing the implications of Thailand’s government use licenses, issued in 2006-2008

Having achieved the UHC in 2001, drugs for treatment of HIV patients in Thailand were provided free-of-charge. This led to continuous increase in national health expenditure. In order to contain the expenditure, Thai government resorted for compulsory licensing (CL) of 7 drugs in 2006-2008, namely drugs for the treatment of cancer, drugs for the treatment of HIV, and drugs for cardiovascular diseases. This led to debates in political and economic aspects. HITAP conducted a research to evaluate the impact of the CL in terms of health, economic, and social to generate concrete evidence for the debates and for stakeholder considerations. This work was used as an input in a National Health Commission meeting as well as was presented to government committee.

Economic evaluation and feasibility analysis of using three-drug antiretroviral regimens as the standard regimens for the prevention of mother-to-child transmission of HIV in Thailand

The cost-effectiveness result indicated that three-drug regimen for HIV treatment was cost-saving when prescribed to mothers in order to reduce rate of virus infection in their children. The Subcommittee for development of the benefits and servicing system in HIV and TB diseases, NHSO decided to suggest the use of the three-drug instead of the two-drug regimen for the prevention of vertical virus transmission from mother to child.

Cost-Utility analysis of hematopoietic stem cell transplantation for severe thalassemic patients

Transplantation of blood stem cell derived from siblings was found to be more cost-effective than other treatment alternatives. The SCBP agreed to include the transplantation in the benefit package, but feasibility of the service provision needed to be studied.

The development of health promotion and disease prevention policies for children aged 0-5 years in Thailand

Health Promotion and Disease Prevention Program Research team for children aged 0-5 years old, consisting of the Royal College of Pediatricians of Thailand; Department of Health, Ministry of Public Health; Burden of Disease Project (Thailand) ; and HITAP examined and analyzed Thai children health problems. The finding suggested that there were 6 health issues that are significant in Thai children, namely unintended pregnancy; congenital disorders e.g. Down Syndrome, thalassymia, and hypothyroidism; developmental disorder, both mentally and physically; malnutrition; vision and hearing problems; and under quality child development centers. The government used the findings as an input to the operation of the Thai future for Child Health Development Program.

A  research development of the system for screening of refractive errors and providing spectacles among pre-primary and primary school children in Thailand

The study revealed that 1 of 10 Thai children who aged 3-12 years old had vision problems. However, they were not screened or treated due to shortage in pediatric ophthalmologist. HITAP in collaboration with the Royal College of Pediatricians of Thailand and the Royal College of Ophthalmologists of Thailand conducted feasibility study of doing eye screening in children by teachers before referring the children who are detected as having an eye problem to ophthalmologists. The findings suggested that this approach was beneficial in the sense that children could access screening and were provided eyeglasses in case they needed. The Ministry of Public Health developed a policy on children eye screening based on the findings.

Development of population-based screening package in Thailand

Previously, out-of-pocket health check-up expenditure in Thai people was as high as 2.2 billion Thai Bahts. However, there had not been a systematic assessment on how health check-up package should be designed for people at different age ranges. Moreover, UHC and Social Security Scheme had not yet included health check-up as a part of the benefit package. HITAP conducted a study to develop appropriate benefit package for health screenings in Thai population to present to NHSO as information for decision-makings on health check-up benefit package development

Cost-effectiveness and budget impact of using imiglucerase for in patients with Gaucher’s disease.

The cost-effectiveness result pointed out that the drug was not cost-effective in Thai context. However, as the drug were the only treatment that could cure the disease, and its costs were so high that catastrophic health expenditure could be caused, the Subcommittee for Development of National List of Essential Medicine employed the study result to develop a copayment scheme between the government and private sectors to make the drug accessible for the patients.

The use of pegylated-interferon 2a and pegylated-interferon 2b for the treatment in patients with hepatitis C virus genotype 2 and 3 infection.

The findings that the drugs were cost-effective were used to support the decision to include pegylated-interferon 2a and 2b in the NLEM for the treatment of hepatitis C virus genotype 2 and 3 infection. The indications for using the drug to treat patients with the virus genotype 1 and 6 and for patients with HIV co-infection were under consideration of the Subcommittee.

Safety and effectiveness of intravitreal bevacizumab and ranibizumab injections for treatment of retinal disease patients: an observational study

Bevacizumab, which was a drug that was registered for the treatment of cancers, was also prescribed for intravitreal injection to treat age-related macular degeneration (AMD) through its anti-vascular endothelial growth factor property. This property of the drug was similar to that of ranibizumab, which was registered specifically for the eye disease treatment. However, the use of bevacizumab was off-label. In 2012, HITAP’s assessment suggested that bevacizumab was as effective for treatment of AMD as ranibizumab was but at a much lower cost. As a result, on 7 August 2012, the NHSO board agreed to include the drug in the NLEM to make the drug accessible for all UHC patients. HITAP was now conducting a clinical trial comparing bevacizumab and ranibizumab on the safety of the drugs. The result is expected to finish in 2016.

Asia Pacific Observatory Policy Brief: Conducive factors to the development of Health Technology Assessment in Asia

The Universal Health Coverage (UHC) had become the norm for many low- and middle- income countries in order to meet the health care need. However, implementing the UHC went side by side with an increase in the health care budget. In order to maintain the UHC’s sustainability, Health Technology Assessment (HTA) had been introduced as a tool in order to set priorities. This work explained about the conducive factors as well as barriers to HTA development, based on the experiences from six Asian countries

International Decision Support Initiative (IDSI)

iDSI was an innovative global partnership between leading government institutions, universities, and thinktanks in the field of healthcare priority-setting. iDSI uniquely provided intellectual insight with hands-on field expertise, and delivered peer-to-peer support to policymakers and international funders. The project aimed to support countries in achiving and sustaining Universal Health Coverage (UHC) through helping policy makers and donors make better healthcare spending decisions. Currently, HITAP was working with Indonesia, Vietnam, Philippines, Nepal, Sri Lanka, Myanmar under iDSI project.