The Thai healthcare system faces pressure to fund high-cost new branded pharmaceuticals. Paying more may encourage innovation with positive implications for future population health, but it also means less money is available to fund other healthcare with negative implications for current population health.
Recent work in the UK estimated, for the first time, the share of value currently being given to manufacturers and what the optimal share should be.This work has had national impact, with implications for pricing of new branded pharmaceuticals, and is informing current negotiation of the Voluntary Scheme for Branded Medicines Pricing and Access (VPAS) in the UK.
We will apply the framework developed in the UK research to Thailand to estimate the share of value accrued to manufacturers versus to the Thai population for a representative sample of drugs appraised in Thailand. This involves, first, estimating the total value of new branded drugs and how this is shared between patients in the Thai healthcare system and manufacturers using a sample of health technology assessments by HITAP. Then, we will estimate the optimal price (i.e., what is paid by the healthcare system to manufacturers) for each drug assessed. Through this, we will demonstrate how to inform future pricing recommendations, not just for Thailand, but across low- and middle-income countries (LMICs) with the potential for significant impact on global prices and access to medicines in LMICs.
This work will be undertaken as a close collaboration between researchers at HITAP and at the University of York. It will make use of an existing dataset of economic evaluations in Thailand. Within HITAP, this collaboration will support the development of the analytical capacity of mid-level researchers at HITAP.
To build capacity around this topic more widely, we will also co-host a special webinar series “Cost-effectiveness thresholds and decision-making in healthcare” aiming to reach audiences in LMICs across Southeast Asia, Africa and Latin America. This kick-off webinar “Cost-effectiveness thresholds: foundations, impact, and ongoing debate” aims to provide an overview of the state of the field and touch on hot topics in the estimation and application of cost-effectiveness thresholds, and will take the format of an organised session.
The existing work in the UK and current work for Thailand will provide proof of concept that optimal prices can be determined in both high-income and LMIC settings, setting the scene for optimising prices internationally. This ultimately provides evidence to inform pricing policies in a way that ensures they improve overall population health. The implications of this work for global pricing, especially in LMICs, are yet unexplored, and there is potential for significant impact on global prices and access to medicines in LMICs.