Expanding access to high-cost medicines through the E2 access program in Thailand: effects on utilisation, health outcomes and cost using an interrupted time-series analysis

Sruamsiri, Rosarin; Wagner, Anita K.; Ross‐Degnan, Dennis; Lu, Christine Y.; Dhippayom, Teerapon; Ngorsuraches, Surachat; Chaiyakunapruk, Nathorn

doi:10.1136/bmjopen-2015-008671

Cited by 27 publications

(41 citation statements)

References 14 publications

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“…It would also allow other cancer medicines to be considered for inclusion on the World Health Organization Model Lists of Essential Medicines. Table describes some methods to help reduce cancer medicine prices …”

Section: Approaches To Decreasing Cancer Medicine Costsmentioning

confidence: 99%

“…Table 4 describes some methods to help reduce cancer medicine prices. 8,24,28,30,[42][43][44][45][46][47][48][49][50][51][52] Although a combination of these methods can continue to be used, recent publications suggest that further change is required. 28,30 Building on the work of others, we propose that an international body comprising representatives from the pricing authorities of all countries is convened.…”

Section: Fairer Prices For Cancer Medicinesmentioning

confidence: 99%

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Enhancing global access to cancer medicines

Cortés

Peréz-García

Llombart-Cussac

et al. 2020

CA A Cancer J Clinicians

153

108

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Globally, cancer is the second leading cause of death, with numbers greatly exceeding those for human immunodeficiency virus/acquired immunodeficiency syndrome, tuberculosis, and malaria combined. Limited access to timely diagnosis, to affordable, effective treatment, and to high‐quality care are just some of the factors that lead to disparities in cancer survival between countries and within countries. In this article, the authors consider various factors that prevent access to cancer medicines (particularly access to essential cancer medicines). Even if an essential cancer medicine is included on a national medicines list, cost might preclude its use, it might be prescribed or used inappropriately, weak infrastructure might prevent it being accessed by those who could benefit, or quality might not be guaranteed. Potential strategies to address the access problems are discussed, including universal health coverage for essential cancer medicines, fairer methods for pricing cancer medicines, reducing development costs, optimizing regulation, and improving reliability in the global supply chain. Optimizing schedules for cancer therapy could reduce not only costs, but also adverse events, and improve access. More and better biomarkers are required to target patients who are most likely to benefit from cancer medicines. The optimum use of cancer medicines depends on the effective delivery of several services allied to oncology (including laboratory, imaging, surgery, and radiotherapy). Investment is necessary in all aspects of cancer care, from these supportive services to technologies, and the training of health care workers and other staff.

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Section: Approaches To Decreasing Cancer Medicine Costsmentioning

confidence: 99%

Section: Fairer Prices For Cancer Medicinesmentioning

confidence: 99%

Enhancing global access to cancer medicines

Cortés

Peréz-García

Llombart-Cussac

et al. 2020

CA A Cancer J Clinicians

153

108

View full text Add to dashboard Cite

show abstract

“…Instead, peritoneal dialysis could be managed at home with dialysis solution supplied to the patient's home. 15 Whichever decision is made, it must be fully informed by evidence. Low-and middle-income countries need to strengthen its HTA capacities.…”

Section: Discussionmentioning

confidence: 99%

“…Anticancer, antiplatelet, drug effecting immune response and drug for genetic disorders, orphan medicines and antidotes were added to the NLEM in 2010 14 ; A study shows it has improved access to these medicines. 15 The current 2019 NLEM consists of 857 medicines. The number of items in the Thailand's NLEM is close to that of World Health Organization (WHO) model list of essential medicines (see Table).…”

Section: Pharmaceutical Benefit: Explicit Positive List Of National Ementioning

confidence: 99%

Defining the Benefit Package of Thailand Universal Coverage Scheme: From Pragmatism to Sophistication

Tangcharoensathien

Patcharanarumol

Suwanwela

et al. 2019

Int J Health Policy Manag

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Benefit package is crucial for implementing universal health coverage (UHC). This editorial analyses how the benefit package of the Thai Universal Coverage Scheme (UC Scheme) evolved from an implicit comprehensive package which covered all conditions and interventions (with a few exceptions), to additional explicit positive lists. In 2002 when the Thai UC Scheme was launched; the comprehensive benefit package, including medicines in the national essential list of medicines, formerly offered by the previous schemes were pragmatically adopted. Later, when capacities of producing evidence on health technology assessment (HTA) increased, rigorous assessment of cost effectiveness is mandatorily required for inclusion of new interventions into the Thai UC Scheme benefit package. This contributed to evidence-informed policy decisions. To prevent emptied promises, whichever policy choices are made about the benefit package, either using a negative or a positive list, developing country governments need to make quality health services available and accessible by the entire population. Political decision on benefit package should be informed by evidence on cost effectiveness, equity dimension and health system capacity to deliver equitable services. Low- and middle-income countries need to strengthen HTA capacity to generate evidence and inform policies.

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“…In Thailand, there was no pharmacotherapeutic agent for treatment of macular edema secondary to RVO available in benefits package for patients under the two major national health insurance schemes, the Universal Coverage scheme (UC) and the Social Security Scheme (SSS), which covers approximately 92% of the country's population [10]. Thus, the patients need to pay out of pocket for both licensed drugs and off-label bevacizumab.…”

Section: Introductionmentioning

confidence: 99%

Comparative efficacy of bevacizumab, ranibizumab, and aflibercept for treatment of macular edema secondary to retinal vein occlusion: a systematic review and network meta-analysis

Sangroongruangsri

Ratanapakorn

et al. 2018

Expert Review of Clinical Pharmacology

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Anti-vascular endothelial growth factor (VEGF) therapy has become the most commonly used treatment for macular edema secondary to retinal vein occlusion (RVO). Although its superior efficacy as compared to other interventions has been proven, there is a lack of evidence for relative efficacy among anti-VEGF drugs. Areas covered: This work systematically reviewed and compared the efficacy of intravitreal bevacizumab, ranibizumab, and aflibercept for treating macular edema due to RVO. PubMed, EMBASE, and the Cochrane Library were searched from their inception until October 2017. Eleven randomized controlled trials (18 articles; 1830 adult patients) were identified. The proportion of patients who gained at least 15 letters in best-corrected visual acuity (BCVA), mean change from baseline in BCVA, and mean change from baseline in central macular thickness (CMT) were reported and these efficacy outcomes at 6 months were analyzed in network meta-analysis. Expert commentary: Apparently, bevacizumab, ranibizumab, and aflibercept were significantly superior to sham injection in terms of BCVA improvement and CMT reduction and had good safety profiles. However, there were no statistically significant differences in any outcomes among anti-VEGF drugs. In selecting an anti-VEGF drug for individual patients, other factors including affordability, drug availability, and patient characteristics should be considered.

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Expanding access to high-cost medicines through the E2 access program in Thailand: effects on utilisation, health outcomes and cost using an interrupted time-series analysis

Cited by 27 publications

References 14 publications

Enhancing global access to cancer medicines

Enhancing global access to cancer medicines

Defining the Benefit Package of Thailand Universal Coverage Scheme: From Pragmatism to Sophistication

Comparative efficacy of bevacizumab, ranibizumab, and aflibercept for treatment of macular edema secondary to retinal vein occlusion: a systematic review and network meta-analysis

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