The main goal of this study was to document the situation of medicine prices in public and private health sectors for policy recommendation. A field study to measure prices of selected medicines was undertaken in Thailand using a standardized methodology developed by the World Health Organization (WHO) and Health Action International (HAI). Prices of 43 medicines were measured in health facilities and pharmacies in the capital city and three districts in different parts of Thailand. Medicine prices were expressed as the ratios relative to a standard set of international reference prices (median price ratio or MPR).
The public sector procured generics and innovator brands at 1.46 and 3.3 MPR while patients paid 2.55 and 4.36 MPR, respectively. Private pharmacies procured lowest price generics at 1.48 MPR and innovator brands at 9.67 MPR.
Because of no medicine pricing policy in Thailand, it was found that between public and private sectors, among different public hospitals, and among different private pharmacies, the same generic products were procured and sold to patients at different prices. The median mark-up for innovator brands were 31% in the public sector and 22% in the private sector. For lowest priced generics, the median mark-up were 80% in the public sector and 96% in the private sector. Different prices for the identical product were problems to the health insurance organizations in terms of reimbursement, and to patients in terms of fairness.
The results highlight priority areas for action by the Ministry of Public Health and others in improving the drug pricing systems. The price regulation system should be implemented at every level of drug supply chain and appropriate pricing strategies should be employed.