International Medicine Pricing and Medicine Price Control System: Impact on Medicine Price and Expenditure-ระบบการกำหนดและควบคุมราคายา ในต่างประเทศ: ผลกระทบต่อราคายา และค่าใช้จ่ายด้านยา

บทคัดย่อ

            Various countries, including Thailand, have faced an increasing burden in health care expenditure mainly caused by the increase in drug spending.  Consequently, many of them have established the medicine price control policy to encounter the problem.  Thailand, however, has not yet developed any.  A study on the international medicine pricing system would be beneficial to the development of such system in Thailand.  The objectives of this study were to study the international medicine pricing and medicine price control system as well as its impacts on medicine price and expenditure.  Systematic review was conducted by searching through two electronic databases, PubMed and ScienceDirect, and other sources of information such as internet, books, and articles during January-February 2008.  Results from twenty articles which had met the inclusion criteria and other related information revealed that medicine pricing and control system differed from country to country, European Union, Australia, Canada and China for example.  The majority of them used direct price control, such as, International Price Comparison in parallel with the Reference Pricing with co-payment system.  In addition, it was also found that medicine prices were higher in the countries where medicine pricing systems were not strictly implemented.  In conclusion, there is a need for Thailand to have an efficient medicine pricing and control system in place.  A feasibility study on the medicine price policy should be conducted in Thailand.  Participation among stakeholders for example, authorities, industry, physicians, Thai citizens and payers should also be encouraged.  Consideration should be placed on pricing rules for new registered drugs and Reference Pricing System with Co-payment as well as the policy of rational use of medicine.

Key words:      medicine pricing, medicine price control, drug expenditure