Progress on Good Governance in
the pharmaceutical sector in
Thailand
Dr.Chanvit Tharathep MD.,
FRCST, Fam. Med., Prev. Med.
Universal Health Coverage inThailand
Health Security
Scheme
30 Baht
Number of
beneficiaries
Percentage of
coverage
46,636,899
73.49
Social Security
9,060,033
14.28
Civil Servant
Medical Benefit
5,119,535
8.07
Unidentified
groups
2,640,356
4.16
63,456,823
100
Total
Health Care Environment in Thailand
Hospitals
MoPH
Beds
Out Patient
Visits
Inpatient
Admission
Inpatient days
Bed occupancy
rate (%)
875
86,667
80,596,859
6,015,238
25,892,528
82
PM office
2
748
69,963
21,146
146,765
54
MoF
1
82
106,810
1,738
18,741
63
MoC
1
120
39,683
1,667
14,967
34
MoI
1
80
15,740
3,290
9,022
31
MoJ
2
550
112,100
5,655
85,233
42
MoE
15
8,556
7,532,728
335,118
2,672,621
86
MoD
63
6,987
3,884,789
181,592
1,508,211
59
Autonomous
7
737
459,393
25,661
124,285
46
13
2,375
2,322,571
109,233
599,207
69
298
26,343
29,346,824
1,601,497
4,602,531
48
1,278
133,245
124,487,460
8,301,835
35,674,111
73
Local
Authority
Private
Total
Activities Before WHO GGM
1997
Economic
Crisis,
1997
Drug
Scandal
1981, 1993 :National Drug Policy
Safety, Quality, Appropriate Price,
Access
2004 GGM
1981-2005 : Essential Drugs list,
Standard Price
introduced to
improve and
enhance
process of Drug
Management
2004 : Public Good Governance Law
1997-2005 Drug management Reform
in MoPH
WHO GGM Program: Changes and Impacts
PHASE I
PHASE II
Assessment
GGM
Flamework
2004-2005
Situation
Analysis
Existing GGM
Infrastructure
strengthening
GGM
Networking
2005-2006
Thai GGM
Strategy
Available Practices,
Guidelines
Forms,
Procedures
PHASE III
Output
Outcome
Impacts
GGM
Implementation
Increased
Awareness
Oct 2006-209
More
Transparency
More
Transparency
By Information
Registration,
Selection,
Procurement
Improvement
Socialization,
Education.
More
Efficiency
Networking
Learning
Process
Strengthening Anti-Corruption Laws, Agency and Mechanism, Moral Value and Ethical Principles
Phase III: Strategy and implementation 2006-2009
Develop Policy Guidelines
National Networking
Strengthen Information
Database
Dissemination of Ethical
Practice Information
Assessment
•GGM Framework, legislation, Policy
•Practice Guidelines, Medicine Promotion Practice criteria
•Standard of Practice (SOP)
•Declare Consent form, Conflict of interest form (ED, SP)
•FDA, DHSS, DMS, Universities, Professional Councils
•Hospital Pharmacy Association
•Community Pharmacy Association
•PReMA,
•Thai Pharmaceutical Manufacturer Association
•NGOs
•Selection, Registration
•Procurement
•Drug Price, Drug Promotion Practice
•Research, Study and cases
•Public accessible Pharmacy Information Center
•Meeting
•Newsletter, Webpage of Good Governance
•Best Practice
•Interested Working Group
•KPI for Health Inspector
•Self Assessment, Assessment New tool
(Promotion Practice, Inspection, Distribution?)
Publications/medias provided (cont’d)

News Letter, Electronic data and information on CDs,
Website: http://dmsic.moph.go.th
Code of Conduct for Sales and Marketing
Meeting 2009 GGM Leadership training
MoPH hospital pharmacists
GGM head of MoPH hospital pharmacists Meeting 2010 group discussion
Key achievements 2005-2013
GGM Components
Achievements
GGM Activities
Consensus Oriented

Participatory

Rule of Law

GGM Framework : Subset
GGM Strategy
GGM Implementation
COI
Code of Conduct
Transparent

Accountable

Responsive

Effective and Efficient

Equitable and Inclusive

Pharmacy Information Center
Group Purchasing
Monopoly Drug Management
Compulsory Licensing
Corruption Control
Socialization
Rational Use of Drugs
3 Health Security Schemes
Harmonization
Key achievements 2011-2013

GGM Framework : Subset :The National Ethical
Framework on Drug Promotion : (National Drug Policy B.E.2554
(2011) on March 14, 2011)


Rational Use of Drugs : Glucosamine, Antimicrobial
Guideline
Corruption Control, Socialization Pharmacy
Information Center strengthening (Pseudoephedrine case 14
hospitals : 5 Hospital Pharmacists were fired 2012)



Monopoly Drug Management (continuing) Single Price policy
Pharmaceutical Logistic Improvement: Regional
Stock for all hospitals (ongoing process)
3 Health Security Schemes Harmonization :
Emergency Service Integration, ARV, Hemodialysis, CA
Reasons for Success






Strong National Good Governance Policy by
Government and MoPH
Participatory Process : among public organizations,
NGO, Media
GGM Strategy
Transparency (Pharmacy Information Center)
GGM teamwork
Focus on Output, Outcome, Impact
Group Purchasing Outcome: More efficiency, cost
reduction
Drug item
Pack unit
Average price
Regular
Separated
purchasing
Provincial
group
purchasing
500
107.86
74.69
57.38
Insulin Human Base vial 100
IU/ml (10 ml)
1
308.99
300.63
310.30
Medroxyprogesterone amp.
50 mg/ml (3 ml)
1
16.08
12.49
13.50
500
200.95
201.34
177.62
Salbutamol inhaler 100 mcg
(200 doses)
1
105.93
112.68
139.10
Salbutamol sol 0.5 % (20
ml)
1
91.87
102.44
85.60
Diclofenac tab 25 mg
Ranitidine tab 150 mg
Regional
group
purchasing
Monopoly Drugs Single price policy
1.Antihypertensive drugs (ARB)
2.Dyslipidemia agent (Statins)
3.Proton pump inhibitor (PPI)
Item
Previous
Price
(Baht)
Proposed
Price
(Baht)
Managed
Price
(Baht)
Save/
Package
(Baht)
Budget
Save
(Baht)
Rosuvastation
tablet 10 mg
(Crestor)
1,108.52
1,108.52
1,007.75
100.77
9,999,407
GGM Operating Framework
National GGM Framework
Health care environment Analysis
Target Priority Setting
Strategic formulation
Information
Networking
Socialization
Guideline
Management System Strengthening Activities
Information System
Transparency
Intervention
Assessment
Output, Outcome Focused Activities
Activities and Implementation
GGM 2010-2013
 Continue System Analysis (GGM Framework, Existing
System, Context change ), Priority Setting
 Strategic Formulation (Selective Implementation)
 Re-Design
 Evaluation, Re-Assessment
Challenges




MoPH Structure changed : Pharmacy Information
Center weakening -> Pseudoephedrine case.
Seperated Operation among organizations
Unlinkage between Government Anticorruption
Policy and GGM program
Knowledge Management Gap.
Conclusion






GGM Framework is the national level management. We should
realize that different country is different context..
Health care environment should be evaluated and priority setting
should be done at first step.
The strategy should be formulated to support and transfer into
operation.
Transparency is the most effective, efficient and feasible for the
first step of good governance implementation. We can achieve
transparency with the Pharmacy Information center.
GGM team consists of related organization should be formed.
Output, Outcome orientated activities