Abstract
The objective of this study was to assess the hospital response to policy implementation of the Glucosamine
(GS) negative list. This study comprised both quantitative and qualitative approaches. A survey
form of quantity and expenditure of GS 6 months before and after policy implementation was sent out to
provincial hospitals, general hospitals and teaching hospitals (107 hospitals). A qualitative approach included
focus group discussion with head pharmacists of 11 teaching hospitals, in-depth interview with
pharmacists who deal with this policy, and an evaluation of patient’s written complaints sent to Comptroller
General’s Department (CGP). Completed data from 58 hospitals (54%) were analyzed. The total
drug expenditure 6 months before policy implementation was 185 million Baht, and total drug expenditure 6 months after policy implementation was 27 million Baht. Total drug expenditure saving was 158
million Baht, or 85% of total drug expenditure before policy implementation. It appeared that this policy
reduced the expenditure of original drug than generic/local drug. Results from focus group discussion
and in-depth interviews showed that hospitals which succeeded in excluding GS from their list because of
the decision of the pharmacy and therapeutic committee and hospital boards or authorized physicians.
On the other hand, hospitals that still retained GS in their list because they did not understand the
evidence which indicated that this drug was not cost-effective. An evaluation of patients’ complaints
revealed their perceptions as follows: GS are not reimbursable even this drug was indicated for joint
disorders, the policy seems to force patients to responsible for their drug expenditure and policy seems to
be cut off the subsidy for CSMBS beneficiaries. The results of this study showed the impact of this policy
on both health care providers and patients, and unveiled the problems and burden associated with the
policy.
