Abstract
Health benefit under the Universal Coverage Scheme (UCS) in Thailand is a comprehensive
health package, with a few services on the negative list; for example, organ transplantation including
liver transplantation in children with biliary atresia.
Since 2011, liver transplantation in children with biliary atresia has been approved for UCS’s
health benefit package. All key actors involved in the health policy process of this new approval
including beneficiaries, health care providers, professional, and academics. This decision making is
an example of evidence-informed health policy explicitly including health need analysis, cost-utility
analysis, long term budget projection, and readiness of service delivery system.
As providing access to effective health care services when needed and protecting household
from catastrophic illness expenditure are key functions of public health insurance and UCS. This article
illustrated the health policy process of including the rare disease with high cost care (a case of
liver transplantation in children) into the health benefit package under UCS considering the threshold
for affordable and worth investment. Besides, critical success factors for the process of evidence-informed
health policy and enabling factors for moving health policy into implementation were discussed
in this paper.
