Abstract
This study aimed to conduct an ex-ante impact assessment of the a (Proposed) National Drug Pricing
Policy, developed under the research project “Survey of Medicine Price Situations and Design of Medicine
Pricing Policy for Thailand.” The assessment sought to forecast and analyze both direct and indirect impacts,
in the short and long term, on stakeholders within the pharmaceutical system. The scope of analysis covered
organizational, societal, and policy levels, as well as potential legal implications.
A mixed-methods research design was employed. The qualitative part involved a stakeholder analysis
to develop stakeholder and impact maps. Data collection was done through literature review, in-depth
interviews with experts and relevant stakeholders, and focus group discussions with key actors. Triangulation
was used to increase data validity and credibility. The quantitative part involved a tracer medicine selection
approach, covering multiple medicine categories, such as originator medicines, high-cost medicines, high-use
generic medicines, first generics, and innovation medicines. Import data and public hospital procurement data
from 2018 to 2022 were used to conduct scenario simulations and systematically assess potential impacts on
medicine prices and pharmaceutical budgetary burden.
Findings from in-depth interviews with key informants from three major stakeholder groups in the
pharmaceutical system—(1) manufacturers and importers, (2) stakeholders involved in procurement, payment,
and medicine use, and (3) policymakers and regulators—together with focus group discussions, indicated that
the proposed measures under the a (Proposed) National Drug Pricing Policy and the institutional structure for
medicine price governance required substantial revision. The most critical problems in the current medicine
price control mechanism were the duplication of price negotiation processes across multiple stages, complex
and time-consuming procedures, fragmented institutional arrangements, and a lack of unified governance, all
of which reduced the overall efficiency of the system.
This study proposes a three-pillar policy framework to address the challenges. The first pillar is a oneoff price negotiation model at the national level to reduce procedural duplication and to clarify the process of
price determination; the second pillar is the establishment of a single authority responsible for the governance
and negotiation of medicine prices to improve the coherence and consistency of decision-making, institutional
accountability and transparency; and the third pillar is reforming health technology assessment and central
reference price-setting processes to make them more streamlined and efficient, including allowing privatesector entities to conduct economic evaluations based on nationally accepted methodological standards,
establishing an expedited review mechanism, and restricting the deliberation of the central reference price to
only those cases that do not meet pre-established criteria.
In addition, the study recommends the adoption of segmented drug categories to guide the selection
of appropriate pricing tools and policy measures according to the characteristics of each medicine group. These
categories include high-cost originator medicines, patented medicines, orphan medicines, and me-too
medicines. Overall, the findings suggest that reform of Thailand’s national medicine pricing system should be
pursued as a structural policy agenda. Such reform should reduce procedural duplication, strengthen
governance coherence, and institutionalise the use of empirical evidence and health economic principles as
the foundation for decision-making. These changes are essential to promote a medicine pricing system that is
efficient, equitable, transparent, and sustainable in the long term.
