Disclaimer: The views expressed in this paper/presentation are the views

of the author and do not necessarily reflect the views or policies of the
Asian Development Bank (ADB), or its Board of Governors, or the
governments they represent. ADB does not guarantee the accuracy of the
data included in this paper and accepts no responsibility for any
consequence of their use. Terminology used may not necessarily be
consistent with ADB official terms.

Health Technology Assessment (HTA):

Thailand and Beyond

Alia Luz
Health Intervention and Technology Assessment Programme of
Thailand

NHI4UHC
September 2016

Thailand
Thailand context:
3 insurance schemes
UHC in 2002
70% of total health spending is from the
government
HTA for the Universal Coverage Scheme (UCS)
of the government, which covers about 80% of
the Thai population
HTA = the systematic evaluation of properties,
effects, and/or impacts of health technology

Roles of HTA in Thailand

Universal Coverage Scheme
UC manager: National Health Security Office (NHSO)
Interventions: diagnosis, treatment, prevention, health promotion,
rehabilitation
Program for Development of UHC Benefit Package
Around 15 topics/year (studied by HITAP, IHPP and other research partners)

National List of Essential Medicines (NLEM)

National pharmaceutical benefit packagea reimbursement list of all three
schemes
Executive Committee, with support from technical working groups
Health Economics Working Group: HITAP (Secretariat/ researchers)
10 topics/year (HITAP assesses 5 topics/ year)

UC BP development
Participatory-Transparent-Evidence-based-Contestable

7 groups of
stakeholders

Criteria:

Nomination of
interventions

a)

Magnitude & severity of

problems

Stakeholders
Working Group

Researchers

Prioritization

Assessments
Cost-effectiveness
Budget impact

Committee for
Benefit
Package
Development

Appraisals

NHSO Board

Decisions

b)

Effectiveness of interventions

c)

Variation in practice

d)

Financial impact on
households

e)

Equity & ethical dimension

problem of the
marginalized

Appeals by
stakeholders

rare diseases

Case Study of a Public Health Intervention

Refractive Errors Screening in Children

Refractive error screening by health professionals in

pre-primary and primary school children is not currently
implemented in Thailand due to resource limitations.
Tools and a manual were developed and tested in 17
schools in 4 provinces. 223 teachers were trained and
5,303 were diagnosed by health professionals and
trained teachers
The detection rate for primary school children is high for
both levels of visual impairment (52% for mild and 74%
for moderate)
A refractive error screening program conducted in
schools by teachers is reasonable and feasible
Can be implemented and conducted with relatively low
costs

Key Points
HTA helps in ensuring that resource allocations are
efficient
Results also assist in price negotiations with
pharmaceutical and medical companies
Conducting HTA for policy use is relatively low-cost
(approx. 0.002% of the UHC budget)
Countries around the region adopting HTA in some
form (e.g. Indonesia, Malaysia, Korea, etc.)
High proportion of investment, political
commitment, good information infrastructure, local
training, collaboration between agencies, and
independence from external support are factors
(APO Policy Brief)

Thank You!