Important note: Information in this article was accurate in 2001. The state of the art may have changed since the publication date.
Bangkok Post - Thursday 15 November 2001
Anjira Assavanonda
Suwit Wibulpolprasert, deputy health permanent-secretary, said the government should not be rushed into a decision.
NGOs and people living with HIV/Aids have demanded the Public Health Ministry speed-up inclusion of HIV/Aids treatment in the 30-baht scheme.
Cheaper anti-retroviral drugs become available next month, which the groups say will lower the potential cost to taxpayers.
However, some doctors say the health system is not ready to shoulder the cost, and that anti-retroviral drugs offer but a short-term solution.
A new formula for anti-retroviral drugs produced by the Government Pharmaceutical Organisation would lower the treatment price from more than 5,000 baht per person per month to 2,310 baht.
Public Health Minister Sudarat Keyuraphan says it is government policy to include HIV/Aids at some stage. However, she has not said when or under what conditions.
Dr Suwit said he was worried about the cost-effectiveness of including anti-retroviral drugs.
"So far there has been no scientific proof that those drugs are good and safe. On the contrary, they are expensive and even cause side-effects," he said.
He insisted he did not oppose the idea but its feasibility depended on factors including the efficacy of the drugs, their toxicity, price, and the support system providing advice, blood tests, and appropriate dosage.
Including the drugs would affect the scheme's budget. Nationwide there are 700,000 with HIV/Aids, and the numbers continue to grow.
Viroj Tangcharoensathien, of the Health Systems Research Institute, said the health care system was still not ready for effective treatment of HIV/Aids, particularly if it was included in the 30-baht scheme.
"At the moment, there are only a small number of physicians who have enough knowledge about HIV and anti-retroviral drugs, their side-effects and proper dose, which is very important for HIV treatment," Dr Viroj said.
He said official records showed that only 10% of people using anti-retroviral drugs had recovered from the disease and patients were likely to develop resistance to the drugs after using them for two years.
Dr Viroj said that this meant that after two years, patients might have to switch to other types of anti-retroviral drugs which could not be produced by the GPO.
This could make the scheme expensive to maintain.
"There's no problem, of course, if we have enough money. But due to budget limitations, what we need to consider most is the cost-effectiveness of the scheme," said Dr Viroj.
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