Bangkok Post - July 26, 2007
Apiradee Treerutkuarkul

Currently, the CL policy on three important drugs for Aids and heart treatment - Efavirenz, Kaletra and Plavix - is basically limited to patients under the universal healthcare scheme run by the National Health Security Office (NHSO).

Better known as the 30-baht healthcare scheme, it covers some 48 million people, mostly children, the poor, the elderly and the unemployed. Some of the patients who are civil servants, with approval from their physicians on a case-by-case basis, also benefit from the policy. Left out from the policy are office workers and labourers who are under the healthcare programme run by the Social Security Office (SSO).

Under the plan, the CL policy will in principle cover all three schemes, said NHSO secretary-general Sa-nguan Nittayarumphong.

At the same time, he said, a sub-committee on CL has been set up to consider a group of essential drugs which CL should be further applied to. The panel comprises academics, health experts and representatives from relevant state agencies such as the SSO, the Commerce and Foreign ministries, the Comptroller-General's Department, and the Budget Bureau.

The Comptroller-General's Office is responsible for the healthcare budget for civil servants whereas the SSO manages the healthcare fund for workers and employees of private firms.

Dr Sa-nguan, who chairs the sub-committee, believes patients under the SSO-run healthcare scheme should also benefit from this state policy.

He also pointed out that the new drug list for the CL policy has yet to be finalised.

So far, the subpanel has studied the possibility of enforcing CL on two cancer drugs, whose names have not been officially disclosed. But Dr Sa-nguan said all drugs listed for CL would be distributed to all healthcare schemes.

Saengsuree Joota, a doctor at Ramathibodi hospital and president of the Thai Society of Haematology, last week urged the government to be careful in announcing CL on a leukaemia drug with the trade name of "Glivec".

She feared that the policy would result in a disadvantage for some patients who already have access to the generic version of the drug.

At present, employees of private companies who suffer from leukaemia have no access to treatment due to the high cost of the drug. Also, the SSO only approves a healthcare fund for bone marrow transplants, which cost about 750,000-800,000 baht. A leukaemia patient will have to pay up to 1.5 million baht a year for treatment with the drug.

Mr Ammar urged health authorities to set up a system to manage and monitor drug distribution among state and private hospitals that provide medical services via the three healthcare schemes, to ensure that these drugs under the patent bypass would not be used for commercial benefit.

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