A Procurement Systems for Medical Devices in Thailand: A Case Study of Coronary Stents
The universal health coverage scheme (UHC) is responsible for providing health service deliveries to76% of the Thai population.In 2013,there were 235medical devices in the UHCs benefit package which beneficiaries can freely access; the expenditure of these devices was approximately 4.5 billion Thai Baht(THB).A large proportion of this amount was used to acquire devices for treating cardiovascular diseases,accounting for roughly 45% of total expenditure.Out of this 45%,coronary stents were the top purchases and this is likely to increase.Thus,an optimal procurement procedure should be developed in order to ensure appropriate use of the budget.This study aims to develop optimal procedures for procuring coronary stents in the Thai setting.Three sources of information were used to conduct this study: (1) Data on the use of coronary stents and their trends between2010 and 2014 were retrieved and analyzed from the reimbursement database; (2) Literature reviews based on other countries were examined to explore case studies of procurement procedures for coronary stents;(3) Expert consultation meetings were conducted for validating information and developing an optimal procedure for the Thai setting.The results show that the trend of coronary stents,especially drug-eluting stents,increased over time.It is estimated that the use of these devices will reach around 180,000 pieces in 2019,costing approximately 1.85 billion THB.It was also found that the rates of inappropriate use of these devices varied between 1.5% and 16.1% of total re-vascularized patients,leading to a waste of more than 68 million THB annually.Additionally,the current centralized procurement procedure does not seem appropriate due to many factors,for instance,limited options of coronary stents that seem to prevent patients from accessing the best options of treatment.It also found that the centralized procurement procedures are likely to make the system becomes less transparent.The results indicate that the optimal procedure agreed upon divides the budget into two portions.The first part comprising 75% of the budget can be used by every hospital based on restriction on types of coronary stents and fixed central prices.The remaining 25% of the budget provides an option for some eligible hospitals to purchase their choice of devices to cope with complex cases or to purchase new effective technologies.
coronary stents health systems medical devices procurement system
Songyot Pilasant Inthira Yamabhai Thanaporn Bussabawalai Yot Teerawattananon
Health Intervention and Technology Assessment Program, Ministry of Public Health, Nonthaburi, Thailand
国际会议
杭州
英文
154-159
2015-10-21（万方平台首次上网日期，不代表论文的发表时间）