ArticleBMJ open2016
Expanding access to high-cost medicines through the E2 access program in Thailand: effects on utilisation, health outcomes and cost using an interrupted time-series analysis.
Article in BMJ open, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed.
- Expert recommendations for biomarker evaluation of advanced non-small cell lung cancer in Thailand.Translational lung cancer research · 2025Review
- Impact of medical insurance access negotiation on the utilization of innovative anticancer drugs in China: an interrupted time series analysis.BMC health services research · 2024Article
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- Antibiotic use in township hospitals during the COVID-19 pandemic in Shandong, China.Antimicrobial resistance and infection control · 2022Article
- Impact of the COVID-19 Pandemic on Antibiotic Prescribing by Dentists in Galicia, Spain: A Quasi-Experimental Approach.Antibiotics (Basel, Switzerland) · 2022Article
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- The Impact of the COVID-19 Pandemic on Antibiotic Prescribing Trends in Outpatient Care: A Nationwide, Quasi-Experimental Approach.Antibiotics (Basel, Switzerland) · 2021Article
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- Impact of a health alert and its implementation on flutamide prescriptions for women: an interrupted time series analysis.BMC health services research · 2020Article
- Defining the Benefit Package of Thailand Universal Coverage Scheme: From Pragmatism to Sophistication.International journal of health policy and management · 2020Article
- Impact of removal and restriction of me-too medicines in a hospital drug formulary on in- and outpatient drug prescriptions: interrupted time series design with comparison group.Implementation science : IS · 2019Article
- Real-World Safety of Intravitreal Bevacizumab and Ranibizumab Treatments for Retinal Diseases in Thailand: A Prospective Observational Study.Clinical drug investigation · 2018Observational
- Strategic purchasing and health system efficiency: A comparison of two financing schemes in Thailand.PloS one · 2018Article
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Authors and funding
7 authors.
Funding
Abstract
objectiveIn 2008, the Thai government introduced the 'high-cost medicines E2 access program' as a part of the National List of Essential Medicines to increase patient access to medicines, improve clinical outcomes and make medicines more affordable. Our objective was to examine whether the 'high-cost medicines E2 access program' achieved its goals.
designInterrupted time-series design study.
setting3 tertiary hospitals in different regions of Thailand, January 2006 to December 2012.
participantsPatients with target acute and chronic disease diagnoses who newly met E2 program criteria for selected study medicines.
interventionHigh-cost medicines E2 access program. MAIN OUTCOMES MEASURES: Level and trend changes over time in the proportions of eligible patients who received the indicated E2 medicines and who improved clinically, as well as in costs of treatment.
resultsA total of 2024 patients were included in utilisation analyses and 1375 patients with selected acute diseases contributed to analyses of clinical outcome. After 1 year of the E2 program implementation, the percentage of eligible patients receiving the indicated E2 program medicines increased significantly (relative change 12.7% (95% CI 4.4% to 21.0%), especially among those insured by the government's universal coverage scheme (relative change 19.9% (95% CI 9.5% to 30.5%)). The increase in the proportion of clinically improved patients with acute conditions was not significant (relative change 6.2% (95% CI -1.9% to 15.1%)). Quarterly healthcare costs per patient dropped significantly (relative change -13.5% (95% CI -26.9% to -1.7%)).
conclusionsIn the study hospitals, the E2 access program seems to have facilitated patient access to specialty medicines, may have contributed to improved health outcomes, and decreased treatment costs. Routine monitoring is needed to assess effects of expanding the programme, including effects on quality of care and financial sustainability.
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