RESULTS:

1. USING ECONOMIC EVIDENCE AND STAKEHOLDER'S PARTICIPATION IN DECISION MAKING ON BENEFIT PACKAGE OF UNIVERSAL HEALTH COVERAGE SCHEME IN THAILAND Pachanee K1, Mohara A2, Teerawattananon Y2, Tantivess S2, Lertiendumrong J1, Prakongsai P1 1International Health Policy Program, Nonthaburi, Thailand 2Health Intervention and Technology Assessment Program, Nonthaburi, Thailand BACKGROUND: In 2002, Thailand achieved universal health coverage (UHC) by introducing a tax-financed health insurance scheme for 47 million of Thais (≈75% of the entire population) who are neither civil servant nor social health insurance beneficiaries. The benefit package of the UHC scheme is comprehensive comprising ambulatory care, hospitalization, operation, health promotion and disease prevention activities, dental care, medicines, and a wide range of expensive medical services. However, some expensive medical care and new health technologies are still excluded from the UHC benefit package due to lacking of economic information and limited fiscal capacity. During the past decade, there is an increasing demand for health care as a result of epidemiological change, low financial barriers to health care due to achieving universal coverage, aging society, and rapid technological advancement. The National Health Security Office (NHSO) of Thailand has supported development of a guideline using economic evaluation and ethical considerations for selection of new cost-effective health interventions to be included into the UHC benefit package. • OBJECTIVES: • To review and describe experiences in: • - using economic evaluation and ethical considerations for • developing a new guideline for economic evaluation, • - participatory process of key stakeholders in submission and topic • selection of including new health interventions into the UHC • benefit package, • To draw lessons learnt from this initiative and share such experiences • of Thailand to other developing countries. Figure 1 : Theparticipatory processes of topic submission and selection • RESULTS: • The participatory process of 7 groups of key stakeholders comprises submission of health intervention topics including health promotion and disease prevention to the UHC Benefit Package Sub-commitee every six month. Then, brainstorming meeting of a working group comprising 4 groups of key stakeholders are arranged to scoring all proposed topics and finalize scores of proposed health interventions. Then independent researchers were responsible for conducting economic evaluation and budget impact analysis of selected interventions approved by the working group. (Figure 1) • Economic evaluation on selected interventions using incremental cost-effectiveness ratio (ICER) threshold of 1 GDP per capita per QALY gained has been applied by the Benefit Package Sub-committee of NHSO. • The process of using this guideline and economic appraisal was successfully applied for the UHC benefit package for 2 years. (Figure 2) • During the past two years, total submission by seven stakeholders are 46 topics and selected for economic appraisal 19 topics. Figure 2 : The processes of economic appraisal and decision making DISCUSSION AND CONCLUSIONS : This guidelineand economic appraisal approach has been gradually accepted by policy makers and all key stakeholders through participatory processes, this initiative not only produced and applied evidence informed decisions in a transparent manner, It also strengthened and sustained institutional capacities in generating evidence on ICER, budget impact assessment and other ethical social dimensions. The NHSO BP Sub-committee is the platform for interchange between evidence and policies. Contact Information : Kumaree Pachanee International Health Policy Program, Ministry of Public Health. Tiwanon Road, Muang district, Nonthaburi province 11000 Thailand Tel: +66 2 590 2355-7 Fax:+66 2 590 2385 Email address : kumaree@ihpp.thaigov.net ISPOR 14th Annual European Congress 5-8 November 2011 Hotel Auditorium Madrid, Madrid, Spain