Effect of the compulsory license on the public provision of the announced medicine in Thailand

Abstract

To have a first field evaluation of the effect of compulsory licensing policy implementation on the access to the announced medicine. This study was a descriptive retrospective study using electronic pharmaceutical prescription data from 3 hospitals in 3 levels of health care settings from the period of 2007 to 2009. Explanatory model was employed to analyze the effect of the compulsory licensing policy implementation on number of patients receiving medicine. In-depth interview was also conducted to explore dimensions of access to medicine that have an effect on the implementation of compulsory licensing policy. Following the implementation of compulsory licensing policy, the number of patients receiving Clopidogrel and Lopinavir/ritonavir has significantly increased by 55.68% and 26.78%. While the number of patients receiving Efavirenz has significantly decreased by 25.86%. This result may be directly related to the policy and indicates that this method is successful in increasing the access to only some particular category of drugs. Type of hospital and health care scheme also has an impact on the access to medicine. Access to medicine may not be an issue in higher level of hospital or employed fee-for-service as its payment method to the health care providers. Quality of compulsory licensed medicine is the factor most interviewee are concerning of. Physician’s perceptions toward the quality of the medicine then have an impact on the access to these medicines.