Research and Systems Development for National Drug Account, Thailand Nusaraporn Kessomboon Rungpetch Sakulbumrungsil Inthira Kanjanapiboon Siripa Udomuksorn Anchalee Jitraknathee Training Workshop on the System of Health Accounts March 2013

Content Why NDA? Objectives Methods Main results Future challenges

Why NDA?: Total drug exp? Total Health Expenditure (NHA 1994 – 2005)

Why NDA?: Previous snap shot studies  1994 – Framework development by Jomjin Chantarasakul et al. o FDA changed annual report format  2002 – Validating FDA annual report by Rungpetch Sakulbumrungsil et al. o For 2001  Drug exp at producer price =51,866 m ฿  Drug exp at consumer price for =73,421 m ฿

NDANDA Moving from cross sectional studies toward systems development in FDA information system

Objectives and methods To develop core structure of NDA To standardize input data To develop reporting system (for NHA, NDA, manufacturers and importers)

Input data Compulsory annual report submitted to FDA production report importation report o exportation report

Import ( ฿ ) NDA-FDA National Drug Supply at producer price ( ฿ ) Export ( ฿ ) eCustom Hospital( ฿ ) %% % National Drug Consumption ( ฿ ) Domestically Manufacturin g ( ฿ ) NDA- FDA Total Manufacturing ( ฿ ) FDA Repackin g ( ฿ ) Ambulatory health care org.( ฿ ) Drug store ( ฿ )Others( ฿ ) 100 % Consum er price factor Consum er price factor Consum er price factor Consum er price factor

Standardization of input data –Anatomical Therapeutic Chemical (ATC) classification system 2010 by WHO Collaborating Center for Drug Statistics Methodology –Strength and dosage form Thai-FDA standard modified from TP, USP, BP, EP –Package unit

Program for data input 2010

Feedback report

Feedback report ATC Level 1

Feedback report ATC Level 2

Yr 2009: 20 volunteers Yr 2010: recommended by FDA to use electronic report - comply 97.7% (335/343) report - not-comply 8 (paper submission by 1 domestic manu, 7 importers) - distribution channel data could not be used Conduct distribution channel survey by FDA to calculate the overall drug distribution for NDA 2010 System testing

billion ฿ Import 99,663,791,613 National Drug Supply at producer price 134,482,077, Export 12,077,467,549 Hospital 84,078,194, %6.50% % 4.70% National Drug Consumption 144,570,906,916 Domestically Manu 46,895,753,527 Total Manufacturing ( ฿ ) FDA Repackin g ( ฿ ) Ambulatory health care org. 8,741,335, Drug store 35,341,889, Others 6,320,657, % Consumer price factor (CPF)1.39% 85,246,881, CPF 29.60% 11,328,770, CPF 15.20% 40,713,857, CPF 15.20% 7,281,397, NDA 2010

Drug consumption (producer price) at ATC level 1 ATC code J ANTIINFECTIVES FOR SYSTEMIC USE ฿ 27,395,297, C CARDIOVASCULAR SYSTEM ฿ 23,418,256, A ALIMENTARY TRACT AND METABOLISM ฿ 20,180,409, L ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS ฿ 15,264,469, N NERVOUS SYSTEM ฿ 13,179,906, M MUSCULO-SKELETAL SYSTEM ฿ 12,353,959, B BLOOD AND BLOOD FORMING ORGANS ฿ 11,665,528, R RESPIRATORY SYSTEM ฿ 9,956,756, G GENITO URINARY SYSTEM AND SEX HORMONES ฿ 7,584,602, D DERMATOLOGICALS ฿ 4,807,334, S SENSORY ORGANS ฿ 3,718,808, V VARIOUS ฿ 2,579,580, H SYSTEMIC HORMONAL PREPARATIONS, EXCL. SEX HORMONES AND INSULINS ฿ 1,487,846, P ANTIPARASITIC PRODUCTS, INSECTICIDES AND REPELLENTS ฿ 515,140,183.29

Future challenges How to have the routine report of distribution channel in the system? Data utilization: o Integration of newly developed drug code o Pharm market index/statistics o Pharm consumption index/statistics

Thank you