Transcript Oral Presentation 1

INCREASING HERBAL
PRODUCT CONSUMPTION
IN THAILAND DURING
THE PERIOD 2001-2003
By Dr Arthorn Riewpaiboon
PATTERNS OF HERBAL UTILIZATION
Food supplements
Herbal beverages
Health foods
Foods
Herbs for primary health care
Household insect repellents
Foods & drugs for animal
Traditional drugs
HERBS
Drugs
Herbal drugs
Modern drugs
Agricultural insecticides
Herbal cosmetics
ECONOMIC CONCEPT OF HERBAL GOODS
Development of drugs from herbs
Isolatedactive-compound
drugs
Potential for increasing information asymmetry
Decreasing barrier to entry
Source: Developed based on the idea of Ashcroft and Li Wan Po, 1999.
Private goods
Public goods
Fresh herbs Prepared herbs Formulated Registered
from garden
from
traditional
herbs
or forest
herbal shop
drugs
from herbalists
HERBAL MARKETS
World Market
Export
Import
Export
Import
Wholesale
Farm
Wild
Raw
materials
system
Direct
sale
Store
Industry
Pharmacy
Hospital
Production
Hospital
Community
Production
Clinic
Health
Consumers
HERBAL PHARMACOECONOMICS;
RESEARCH FRAMEWORK
Determinants
Research on
demand-supply
Demand
Economic evaluation:
cost analysis,
CEA, CBA, CUA
Consumption:
Clinical outcomes
Economic outcomes
Governmental
Promotion/
Regulation
Supply
RESEARCH ON DEMAND-SUPPLY (MARKETS)
•Raw material
production
•Raw materials
procurement system
•Industry
•Distribution
•Outlets
•Consumption
•Quantity
•Characteristics
•Predictors
GUIDELINES ON MEASURING
THE QUANTITY
• Definition of herbal products
• Source or sample
• Condition of use
• Prices; wholesale or retail
• Time; adjusting of inflation
• Estimation; sensitivity analysis
STUDY ON HERBAL
PRODUCT CONSUMPTION
Thailand
Stratified sampling
13 areas; 12 Public health regions and capital city (Bangkok)
Convenience sampling
SAMPLING
13 provinces; one province from each area
Stratified sampling
Classify drugstores in each province into type 1, type 2, type 3
1% by convenience sampling
132 samples from all 3 types in 13 provinces
STUDY ON CONSUMPTION
ANALYSIS
Items and their values
of individual store
for 2 months
Percentage
calculation
Grouping by
indications
Proportion
adjusting to
1 year
Medians of total
Number of
stores adjusting
to the country
Mark-up
adjusting
Country volume
per year by
indication
groups
value by groups;
Bangkok; type1
Bangkok; type2
Bangkok; type3
Provincial; type1
Provincial; type2
Provincial; type3
Volume
at
wholesale
price per
store
per year
Volume
at
wholesale
price per
country
per year
Country
volume
at retail
price
per year
COST-EFFECTIVENESS ANALYSIS
Cost=CH2 $
Cost=CH1 $
AEs
Rx
Success (NH1 cases)
Herbal drug
NH cases
Success (NH2 cases)
Failure (NH-NH1-NH2 cases)
Failure (NS-NS1-NS2 cases)
Synthetic drug
NS cases
Cost=CS1 $
AEs = Adverse effects
Rx = Conventional treatment
Success (NS2 cases)
AEs
Success (NS1 cases)
Rx
Cost=CS2 $
Cost-effectiveness ratio of treatment by herbal drug = (CH1+CH2)/(NH1+NH2)
Cost-effectiveness ratio of treatment by synthetic drug = (CS1+CS2)/(NS1+NS2)
“Success” is evaluated comparing to effective measure related to the objective.
COST-BENEFIT ANALYSIS
BEFORE INTERVENTION
Healthcare
sector(C1a)
Resources Patient &
consumed family(C2a)
AFTER INTERVENTION
Costs of the
intervention (Q)
Herbal Resources
program consumed
Societal
Productivity
(C3a)
Healthcare
sector(C1b)
Patient &
family(C2b)
Societal
Productivity
(C3b)
Net benefit = (C1a+C2a+C3a)-(C1b+C2b+C3b)-Q
Source: Developed based on the idea of Drummond et al, 1997.