Cancer is one of the 10 non-communicable diseases that has been a threat to global health. In 2020, some 10 million people were killed by the disease, the World Health Organisation said.
The Union for International Cancer Control (UICC) marks World Cancer Day on February 4 every year to highlight that the disease could affect everyone and the entire nation in multiple aspects, and to encourage people to take care of their health.
Cancer is a global problem of the public health system even for developed countries. In Thailand, medical knowledge and cancer treatment innovation has developed quickly and helped more patients to survive the disease than in the past.
However, cancer is still the number one cause of death for Thai people because a large number of patients could not access efficient cancer treatment equally.
The white paper addressed the limitations in access to treatment and suggested a number of solutions from foreign countries to adopt and implement for prompt access to innovative cancer treatments.
The most possible solution is Managed Entry Agreements (MEA), which, according to experts, will be a key mechanic to ensure equity in accessing cancer treatments in Thailand as in many other countries that are facing this challenge.
Thailand has three healthcare programmes that provide universal health care to the country's citizens — the Universal Coverage scheme or gold card, which covers the majority of the population; the social security for private employees; and the civil service welfare system for civil servants and their families.
Not only is cancer a crisis that kills a large population each year, but it also forces countries to invest medical resources and economic budgets to prevent productivity loss from disability and premature death.
Cancer treatment innovations, such as immunotherapy or targeted therapy, have progressed tremendously in recent years. However, the guideline to access effective cancer treatment in Thailand is limited when compared to the National Comprehensive Cancer Network (NCCN) in the United States.
The management to access such treatments might be costly. As a result, Thailand may have to consider adapting the guidelines from other countries as presented in the study to be in line with its healthcare schemes.
Sirintip Kudtiyakarn, President, Thai Cancer Society (TCS), shared her personal experience as a cancer survivor. Her cancer has been in remission for six years and she could get back to her normal life happily.
She also delivered a keynote address on Thailand’s cancer readiness and offered an in-depth analysis of patients’ and medical professionals’ needs.
She said that cancer patients need improvements in many aspects - from a better quality of life through treatment plans with reduced side-effects, caring and encouragement from families, and access to cancer treatment which is currently not thorough, due to geographical distance of hospitals, the readiness of tools and equipment, and limitation to access some cancer treatments.
Since most oncologists are commonly found working in Bangkok or major cities, upcountry patients have difficulty travelling to seek medical services. The process of diagnosis or treatment also takes a long time due to the waiting period in overcrowded hospitals. The cost of travelling and the time it takes are prevalent pain points, requiring more effort for improvement.
Sirintip stated, “To deal with cancer, one needs consciousness, encouragement, and appropriate treatment to recover and get back to their lives happily.”
Next, there was a panel discussion on “How to achieve more equitable access to cancer treatments and better quality of lives for the Thai people” by Prof. Chirayu Auewarakul, MD, PhD, Dean of Princess Srisavagavadha College of Medicine and Medical Oncologist, Jadet Thammathat-aree, MD, Secretary- General, National Health Security Office (NHSO), Nopporn Cheanklin, MD, Executive Director, Health Systems Research Institute (HSRI), Assoc. Prof. Ekaphop Sirachainan, MD, President, Thai Society of Clinical Oncology (TSCO), and Asst. Prof. Aumkhae Sookprasert, MD, medical oncologist, Faculty of Medicine, Khon Kaen University. Sirintip also took part as one of the panelists.
Nopporn, MD, elaborated that the new guideline consideration process for innovative cancer treatments may be time-consuming, and the working team is currently investigating the National List of Essential Medicines. He is convinced that the Managed Entry Agreements or MEAs proposed in the white paper potentially offer Thailand a tangible solution.
“The overall challenge of access to cancer treatments is their high cost, so the role of the NHSO is to make them more affordable. One concept that I believe in is helping each other to reduce the cost in general. Last year, the NHSO initiated the ‘Cancer Anywhere’ project for patients to receive treatment in hospitals with reduced waiting time and cost while the service quality remains satisfactory.”
Summing up the event, Prof. Chirayu, MD, said: “The seminar that we organised on World Cancer Day offered a great opportunity for all stakeholders to come together and discuss better solutions to improve access to treatment for Thai cancer patients.”
Chirayu thanked everyone for their solutions and recommendations, saying: “Chulabhorn Royal Academy is ready to join hands with the NHSO, HSRI, TSCO, TCS and other sectors in the healthcare ecosystem to advocate equity of access to innovative cancer treatments. Subsequently, the survival rate and the quality of lives of Thai cancer patients will improve, which is in alignment with the determination of Professor Dr. Her Royal Highness Princess Chulabhorn Krom Phra Srisavangavadhana, the CRA’s founder.”
More information: Modernization of Thailand Health Technology Assessment
https://www.ipsos.com/en-sg/modernization-thailand-health-technology-assessment
More information: Modernization of Thailand Health Technology Assessment-Ipsos-v8
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