Health - Thailand

Market trends

The Ministry of Health is responsible for management of healthcare services in the public sector. Responsibilities are divided between the central and provincial administration. Each region has a Regional General Hospital that has a capacity of 500-1000 beds. Each province has a Provincial General Hospital and a Provincial Health Office. Each district also has a District Health Office. At village level, health centres provide healthcare services.

The healthcare sector comprises around 1360 hospitals, of which about two-thirds are in the public sector. In 2006 Thailand had an estimated 145,000 hospital beds, with 40,000 of these in the private sector. 

The public sector hospitals provide good coverage at various levels. At the provincial level the country has coverage of 100 per cent with a 90.6 per cent coverage at district level. 

The Ministry of Public Health (MOPH) is the largest agency operating in two-thirds of all hospitals and beds across the country. Approximately, 67 per cent of hospitals and 64 per cent of beds belong to the MOPH. Of all public sector hospitals, over 80 per cent are community hospitals in various districts, and only 5.5 per cent of the hospitals belong to other ministries.

There has been an increase in the number of private hospitals in the past few years. In 2006 there were 471 private hospitals, most of which were concentrated in urban areas and 44 per cent of private hospitals being located in Bangkok. Most private hospitals now have occupancy rates of only around 30 per cent, as more Thais covered by the government scheme opt for treatment under the Bt30 scheme.

The Bt30 medical care program

The Bt30 medical care program was launched in April 2001. It is a national healthcare scheme that is affordable to all. All kinds of medical care provided at public hospitals will be conducted under Bt30. The main factor is the reduction in medical costs and the maximisation of the health budget for the benefit of poor people.

The annual medical cost per head stands at Bt1396, but the new health program means that for Bt30 per session, Thais can obtain treatment for diseases.

More than 47 million Thai consumers have registered for this health program, and more than 160,000 have been given high cost treatments. For example, more than 7000 patients have received brain operations, more than 5500 have been treated for heart disease, and over 46,000 cancer patients have been treated.

The National Economic and Social Development Board in Thailand found that 77 per cent of the Thai population is pleased with this program, especially those in low-income groups. However, a negative aspect of the program is that medical staff – doctors, nurses and pharmacists – are overworked. Hospitals, particularly those in rural areas, suffer from high expenses and operate at a loss. 

The Ministry of Public Health cooperates with other government ministries with the aim of making Thailand the centre for health services in Asia by 2010. The target is to increase the number of foreigners seeking medical treatment in Thailand’s hospitals from a total of 970,000 in 2003 to two million by 2010. As Thailand’s cost of living is much lower than in Japan, the US and Europe, it is much cheaper for foreigners to obtain medical care in Thailand than in their own countries.

The government has introduced a plan to run over the 2004-2009 period to turn Thailand into a medical services hub for Asia, and has set aside more than Bt2.6 billion to make Thailand Asia’s centre of healthcare excellence.

Apart from the provision of medical services, the plan places an emphasis on spa and traditional massage services. The plan envisages that revenue of Bt200 billon will be generated in the next five years. Of this, two-thirds is expected to come from medical services, Bt50 billion from the spa business and Bt20 billion from health products. 

The Ministry of Commerce is considering shortening the waiting time for visas for people who want to come to Thailand for treatment, and has been encouraging the state hospitals to get involved by offering foreign-language courses to staff. Private hospitals have also started offering non-medical services, such as booking flights and arranging visas for patients. In addition, the government is backing a Hospital Accreditation (HA) scheme, whereby a hospital is accredited if it reaches international standards. The government is targeting a total of 1170 hospitals by the end of 2009.

Pharmaceuticals

Thailand has a well-developed and dynamic pharmaceutical sector, but it too has been critical of the universal healthcare program. Manufacturers complain that they are being forced to cut profit margins because of the health systems funding crisis, and foreign manufacturers have said that since the introduction of the scheme the demand for premium products has fallen.

Growth in the overall market, however, has remained strong. The local pharmaceutical sector is already fully liberalised, with no limits on foreign entrants to the market.

The Thai pharmaceutical market is divided roughly in half between prescribed and over-the-counter (OTC) drugs. The prescription sector, which accounted for 56 per cent of the market, includes all drugs prescribed by a doctor and distributed by hospitals and chemists. The OTC market includes common household remedies and a few medicines that are also prescribed. It is estimated that as much as 60 per cent of the population’s health expenditure goes directly to drugs. 

Medical equipment and supplies

Thailand’s market for medical equipment and supplies grew by an estimated 23 per cent in 2005 and is expected to maintain steady growth of 20 per cent in 2007. About 87 per cent of products used in this sector are imported. The growth is expected mainly from healthcare facility expansion and medical equipment replacement and upgrades.

Thailand relies on the import of medical devices, especially sophisticated, higher-end devices. Local production of medical devices in Thailand is reduced to less sophisticated devices, mainly due to the limited number of qualified researchers and limited capability to invest in the R&D required to produce more sophisticated devices.

Locally-produced products include reagents, simple disposable test kits, disposable syringes, artificial legs and other orthopedic accessories, and other simple disposable items. 

Thailand relies on the import of medical devices, especially sophisticated, higher-end devices. Public hospitals are still major users and buyers of medical devices and supplies in Thailand. They account for approximately 60 per cent of total purchases.

Other areas of opportunities include diagnostic kits for tropical diseases, multi-vitamins and supplements, hospital information systems, etc.

The importation of medical devices is controlled by the Thai Food and Drug Administration (FDA) and prior approval of imports is required.

The Thai FDA will accept medical devices that pass the following standards:

All manufacturers and importers of pharmaceutical products have to obtain a certificate of registration before a drug can be sold.

The Government Pharmaceutical Organisation (GPO) is responsible for regulating pharmaceutical prices and quality controls. The GPO also produces generic drugs, and the government undertakes trading of pharmaceutical products through the GPO.

Use of local agents or distributors is highly recommended for marketing medical devices in Thailand. The agent provides immediate access to an established marketing network and in-depth knowledge about pertinent regulations.

Buyers and end-users expect a local representative to handle after-sales service and stock spare parts. The agent also should be expected to develop close personal relationships with the buyers and end-users, an important factor in future procurement decisions.

Ministry of Public Health - www.moph.go.th
Food and Drug Administration - www.fda.moph.go.th
Government Pharmaceuticals Organisation - www.gpo.go.th
Private Hospital Association - www.pha.or.th
Thai Medical Device Suppliers Association - www.thaimed.go.th