EXPLORING ALTERNATIVE PATHWAYS: THAILAND’S SUSTAINABLE HEALTHCARE FINANCING SOLUTIONS TO IMPROVE ACCESS TO IMMUNOTHERAPY IN LUNG CANCER...
Author(s)
Jomtana Siripaibun, MD1, Thanyanan Baisamut, MD2, Chanin Limwongse, MD3, Sarayut Lucien Geater, MD4, Passakorn Wanchaijiraboon, MD5, Chumut Phanthunane, MD6, Danupon Nantajit, MD7, VICHIEN SRIMUNINNIMIT, MD3, Thanarath Imsuwansri, MD8, Teerapat Ungtrakul, MD9.
1Chulabhorn Hospital, Chulabhorn Royal Academy, Bangkok, Thailand, Bangkok, Thailand, 2Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand, Bangkok, Thailand, 3Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand, Bangkok, Thailand, 4Department of Clinical Research and Medical Data Science, Faculty of Medicine, Prince of Songkla University, HaT Yai, Thailand, 5Phrapokklao Cancer Center of Excellence; Division of Medical Oncology, Phrapokklao Hospital, Chanthaburi, Thailand, Bangkok, Thailand, 6Division of Medical Oncology, Chulabhorn Hospital, Chulabhorn Royal Academy; Bureau of research and Innovation management, Chulabhorn Royal Academy, Bangkok, Thailand, 7Princess Sirivangavadhana Faculty of Medicine, Center for Cancer Discovery and Genomics, Bureau of Research and Innovation Management, Chulabhorn Royal Academy, Bangkok , Thailand, Bangkok, Thailand, 8National Cancer Institute, Bangkok, Ministry of Public Health, Thailand, Bangkok, Thailand, 9Princess Sirivangavadhana Faculty of Medicine, Chulabhorn Royal Academy, Bangkok, Thailand, Bangkok, Thailand.
1Chulabhorn Hospital, Chulabhorn Royal Academy, Bangkok, Thailand, Bangkok, Thailand, 2Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand, Bangkok, Thailand, 3Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand, Bangkok, Thailand, 4Department of Clinical Research and Medical Data Science, Faculty of Medicine, Prince of Songkla University, HaT Yai, Thailand, 5Phrapokklao Cancer Center of Excellence; Division of Medical Oncology, Phrapokklao Hospital, Chanthaburi, Thailand, Bangkok, Thailand, 6Division of Medical Oncology, Chulabhorn Hospital, Chulabhorn Royal Academy; Bureau of research and Innovation management, Chulabhorn Royal Academy, Bangkok, Thailand, 7Princess Sirivangavadhana Faculty of Medicine, Center for Cancer Discovery and Genomics, Bureau of Research and Innovation Management, Chulabhorn Royal Academy, Bangkok , Thailand, Bangkok, Thailand, 8National Cancer Institute, Bangkok, Ministry of Public Health, Thailand, Bangkok, Thailand, 9Princess Sirivangavadhana Faculty of Medicine, Chulabhorn Royal Academy, Bangkok, Thailand, Bangkok, Thailand.
OBJECTIVES: Rising incidence and mortality of lung cancer in Thailand increase the demand for innovative treatments such as immunotherapy. However, expanding access remains challenging because of financial constraints and reimbursement limitations. This study explored alternative financing pathways to improve sustainable access to immunotherapy in Thailand.
METHODS: A preliminary framework for alternative financing pathways was developed based on a review of the literature and expert inputs. This framework was further refined through two rounds of multi-stakeholder consultations, involving clinicians, public payers, health economists, academia, and government representatives.
RESULTS: Stakeholders recognize that the clinical and economic uncertainties surrounding immunotherapy make traditional reimbursement approaches challenging to maintain within the Thai healthcare system. The proposed framework aims to enhance access to innovative lung cancer treatments in Thailand by focusing on financial mechanisms that enhance affordability and long-term sustainability. Treatments are prioritized based on unmet medical needs, public health significance, and health technology reassessment criteria. Eligible therapies can seek funding from the proposed Cancer Drug Fund (CDF) through lung cancer supplementary insurance, and other dedicated funding sources or choose copayment solutions involving government and third-party support. Financial strategies within the CDF encompass Managed Entry Agreement (MEA) approaches and non-MEA strategies, including discounts, price-volume agreements, and utilization caps, to address these challenges effectively. Free initial treatment was the least preferred MEA, among stakeholders despite its commonly use in Thai practice.
CONCLUSIONS: Blended financing pathways may provide a pragmatic approach for addressing affordability and reimbursement challenges while improving sustainable access to immunotherapy in Thailand. Further evaluation is needed to assess feasibility, implementation, and long-term impact in Thailand and other LMIC settings.
METHODS: A preliminary framework for alternative financing pathways was developed based on a review of the literature and expert inputs. This framework was further refined through two rounds of multi-stakeholder consultations, involving clinicians, public payers, health economists, academia, and government representatives.
RESULTS: Stakeholders recognize that the clinical and economic uncertainties surrounding immunotherapy make traditional reimbursement approaches challenging to maintain within the Thai healthcare system. The proposed framework aims to enhance access to innovative lung cancer treatments in Thailand by focusing on financial mechanisms that enhance affordability and long-term sustainability. Treatments are prioritized based on unmet medical needs, public health significance, and health technology reassessment criteria. Eligible therapies can seek funding from the proposed Cancer Drug Fund (CDF) through lung cancer supplementary insurance, and other dedicated funding sources or choose copayment solutions involving government and third-party support. Financial strategies within the CDF encompass Managed Entry Agreement (MEA) approaches and non-MEA strategies, including discounts, price-volume agreements, and utilization caps, to address these challenges effectively. Free initial treatment was the least preferred MEA, among stakeholders despite its commonly use in Thai practice.
CONCLUSIONS: Blended financing pathways may provide a pragmatic approach for addressing affordability and reimbursement challenges while improving sustainable access to immunotherapy in Thailand. Further evaluation is needed to assess feasibility, implementation, and long-term impact in Thailand and other LMIC settings.
Conference/Value in Health Info
2026-09, ISPOR Asia Pacific 2026, Bangkok, Thailand
Value in Health, Volume 55, Issue S1
Code
HPR5
Topic
Health Policy & Regulatory
Topic Subcategory
Insurance Systems & National Health Care, Reimbursement & Access Policy, Risk-sharing Approaches
Disease
SDC: Oncology