INCREASING HERBAL PRODUCT CONSUMPTION IN THAILAND DURING THE PERIOD 2001-2003 By Dr Arthorn Riewpaiboon.

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INCREASING HERBAL PRODUCT CONSUMPTION IN THAILAND DURING THE PERIOD By Dr Arthorn Riewpaiboon

HERBS Drugs Traditional drugs Modern drugs Herbal drugs Foods Food supplementsHerbal beverages Herbal cosmetics Foods & drugs for animal Health foods Agricultural insecticides Household insect repellents Herbs for primary health care PATTERNS OF HERBAL UTILIZATION

Fresh herbs from garden or forest Prepared herbs from herbal shop Formulated herbs from herbalists Registered traditional drugs Isolated- active-compound drugs Public goodsPrivate goods Potential for increasing information asymmetry Decreasing barrier to entry Development of drugs from herbs Source: Developed based on the idea of Ashcroft and Li Wan Po, ECONOMIC CONCEPT OF HERBAL GOODS

Farm Raw materials system Industry Direct sale Clinic Store Pharmacy Export World Market Import Hospital Health Consumers Hospital Production Whole- sale Wild Community Production HERBAL MARKETS

Demand Consumption: Clinical outcomes Economic outcomes Determinants Supply Governmental Promotion/ Regulation Economic evaluation: cost analysis, CEA, CBA, CUA Research on demand-supply HERBAL PHARMACOECONOMICS; RESEARCH FRAMEWORK

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

Thailand 13 areas; 12 Public health regions and capital city (Bangkok) Classify drugstores in each province into type 1, type 2, type samples from all 3 types in 13 provinces 1% by convenience sampling Stratified sampling Convenience sampling 13 provinces; one province from each area SAMPLING STUDY ON HERBAL PRODUCT CONSUMPTION

Items and their values of individual store for 2 months Grouping by indications Percentage calculation Medians of total value by groups; Bangkok; type1 Bangkok; type2 Bangkok; type3 Provincial; type1 Provincial; type2 Provincial; type3 Volume at whole- sale price per store per year Volume at whole- sale price per country per year Country volume at retail price per year Country volume per year by indication groups Proportion adjusting to 1 year Mark-up adjusting Number of stores adjusting to the country ANALYSIS STUDY ON CONSUMPTION

Herbal drug NH cases AEs Rx Success (NH 1 cases) Success (NH 2 cases) Failure (NH-NH1-NH2 cases) Synthetic drug NS cases Rx Success (NS 1 cases) Success (NS 2 cases) Failure (NS-NS 1 -NS 2 cases) AEs Cost=CS 1 $ Cost=CH 1 $ Cost=CH 2 $ Cost=CS 2 $ AEs = Adverse effects Rx = Conventional treatment Cost-effectiveness ratio of treatment by herbal drug = (CH 1 +CH 2 )/(NH 1 +NH 2 ) Cost-effectiveness ratio of treatment by synthetic drug = (CS 1 +CS 2 )/(NS 1 +NS 2 ) “Success” is evaluated comparing to effective measure related to the objective. COST-EFFECTIVENESS ANALYSIS

Herbal program Healthcare sector(C1a) Patient & family(C2a) Societal Productivity (C3a) Resources consumed Resources consumed BEFORE INTERVENTION Net benefit = (C1a+C2a+C3a)-(C1b+C2b+C3b)-Q Costs of the intervention (Q) AFTER INTERVENTION COST-BENEFIT ANALYSIS Source: Developed based on the idea of Drummond et al, Healthcare sector(C1b) Patient & family(C2b) Societal Productivity (C3b)