Drug expenditure and economic impact of community pharmacy visits by poor households

Main Article Content

Pariya Thomudtha
Onanong Waleekhachonloet
Sumon Sakolchai
Supon Limwattananon
Chulaporn Limwattananon


Introduction: This research aimed to study drug expenditure and economic impact of community pharmacy visits by poor households with respect to five common symptoms, including fever/headache, joint/back/musculoskeletal pains, throat/nose symptoms, skin diseases, and gastrointestinal tract symptoms. Method: A total sample from 304 poor households was interviewed face-to-face using a structured questionnaire during May-July2009. Results: Nearly all (95.5%) were under Universal Health Care coverage (UC) scheme. The majority (61.5%)was in the agriculture sector. The median household expense per month was 6,528 Baht (interquartile range-IQR 4,945), which was higher than the median income (5,575 Baht) (IQR 6,575). Medication through pharmacist initiation was common for fever/headache (68.3%), joint/back/musculoskeletal pains (65.6%), throat/nose symptoms (64.5%), and skin diseases (63.3%); whereby self-request medication was common for gastrointestinal tract symptoms (75.4%). The median (IQR) out-of-pocket payments for drugs for each of the five symptoms were 25.0(37.0), 30.0 (20.0), 39.0 (30.5), 40.0 (30.0), and 30.0 (15.0) Baht, respectively. The median (IQR) expenditures based on standard treatments for each of these symptoms were 30.0 (50.0), 60.0 (15.0), 25.0 (37.0), 35.0 (20.0),170.0 (0.0) Baht, respectively. The median value of the maximum ability to pay for the standard treatment for every symptom was 100 Baht. Those who were not able to pay for the standard treatment mostly suffered from gastrointestinal tract events (63.6%), followed by throat/nose symptoms (25.5%), and fever/headache (13.8%). The highest gap between the ability to pay and the standard treatment was equal to 81.0 Baht (median) (IQR 51.0) for gastrointestinal tract symptoms. For those who could not afford the standard treatment, major economic coping would go to household savings (63.5%), of which 54.6% were unable to save. The second most frequent impact was on their daily consumption (35.2%), of which 32.2% had decreased in the consumption. One-fifth (21.7%) had to use some kind of coping strategy, 20.4% of which was obtained from relatives. At the level of actual payment, the majority (62.2%) had no impacts, whereas 36% had their savings reduced and 15% had an impact on daily consumption. Conclusion: Most poor households were able to pay out of pocket for the drugs received and for standard drug treatments, except for the case with gastrointestinal tract symptoms. Such payments would affect the household savings and daily consumption the most.


Download data is not yet available.

Article Details

Pharmaceutical Practice


Chaiyasong S, Osiri S, Hirunyapanich V, AphasrithongsakulS, Satayawongtip P. Primary care services of community pharmacy in health insurance system: a case study of MahasarakhamUniversirty pharmacy in Universal health care coverage. Mahasarakham: Faculty of Pharmaceutical Sciences, Mahasarakham University. 2005.
Chalongsuk R, Pongchroensuk P, Lochid-amnuay S. A Survey of utilization of pharmacy services by social security beneficiaries in Bangkok and the vicinity. Journal of Health Science 2008; 17(1): 48-58.
Gotsadze G, Bennett S, Ranson K, Gzirishvili D. Health care seeking behavior and out of pocket paymentin Tbilisi, Georgia. Health Policy Plan 2005; 20(4): 232-242.
Gwatkin DR. Health inequalities and the health of the poor: What do we know? What can we do? Bull World Health Organ 2000; 78: 3-18.
Kanchanakitsakul M. Self-medication of Thai people suffering illness.IJPS2006; 2(2): 87-98.
Kapol N, Chalongsuk R, Amrumpai Y, Sornwanee K, Phanucharas D. The situation of drug use of people: preliminary data in the west region. Silpakorn University Journal 2001; 21: 74-93.
Khunothai H, Worakasemsuk S, Sukneskul S. The survey of pharmaceutical care in community pharmacy in Bangkok. [Online] [cited 2010 Apr 28] Available from: http://www.pha.nu.ac.th/GradCommunity/commu_ResLink.html
Limwattananon S, Kongsawatt S, Pannarunothai S. Screening for poor people using household information Journal of Health Science 2005; 14(2): 275-286.
Limwattananon S, Tangcharoensathien V, Prakongsai P. Catastrophic and poverty impacts of health payments: results from national household surveys in Thailand. Bull World Health Organ 2007; 85(8): 600-606.
NaRanong V, NaRanong A, Leckcivilize A. Measuring catastrophic health expenditures using the poverty approach. Journal of Health Systems Research 2008; 2(3): 372-387.
National Statistical Office, Thailand. Preliminary report of data analysis of health and welfare survey 2007. Bangkok 2007.
Saengcharoen W. Factors affecting antibiotic dispensingfor upper respiratory infections among community pharmacists. [Thesis]. Songklana-garind University. 2007.
Satayawongtip P, Maleewaong A, Sachawktee P, Kiasakol T, Asawatanabodee P, Busadee S, et al. Survey of health status and drug utilization of people in community. Research report, Health Systems Research Institute. [Online] 2003 Jul 31. [cited 2010 Apr 28]. Available from: http://dspace.hsri.or.th/dspace/handle/123456789/1331
The committee of Thai drug system analysis study 2002. Drug System of Thailand. Bangkok: Coopera-tive assembly of agriculture of Thailand. 2002.
Vasavid C, Tisayaticom K, Patcharanarumol W, Tang-charoensathien V, Lertpatraphong K. Health and welfare of Thai population after Universal Health Care Coverage (UC)-part II: house-hold health expenditure before and after UC. Journal of Health Science 2005; 14: 317-325.
Viboonphonprasert S, Yampayak N, Lawanprasert Y, Chutikul R, Dilokpattanamongkol S, Piya-pramote R, et al. Drug system of Thailand. Bangkok: Aroon Publishing. 1994.