Social Return on Investment of Establishing a Cancer Drug Fund in Thailand

Abstract

Cancer remains the leading cause of death in Thailand, with 336 new cases and 221 deaths daily, yet access to high-cost cancer therapies under the universal health coverage system remains limited. This disparity creates significant treatment inequities and highlights the need for innovative financing mechanisms to expand access to life-saving drugs. Drawing lessons from the United Kingdom’s Cancer Drug Fund, this study evaluates the potential social return of establishing a similar fund in Thailand. A two-pronged framework was adopted to quantify social benefits: (1) improvements in quality of life, measured by changes in Disability-Adjusted Life Years using an Interrupted Time Series with Control Group model comparing the United Kingdom (treatment group) and Germany (control group), and (2) reductions in inequality of health access, assessed using the Transferability of Economic Evaluation framework by applying per-patient cost data from the UK CDF to the Thai context. Monetary values were derived using Thailand’s GDP per capita as a financial proxy. The ITSCG analysis indicated a reduction of 16.95 DALYs per 100,000 population associated with CDF implementation, equivalent to THB 3,381.76 million in social value. In addition, under a simulated annual budget of THB 15,000 million, expanding access to high-cost cancer drugs was estimated to benefit 8,367 patients, generating THB 14,808.68 million in social value. Combining these outcomes, the total social benefit was estimated at THB 18,190.45 million, yielding a Social Return on Investment ratio of 1.21. These findings suggest that establishing a CDF in Thailand could deliver a substantial positive social return by improving health outcomes, reducing access inequalities, and alleviating the long-term burden of cancer. Policy adoption of such a fund could enhance equity, ensure financial sustainability, and strengthen Thailand’s public health system