Hospitals have usually sold medicines at a rate much higher than actual cost, according to a study by the Thailand Development Research Institute (TDRI).
The study said each paracetamol tablet, for example, was available at just Bt1 at general drugstores but inpatients and outpatients at hospitals have usually been required to pay at least Bt10 per tablet and Bt3 respectively.
"Inpatients have been charged more because they are unable to refuse the medicines given to them," the study pointed out.
According to the study, although most outpatients have bought medicines prescribed by doctors from hospitals they are visiting, they still have the choice of not accepting the medicine if the price is too high. Therefore, the hospitals have tended to charge them less when compared with inpatients.
The TDRI forwarded the study's findings to the Department of Intellectual Property (DIP) earlier this year.
The study recommended that the government lay down an efficient system for monitoring medicine prices at both state and private hospitals to prevent unfair pricing and to encourage efficient drug prescription.
"The government needs to pay special attention to private medical facilities that have now eaten two thirds of the medical cost in the country," the study said.
It also suggested that the government consider taking necessary actions in ensuring that the price of patent medicines is not too high.
Some foreign countries have already proceeded through available legal channels in tackling the problem of expensive patent medicines. Nongovernmental organisations in South Africa, for instance, called on the country's trade competition commission to take action against GlaxoSmithKline in 2002 for charging too high for its Aids drugs. In the end, the patent owner agreed to let three local drug manufacturers churn out similar drugs to help patients in South Africa and nearby countries.
"Laws about trade competition and monopoly can be invoked to ensure that the medicine price is not too high," the study said.
According to the study, the government has suffered direct consequences from the unnecessarily high medicine prices. As the government has paid medical facilities based on services given to civil servants and their family members, it has shouldered a huge cost. The ComptrollerGeneral's Department has to reimburse money for these medicalservice providers.
In 2005, the total reimbursement amount stood at around Bt30 billion. However, the figure has soared, to more than Bt60 billion last year.
According to the ComptrollerGeneral's Department, up to Bt 40billion were for medicines.
The huge amount of money spent on medicines has raised concerns that the medicalservice providers might have deliberately prescribed unnecessarily expensive medicines for patients.
Widespread arguments are that hospitals have to charge high for medicines because they need money to offset heavy burden from the government's universal healthcare scheme.
The scheme basically has offered free treatments for more than 45million people. Apart from their heavy workloads, state hospitals have limited budgets also because the government has provided perhead subsidies, not fees for service.
However, a recent seminar was told that the Public Health Ministry's remaining cash amount had increased over the past several years. In 2002, the year universal healthcare was introduced, the remaining cash amount was at Bt14.6 billion. Last year, the remaining cash amount was at Bt42.96 billion.
The TDRI, therefore, has questioned whether the state hospitals are really operating at a loss. It also pointed out that even if the state hospitals had suffered from financial losses, it was not right to prescribe unnecessary drugs.
"All medicines have side effects," it said.