Table 3

Medications for paediatric ALL—estimated volumes needed, cost and actual sales in Thailand in 2017 and 2021

RouteSmallest unit2017Percentage2021
Total smallest unitsExpenditure (US$)Total smallest unitsExpenditure (US$)
DXDX +uDXDXDX +uDXDXDX +uDXDXDX +uDX
AsparaginaseIM10 0004,607(10,365)7719225 847378 39427.743487263236 209394 571
MethotrexateAll213 031356 92526.1222 654371 993
MethotrexateIntravenous5083 180139 364190 358318 93478 482131 109199 042332 511
MethotrexateOral2.5235 036393 79819 28532 311221 110369 70120 10533 617
MethotrexateIT10673011 28133885680628510 51235075865
MercaptopurineOral50223,501(340,035)374 472164 313275 30320.2210 281351 584171 324286 448
CytarabineIntravenous10018 90531 67473 572123 2689.017 79829 75276 763128 319
VincristineIntravenous117 36329 09270 469118 0708.616 34127 32073 507122 891
TioguanineOral405429909612 01120 1251.55107853912 52220 938
MitoxantroneIntravenous1011218811 58619 4131.410517612 08120 199
DoxorubicinIntravenous1034015698970516 2601.23211536310 15516 961
CyclophosphamideIntravenous50013862322655110 9760.813092186685411 448
EtoposideIntravenous100375628211235380.358922023681
LeucovorinIntravenous303438576121 03035 2362.63235540921 92836 663
MESNAIntravenous4008221378256542980.3780130124014004
PrednisoloneOral5183 024306 654186331220.2172 180287 88919433249
DexamethasoneOral221 04835 2652954940.019 80133 107307514
Antineoplastic agents789 1981 322 272824 2701 377 449
Chemoprotective agents25 75443 14926 57944 430
Total expenditure on antineoplastic and chemoprotective agents814 9521 365 422850 8491 421 880
Total health expenditure (in million constant (2017) US$)17 055
Percentage of total health budget0.0050.008
  • Route of administration: (volume sold) is provided for medicines used mainly for the treatment of paediatric ALL. Tioguanine is also known as thioguanine.

  • Source: Authors’ estimation based on Thai ALL treatment protocol,31 incidence data,12 IQVIA sales data, WHO Global Health Expenditure Database.37

  • ALL, acute lymphoblastic leukaemia; DX, diagnosed; DX+uDX, diagnosed and undiagnosed; IM, intramuscular; IT, intrathecal.