INCREASING HERBAL PRODUCT CONSUMPTION IN THAILAND DURING THE PERIOD 20012003

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INCREASING HERBAL PRODUCT CONSUMPTION IN
THAILAND DURING THE PERIOD 2001-2003

• Assoc Prof Dr Arthorn Riewpaiboon
• Department of Pharmaceutical Botany
• Faculty of Pharmacy
• Mahidol University
• Bangkok 10400 Thailand
• Email address pyarp_at_mahidol.ac.th

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Increasing Herbal Product Consumption in Thailand
During the Period 2001-2003 Riewpaiboon
A Faculty of Pharmacy, Mahidol University,
Bangkok 10400 Thailand. Problem Statement
Herbal products have increased importance in both
health care and business. Studies on consumption
of herbal products are pivotal in public health
planning. There has never been such a study
collecting data at drugstore level and covering
the whole country in Thailand. Objectives To
investigate expenditures and categories of herbal
product consumption in drugstores in
Thailand. Design Cross-sectional descriptive
research Setting Registered drugstores. Study
Population Drugs and foods produced from herbs
sold in all registered drugstores in Thailand.
Methods The country was first divided into 13
regions. One province was selected from each
region by convenience sampling. Drugstores in
each province were categorized into 3 types based
on their registration status Type 1 (eligible to
sell all drugs), Type 2 (eligible to sell
ready-packed modern and traditional drugs), and
Type 3 (eligible to sell traditional drugs).
Finally, drugstores were included at a proportion
of 1 of the population in each type by a
convenience sampling method. Purchasing documents
for herbal products sold in the drugstores were
collected for two consecutive months during
September-December 2001 and March-April 2003.
All items of these products were classified into
groups by their indications. Purchase prices
(wholesale prices) were used to calculate the
values of herbal products obtained in each store
per study period. The medians were converted to
annual values for each type of store, then
derived estimates for the whole country. Results
The sample included 129 and 121 drugstores in
2001 and 2003, respectively. Total consumption
was 27 million US in the year 2001(1 US 40
Thai baht), or amounts of US13 million, 8
million, and 6 million from type 1, 2, and 3
drugstores respectively. The total consumption
increased to 32 million US in 2003. At constant
prices, this represented an increase of 11.
Focusing on type of drugstores, the changes were
32, 24 and -52 for type 1, type 2 and type
3 respectively. Based on retail prices (78
mark-up), the five top-ranked categories of
products used in 2003 were haematonics (valued at
US14.4 million 26 of total value), post
delivery drugs (5.3 million 10),
anti-constipation (5.1 million 9), anti-cough
(4.9 million 9) and Yahom or cardiotonics
(4.1 million 7). Conclusions Herbal product
consumption increased by 11 from 2001 to 2003.
A decrease in consumption in type 3 drugstores
might be explained by their decreased popularity.
To cover the full range of consumption of herbal
products, further studies should include other
outlets e.g. hospital and direct sales. Due to
high and increasing sales volume, drug use
evaluation of herbal products should be
conducted. Study Funding The National Research
Council of Thailand
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• PROBLEM STATEMENT
• Popularity of herbal utilization has
  dramatically increased in Thailand during the
  past decade. Herbs were always promoted based on
  their values of both health and economic aspects.
  A number of herbal drugs have been incorporated
  into the national essential drug list.
  Similarly, herbal products have been promoted as
  a part of national economy development. To
  achieve these policies, in terms of planning,
  information on utilization or consumption is
  pivotal. There are some reports on herbal
  product consumption e.g. from surveys and
  manufacturing reports to the Food and Drug
  Administration , but they are not consistent.
  There has never been such a study collecting data
  at drugstore level and covering the whole
  country. So, we do not know real situation of
  consumption. This is a basic problem to further
  studies on interventions pursuing cost-effective
  use of herbal products.

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OBJECTIVE The study was designed to investigate
expenditure and categories of herbal product
consumption in drugstores in Thailand. STUDY
DESIGN Cross-sectional descriptive
research. SETTING Registered drugstores. STUDY
POPULATION All drugstores in Thailand (13,105
stores in 2002). METHODS Scope Herbal products
in this study cover drugs and foods produced from
herbs i.e. traditional drugs (produced based on
knowledge of traditional medicine), herbal drugs
(produced based on integration of traditional and
simple modern knowledge and technology), food
supplement and herbal beverage.
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• METHODS (Continued)
• Sample size and sampling techniques
• The country was first divided into 13
  regions. One province was selected from each
  region by convenience sampling method. Drugstores
  in each province were categorized into 3 types
  based on registration i.e. type 1 (eligible to
  sell all drugs), type 2 (eligible to sell
  ready-packed modern and traditional drugs) and
  type 3 (eligible to sell traditional drugs).
  Finally, the drugstores were included at a
  proportion of 1 of the population in each type
  by convenience sampling method (Figure 1).
• Data collecting Purchasing documents for herbal
  products sold in the drugstores were collected
  for two consecutive months during
  September-December 2001 and March-April 2003.
• Analysis All items of the products were
  classified into groups by their indications.
  Purchasing prices (wholesale prices) were used to
  calculate the values of herbal products obtained
  in each store per study period. The median values
  were converted to annual values. Finally, the
  annual values of drug store types were used to
  derive estimates for the whole country.
  Percentage mark-up was employed in estimation of
  expenditure at retail prices (Figure 2).

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Figure 1 Diagram of sampling methods.
Thailand
Stratified sampling
13 areas 12 Public health regions and Capital
city (Bangkok)
Convenience sampling
13 provinces one province from each area
Stratified sampling
Classify drugstores in each province into type 1,
type 2, type 3
1 by convenience sampling
132 samples from all 3 types in 13 provinces
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Figure 2 Analysis chart.
Percentage calcu- lation by indica- tion groups
Grouping by indications
Items and their values of individual store
for 2 months
Country volume per year by indication groups
Mark-up adjusting
Proportion adjusting to 1 year
Number of stores adjusting to the country

• Medians of
• total
• values by
• drugstore
• groups
• Bangkok
• type1
• - type2
• - type3
• Provincial
• type1
• -type2
• - type3

Volume at wholesale prices per drugstore per
year
Country volume at wholesale prices per year
Country volume at retail prices per year
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• RESULTS
• The sample included 129 and 121 drugstores in
  2001 and 2003, respectively. Total consumption
  was 27 million US in the year 2001(1 US 40
  Thai baht), or amounts of US13 million, 8
  million, and 6 million from type 1, 2, and 3
  drugstores respectively. The total consumption
  increased to 32 million US in 2003. At constant
  prices, this represented an increase of 11.
  Focusing on type of drugstores, the changes were
  32, 24 and -52 for type 1, type 2 and type
  3 respectively (Table 1, Figure 3). Market
  structure classified based on location and
  drugstore types is composed of type 1, type 2 and
  type 3 drugstores in Bangkok, and type 1, type 2
  and type 3 drugstores in provincials. Sale
  volumes in 2003 were 4.2, 1.4 and 0.6 million
  US in Bangkok drugstores, and 13.7, 9.2 and 2.4
  million US in provincial drugstores respectively
  (Table 2, Figure 4). Consumption in Bangkok
  (19) was accounted for one-fifth of the total
  amount. This was corresponding to the population
  proportion. In terms of drugstore types, in
  2001, consumptions in type 1, type 2 and type 3
  were 48 , 30 and 22 respectively. The market
  structure changed in 2003, consumptions in type
  1, type 2 and type 3 were 57 , 34 and 9
  respectively.

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RESULTS (Continued) Based on retail prices (78
mark-up), the five top-ranked categories of
products used in 2003 were haematonics (valued at
US14.4 million 26 of total value), post
delivery drugs (5.3 million 10),
anti-constipation (5.1 million 9), anti-cough
(4.9 million 9) and Yahom or cardiotonics
(4.1 million 7) (Table three, Figure 5). These
major indication groups were accounted for
approximately 60 of the total consumption. DISCU
SSION It is essential to keep in mind that the
herbal product consumption in drugstores is just
one part of the total amount. Another outlet of
consumption is direct sales. This is expected to
be huge. But there is no specific study on
consumption via this channel. Based on magnitude
of consumption by indication groups, generally,
it implies to types of illnesses. However, in
case of herbal drugs, indication classification
system is based on the concept of holistic
medicine. Each drug may have more than one
different indications.
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Table 1 Increasing consumption during the
period 2001-2003 at constant price
calculated based on wholesale
price.
Producer Price Index in 2001 and 2003 102.5
and108.4, respectively. Based year is 2000.
Figure 3 Graphically demonstration of table one.
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Table 2 Total herbal consumption at wholesale
prices in the year 2003.
Figure 4 Graphically demonstration of table two.
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Table 3 Top five rank of highest amount of
products in 2003.
Figure 5 Graphically demonstration of table three.
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• DISCUSSION (Continued)
• In this study, the drugs were classified based
  on only the first indication stated.
• While overall consumption was increased, the
  decreased consumption in type 3 drugstores might
  be explained as a decrease in popularity of such
  drugstore. Type 3 drugstores legally provide
  services by traditional registered pharmacist and
  provide a limited goods. While in type 2 and 3
  provide more goods. So, customers can have what
  they need in one stop.
• CONCLUSIONS
• Herbal product consumption increased by 11 from
  2001 to 2003. A decrease in consumption in type
  3 drugstores might be explained by their
  decreased popularity. To cover the full range of
  consumption of herbal products, further studies
  should include other outlets e.g. hospital and
  direct sales. Due to high and increasing sales
  volume, drug use evaluation of herbal products
  should be conducted.