Executive Summary
Total healthcare expenditure in Thailand amounts to approximately $25.3 billion. Costs are expected to increase to $47.9 billion by 2026, reflecting a ten-year compound annual growth rate of 6.6%. Healthcare expenditure as a proportion of GDP is also sizable at 6.6%. The Thai government allocates approximately 13.3% of its total budget to public health services, as Thailand’s Universal Coverage Scheme has been responsible for the rapid increase in demand for medical services and drugs since its initial introduction in 2002. Another factor is Thailand’s aging population: by 2021, 20% of the Thai population will be 60 years of age or older.
Thailand is recognized as one of the world’s most competitive destinations for high-quality and affordable care. Healthcare costs in Thailand are around only one-fifth of those in the United States and Europe. In 2016, the International Healthcare Research Center ranked Thailand’s medical tourism industry as sixth in the world based on the attractiveness of the destination and medical tourism costs. Healthcare in Singapore costs three times, and Malaysia two times, more than in Thailand.
Medical tourists coming to Thailand have in the past accounted for 38% of such visitors to Asia. According to Bangkok Dusit Medical Services PLC (BDMS), Thailand’s largest private hospital group, in recent years, medical tourism in Thailand has been growing at a rate of 16%. Private hospitals are equipped with the latest medical facilities and patients do not have to wait to obtain treatment. Doctors in the country are very well trained in the latest treatments and procedures, and hospitals are outfitted with the most cutting-edge medical technology. Additionally, doctors and other staff in the hospitals have fluent language skills, so patients have little to no communication issues.
Medical services in Thailand save a patient 50% to 75% on medical expenses they would have incurred for similar services in the United States. For example, the average cost of an MRI scan in the United States is $2,611; in Thailand, the same scan costs about $190. The average cost of Lasik vision surgery in the United States is about $2,250, while the same procedure can cost nearly half of that in Thailand. For more serious procedures like a heart-valve replacement including bypass surgery, the biggest savings can be realized. While this type of procedure might cost $75,000 in the United States, it is likely to cost only a third of that price in Thailand. Hip replacement in the United States can cost over $33,000. In Thailand the same procedure may cost only $13,000. Knee replacement surgery in the US can cost $30,000, but only $11,500 in Thailand.
As of May 2019, Thailand has 66 hospitals and healthcare institutions certified by Joint Commission International (JCI). Popular healthcare services among medical tourists include cosmetic surgery, dentistry, cardiovascular disease services, and orthopedic services. Apart from medical treatments, medical tourists also visit Thailand for health checks, cosmetic treatments (such as Botox), wellness, and traditional medicines.
The Royal Thai Government has approved 90-day visas for patients and medical visitors from China, Cambodia, Lao PDR., Myanmar, Vietnam, and the Gulf Cooperation Council (GCC) countries. The Ministry of Public Health has so far listed 118 hospitals and healthcare centers that are eligible to provide a confirmation letter to patients or visitors seeking medical treatment in Thailand.
Market Entry
U.S. manufacturers of healthcare products should work with qualified local distributors or representatives. Local agents will provide immediate access to an established marketing network and in-depth knowledge of regulations. A critical role of local representatives is to provide after-sales service support to customers and to develop and maintain strong personal relationships with customers. In Asia, relationships play a key role in business and greatly influence customers’ procurement decisions.
An agent’s role includes product marketing as well as product registration with Thailand’s Food and Drug Administration (FDA), which is required prior to any importation of medical devices, pharmaceuticals, or food supplements.
Current Market Trends
The private hospital sector is expanding rapidly following a rise in domestic demand and a surge in medical tourists. The number of international patients is increasing steadily, along with the number of expatriates living in Thailand and neighboring countries.
According to the Kasikorn Research Center, in 2017, foreign patients made 3.3 million visits to Thai hospitals, with 2.4 million for medical tourism and 900,000 by expatriates. Visits by patients from Japan, China and Myanmar are on the rise, while arrivals from the Middle East are decreasing.
Moreover, the Thai government is developing the Eastern Economic Corridor (EEC), which covers three provinces (Chacheongsao, Chonburi, and Rayong) to be the hub for Thailand 4.0 – an innovation-based economy. Healthcare projects located in the EEC are entitled to additional privileges such as a 50% corporate income tax reduction (for five years after the corporate income tax exemption expiry date), a flat personal income tax of 17%, and provision of a five-year work visa.
Market Size
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Healthcare spending (including investment)
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$1,051 billion
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… as percent of GDP
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6.6%
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Hospitals, Procedures, Healthcare Professionals
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Number of hospitals
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1,421
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…Public
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1,074
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…Private
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347
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Number of hospital beds
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157,072
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… available beds per capita
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2.4 beds: 1,000 population
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…of which in general hospitals
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122,470
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Physicians
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31,484
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…of which surgeons
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4,664
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…of which internists
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11,610
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…of which pediatricians
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5,329
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Dentists
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15,951
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Demographics
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Population
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69,302,725
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Life expectancy men/women
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77.01
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Infant mortality (per 1000 live births)
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9.2
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Percent of population older than 65
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12%
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…projection, 2030
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23.39%
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Annual deaths
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7.7 deaths per 1,000
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…caused by Cancer
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78,540 in 2018
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…caused by Stroke
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51,787 in 2018
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Prevalence of Heart Disease and Diabetes
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Heart disease, 432,943 (2018)
Diabetes, over 5 million (2018)
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Sources: WHO, Hfocus, World Bank; Institute for Population and Social Research; Mahidol University, Medical Council of Thailand, LeDuc Media, Statista, CIA World Factbook, Thailand Ministry of Public Health; Deloitte Thailand, Hfocus, Krungsri Research, Macrotrends, Bangkok Business News, Sun Institute, World Population Review
Main Competitors
Thailand’s medical device market was estimated at $2.7 billion in 2018. Imports of medical devices were approximately $2.1 billion; medical devices from the United States were valued at $441.2 million (20.5% of the imported products), followed by China (13.2%), Germany (9.8%), Japan (8.8%), and Ireland (6.1%). Local manufacturers of medical devices are mostly makers of single-use devices such as disposable test kits and syringes, surgical gloves and catheters. Over 80% of domestic production is exported.
Current Demand
As Thailand’s medical device market has continued to grow, there are many opportunities for American companies. The best areas include those related to surgical procedure equipment, respiratory devices and oxygen therapy, orthopedic implant devices, heart valves, neurosurgical devices, rehabilitation equipment, and dermatological devices. Products for elder care such as home-use blood pressure monitors, blood glucose meters, and wheelchairs will be in demand.
Diseases that are the leading causes of death for Thais are cancer, cardiovascular diseases, influenza and pneumonia, stroke, kidney disease, diabetes, Alzheimer’s disease, liver disease, HIV/AIDS, tuberculosis, hypertension, and asthma. Consequently, demand for medical devices and drugs for treating these diseases is significantly high.
Registration Process
Medical devices are required to be registered before they can be imported and sold in Thailand. The Thai FDA classifies medical devices into the following 3 categories:
Classification of Medical Devices
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Classification
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Type of Device
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Examples
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Risk Level
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Type of Regulation
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Class 1
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Licensed Medical Devices
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condoms, examination gloves, surgical gloves, sterile hypodermic disposable syringes, sterile insulin disposable syringes,
HIV test kits for diagnostic use, contact lenses
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High
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Require license for sale. Must show compliance with Thai Industrial Standards
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Class 2
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Notified Medical Devices
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physical therapy devices, alcohol detector, implanted silicone breast prosthesis, breast enhancement devices, HIV test kits
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Moderate
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Must register with TFDA but do not require license.
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Class 3
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General Medical Devices (lowest risk)
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This category includes about 90% of medical devices
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Low
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Must be validated by the Thai FDA
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Premarket Approval Process
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Class 1
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Class 2
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Class 3
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3-6 months
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3-6 months
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7 to 10 days
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Prepare application dossier which includes Certificate of Analysis from the Department of Medical Sciences (DMSc), stability data, clinical study and/or evaluation data, Thai label and leaflet, product formulae, and production procedure
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Prepare application dossier. This should include the same documents as Class 1 devices.
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Class 3 devices do not require a license. Documents to be submitted: product description/information, the catalogue, and Certificate of Free Sale (USFDA Certificate to Foreign Government) are required.
If sterile: ISO certification required.
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Documents will be reviewed by the Medical Devices Control Division and if verified, device will receive letter of approval for importation.
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Reimbursement
The key development in the Thai healthcare system occurred in 2001, when the Universal Healthcare Program was initiated. Under this system, patients may visit public hospitals where they previously registered. Then, most of the treatment costs are subsidized by the government. The system provides basic healthcare coverage to approximately 47.7 million Thais.
The Social Security Scheme (SSS), administered by the Social Security Office, was initiated to assure benefits for insured employees to mitigate their difficulties relating to illness, maternity, physical disability, unemployment, death and old-age pension. This scheme is financed by tripartite contributions from the government, employers, and employees. The SSS covers about 10.4 million private sector workers.
The Civil Servant Medical Benefit Scheme (CSMBS) is a medical service welfare system for civil servants, state enterprise employees and their dependents (including spouses, up to three children, and parents). The budgets of both government and state enterprises are the source of funding. The Civil Servant Medical Benefit Scheme provides healthcare benefits to approximately 4.9 million government workers.
The rest of population are those who do not intend to use the benefits described above and pay medical expenses themselves or via private, voluntary health insurance.
Barriers
Dealing with the regulatory requirements can be challenging for foreign companies that wish to export into Thailand. Therefore, it is important to seek experienced local partners and distributors who are familiar with product registration and dealing with Thai government agencies.
U.S. Commercial Service Contact Information
Name: Ms. Kornluck Tantisaeree
Position: Commercial Specialist
Email: ktantisa@trade.gov
Phone: +66 2 205 5242
