A Review on the Selection of Drugs in Thai Heath Care at National, Pharmaceutical industries and Public Hospital Levels - การทบทวนการคัดเลือกยาในบริบทของประเทศไทยในระดับประเทศ สถานบริการสาธารณสุขและอุตสาหกรรมยา

Drug selection of pharmaceutical drugs plays a crucial role in management. We have identified three levels of the drug selection at country, hospital, and pharmaceutical industries. This study aims to describe the history, current situation of each level, and the success and challenges for further improvement. The finding revealed that the main criteria in drug selection are efficacy, safety, and quality for all levels, but the details may be different. Drug registration is an important regulation channel before drugs can be sold in the country. In addition, there is also a mechanism for surveillance and management to fulfill drug shortage and orphan drugs. The selection process of National List of Essential Medicine (NLEM) based on criteria national affordability, cost-effectiveness, and equity. At hospital level, there is the Pharmacy and Therapeutic Committee (PTC) to support effective and efficient medicine management through medicines selection and promoting safe and rational use of medicines but these can vary between hospitals. Pharmaceutical industries’ selection is driven by profitability and incentives provided by the government measures related to the targeted medicines, which encourage earlier generic entries either as locally produced or imported drugs. The challenge in the near future for the Thai FDA is the urgent revision of drug registration process according to importance based on risk evaluation. Additionally, information related to drug registration should be made publicly available through a public assessment report to promote transparency and allow other relevant government agencies, such as the Subcommittee on National Essential Medicine and hospitals to use the information for their selection processes.