Sources and Distribution of Unlawful Medicines in 8 Provinces of Thailand to Inform The Public Policy Change

Abstract

Introduction: According to the current law governing the medicines in Thailand (Thailand Drug Act,B.E 2510), selling medicines outside of registered pharmacies is not allowed except Over-The-Counter (OTC) medicines which have been approved for general distribution. Despite this law, general distribution of restricted medicines is occurring. This activity is of concern because of the increased possibility of harm. Methods: Data from 8 hospitals in 8 provinces showed that 18 % of adverse drug reactions (ADRS) cases were from unlawfully dispensed medicines. This survey was conducted to track original sources of medicines and distribution routes and non appropriate medicine from 613 groceries in 8 provinces of Thailand. Patients who have been affected by ADRs were evaluated. Results: After investigating non-pharmacy stores, several types of drug were found including dangerous drugs (30.9%), common household drugs (21.8%), ready packed modern drugs (20.3%), Thai traditional drugs (13.6%), mixed medicine packaged in a set with steroid and antibiotic (“Ya-Chud”) (4.4%), herb medicine (0.9%), special control medicines (0.4%). Further investigation showed that these stores received their supplies from several sources. There were wholesale dealers (32.5%), drug stores type 1 (31.5%), drug stores type 2&3 (14.7%) food trucks (11.5%), department stores (7.7%), others (2.6%). Routes of distribution were direct delivery, postal service and medicine trucks, the trucks that travel to village and entertain villagers with various shows, i.e.animal shows or movies. At the end of the shows, sellers will sell medicines to audiences. Additionally, in household we found stockpiles of medicines waiting to be distributed. Findings have been forwarded to 8 Provincial Public Health Offices. The FDA, the Drug System Monitoring Development Program (DMD) and the Regional Medical Science Center. Conclusion: The data gathered in order to inform the public policy changes, improve medicine distribution channels and protect consumers by limiting access to potentially harmful medicines without professional medical consultation and authorization.