Doctors at Thai state hospitals will now start prescribing traditional remedies for common illnesses, replacing five modern drugs that are being removed from the National List of Essential Medicines prescribed for free.
Health authorities have assured the public that these herbal options are effective and reduce reliance on pharmaceuticals – but many people are worried by the move.
Herbs instead of drugs
The Public Health Ministry recently removed analgesic balm (used to treat muscle pain), M. Tussis (flu symptoms), Carminative (bloating/flatulence), Bisacodyl (constipation) and Daflon (haemorrhoids), replacing them with Plai, Prasah Ma Waeng, turmeric, Alexandrian senna and veldt grape.
The Department for the Development of Thai Traditional Alternative Medicine (DTAM) says these herbal options are effective and guidelines have been provided to doctors on how they should be prescribed.
Traditional remedies have been included on the National List of Essential Medicines since 1999, though the shift towards herbal medicines accelerated last year in line with Public Health Minister Somsak Thepsutin’s policy to reduce imports of pharmaceuticals from the West.
The minister expects state hospitals to prescribe herbal medicines worth 1 billion baht in fiscal year 2025, anticipating a rise to 3 billion baht next year.
Meanwhile, the ministry has allocated 60 million baht in rewards as an incentive for hospitals to adopt the policy quickly.
Thailand’s 700-plus state hospitals will compete for 200,000-baht bonuses awarded to those who replace the modern medicines with herbal counterparts the quickest.
Over the years, DTAM, in partnership with the National Health Security Office (NHSO), has added 32 herbal remedies to the National List of Essential Medicines.
The NHSO manages the universal health scheme, which covers some 50 million Thais.
Safety concerns
MP Kalyapat Rachitroj of the opposition People’s Party has warned of potential dangers in the government’s push for traditional medicines.
She cautioned that prescribing certain herbal concoctions – including the newly endorsed Prasah Ma Waeng – to pregnant women poses risks, as they can affect foetal development.
“The ministry’s guidelines appear to restrict doctors from exercising their own judgement on prescribing medicines,” Kalyapat said in a Facebook post.
She warned that the top-down policy to expand use of traditional medicine may erode public confidence in the effectiveness of these herbal remedies in the long run.
She also queried the decision to have doctors trained in modern medicine prescribe traditional remedies, arguing that such treatments should be administered by traditional Thai medicine practitioners.
Some doctors are reportedly side-stepping the new guideline by issuing prescriptions but telling patients to have them filled at private pharmacies rather than at the hospital.
Critics have also highlighted a potential conflict of interest held by Department of Medical Services director-general Dr Taweesilp Visanuyothin, who served as director-general of DTAM from 2023 to 2024 before joining the board of Thai Herbal Product Co Ltd – a major manufacturer of herbal medicines – in July 2024.
The minister’s explanation
Minister Somsak has dismissed concerns about promoting herbal medicines at state hospitals, saying the budget for traditional remedies is minuscule compared to the 70 billion baht allocated every year for modern medicines.
“We are only promoting herbal medicines as an alternative, in the hope that this will reduce the reliance on chemical-based modern medication where possible,” he said.
Regarding the five modern remedies that have been removed from the essential medicines list, he said doctors can opt to prescribe other, equally potent drugs rather than the herbal replacements.
DTAM director-general Dr Somlerk Jeungsmarn said his department will strengthen communication with hospitals to improve understanding and implementation of the new prescription guidelines.
“We will also study the effectiveness of herbal medicines in the system,” he added.
