This talk will provide an overview of the current pharmacogenomics practices and research in Thailand, address the challenges and lessons learned from delivering clinical pharmacogenomic services in our country, emphasize the pharmacogenomics implementation issues that must be overcome, and identify current pharmacogenomic initiatives and plans to facilitate clinical implementation of pharmacogenomics in Thailand.

Since the pharmacogenomics research began in 2004 in Thailand, a multitude of pharmacogenomics variants associated with drug responses have been identified in the Thai population, such as HLA-B*15:02 for carbamazepine and ox-carbazepine, HLA-B*58:01 for allopurinol, HLA-B*13:01 for dapsone and cotrimoxazole, CYP2B6 variants for efavirenz, CYP2C19 for clopidogrel, TPMT and NUDT15 for thiopurine drugs etc. Generally, the successful implementation of pharmacogenomics in routine clinical practice will improve drug efficacy and reduce adverse drug reactions, and decrease the overall cost of health care with the reduction in adverse drug reactions. Practically, the collaborative research is needed for evidence to support the utility of pharmacogenomics in Thailand, reimbursement for pharmacogenomics test is a contentious matter, IT infrastructure should be developed within the hospitals to inform clinical decision-making, and knowledge of pharmacogenomics is lacking or inadequate among the health workforce. Although several challenges play a role in the implementation of pharmacogenomics in clinical care across Thailand, we see the acceleration of the clinical implementation of pharmacogenomics to improve healthcare and to be cost-effective in Thailand.