Voices from psychiatric patients bear medication costs of tens of thousands of baht per dose, highlighting the need for government support to unlock quality drugs at affordable prices.
In a report by Thairath Online's special news team, a psychiatrist revealed that some essential drugs produced by Thai state agencies are sold at higher per-pill prices than private-sector medicines, leading to an exposé titled “Psychiatric drugs are expensive; doctors call for identifying causes and unlocking solutions.”
The team interviewed psychiatric patients on this issue; many said "psychiatric drugs are expensive" due to different factors. Some patients took essential drugs but did not improve, forcing them to use non-listed medications with costs beyond the National Health Security coverage, which can be quite high, sometimes causing them to stop treatment or borrow money due to insufficient funds.
This reflects the pricing structure for psychiatric patients' medications, most of whom face financial problems, further intensifying chronic stress.
Speaking clearly even via video call, Ms. Sasivimon Chaibundit, 55, told Thairath Online that she has sought treatment from many places—public and private hospitals, psychiatric clinics, and state psychiatric hospitals—requesting doctors to prescribe "medications that do not cause weight gain." This condition led her to pay for non-listed medications, resulting in very high treatment costs of tens of thousands of baht per session.
Ms. Sasivimon shared that she has had panic disorder since she can remember, caused by a strict family environment that made her fearful and unhappy. She wanted to leave home to build her own family to escape pressure, but her family continued to support her in every way, making her feel that "her family controlled her life."
She first saw a psychiatrist near her menstrual period due to mood swings and her husband noticing she was "not normal." However, the doctor explained her symptoms were due to premenstrual syndrome.
Ms. Sasivimon grew more fearful of her family and began treatment at a psychiatric clinic, where she was referred to a therapist. After only 3-4 sessions, she felt more afraid because therapy seemed to dig into past wounds, so she decided to stop treatment.
Later, Ms. Sasivimon received treatment at a premium public hospital, taking medication for about a year at an average cost of 3,000–4,000 baht per month. However, the medication caused weight gain, which concerned her most, leading her to stop the medication again. When she stopped, her condition worsened severely, even having self-harm thoughts, prompting her to consult an online psychotherapist who advised going immediately to the emergency room.
After asking people around her, she found no one else paid such high medication costs, raising doubts about whether she was "sicker" than others, since many used public hospital services with gold card coverage paying only 200–300 baht per visit.
She then chose to be treated at that hospital, where they asked if she wanted to use the gold card. She refused, having heard that medications were cheaper. However, actual treatment cost 8,000 baht per month, and she could only afford 4 months before stopping again.
"If I have to take medication costing 8,000 baht every month for life, I don't think I can manage. No one can, even if they are rich."
Ms. Sasivimon said after stopping medication, her symptoms worsened again, so she sought treatment at a psychiatric clinic, but the doctor was the same as before, resulting in medication costs differing by only 500–1,000 baht. She could only afford two courses before stopping due to financial strain. Currently, she returns to the premium public hospital, paying about 3,000 baht monthly, mostly for non-listed drugs.
"I want the government to implement measures to help, using better standard drugs for psychiatric patients, not ones causing other side effects. For example, if you are stressed and see a doctor, you pay money and then take medication that causes weight gain. If the medication has side effects, we don't want to take it. When we refuse medication, we stop treatment, and the illness worsens."
Ms. Sasivimon added that although her monthly expenses have dropped to about 3,000 baht, every three-month psychiatrist appointment requires paying 8,000–9,000 baht for medications, forcing her to cut other costs such as pet food and non-essential expenses wherever possible.
"I asked a doctor why psychiatric medications are so expensive. The answer was always that these are non-listed drugs. When I asked why doctors don't prescribe listed drugs, the doctor replied, 'You said you don't want to gain weight.' I didn't know how to argue further."
When asked if including non-listed drugs into the system to reduce prices would be a solution, Ms. Sasivimon said, "Yes, if the government can do that, it would be very good."
"I want the government to help improve drug quality and include medications with the fewest side effects into the system, making prices affordable through state support. It shouldn't be that if you have no money, you receive random drugs, while those who can afford it get better ones without side effects. That is unfair."