Regulatory evolution and service delivery models of telepharmacy in Thailand: a review of pandemic responses and future policy directions.

BACKGROUND: The COVID-19 pandemic accelerated digital health adoption in Thailand, disrupting traditional healthcare delivery and prompting rapid pharmaceutical system reforms. Prior to 2020, telepharmacy was virtually non-existent due to strict regulations mandating in-person dispensing at licensed premises; however, the public health crisis prompted policy changes, leading to regulatory relaxation and the formal establishment of telepharmacy standards. To understand these transformative shifts, this review examines the regulatory evolution of telepharmacy in Thailand, classifies diverse service delivery models implemented across hospital and community pharmacy settings, and synthesises effectiveness evidence to inform future pharmaceutical policy and sustainable system integration. METHODS: An integrative narrative review using documentary analysis of official policy and regulatory documents was conducted. Studies evaluating telepharmacy or medication delivery services were identified through PRISMA-guided searches of Thai-Journal Citation Index (TCI), PubMed, and Google Scholar (2020-2025). RESULTS: Thailand implemented a phased policy response progressing from emergency regulatory flexibility toward institutionalised governance. Seven hospital-based telepharmacy models were identified. Synthesis of 31 included studies (14 pharmacist-led and 17 telemedicine with medication delivery or medication delivery without pharmacist counselling studies) suggested that telepharmacy and medication delivery services generally supported continuity of care for chronic diseases. Studies involving pharmacist interventions more frequently reported favourable outcomes, although findings varied across service models. Implementation relied largely on social media platforms and proprietary applications, though independent pharmacies faced financial barriers to accessing certified platforms. CONCLUSION: While telepharmacy has been integrated into routine care under the Universal Coverage Scheme (UCS), an institutionalisation gap remains regarding sustainable public financing and digital infrastructure. Addressing regulatory clarity, reimbursement mechanisms, digital equity, and platform interoperability will be essential for the long-term and equitable integration of telepharmacy.