57 Comparison of Traditional Herbal Medicine and Standard Western Medicine in the Management of Dyslipidemia N. Kamkaen and N. Thongnopnua J. Wilkinson and M. Simpson Faculty of Pharmacy School of Biomedical Sciences Srinakharinwirot University Charles Sturt University Nakhon-Nayok, 26120 Wagga Wagga, NSW 2678 Thailand Australia Keywords: gemfibrozil, safflower, therapeutic efficacy Abstract A comparison of a traditional herbal and standard western medicine for dyslipidemia was conducted in 316 Thai patients. Therapeutic equivalence of five brands of gemfibrozil available in Thailand and the therapeutic efficacy of gemfibrozil compared with safflower were studied using a randomized controlled double-blind design. The purpose of this study was to evaluate the efficacy and safety of gemfibrozil or safflower on plasma lipid profiles. The therapeutic outcomes were demonstrated by measurement of the mean change in lipid profiles in terms of total cholesterol, total triglyceride, and HDL-cholesterol from baseline over a 6- month treatment period. Toxicity outcomes were monitored by assessing renal toxicity in terms of blood urea nitrogen and serum creatinine and hepatotoxicity in terms of serum glutamic oxaloacetic transaminase and serum glutamic pyruvic transaminase. These findings suggest that in Thai dyslipidemia patients, some effects are similar. Both gemfibrozil and safflower can safely and effectively decrease serum total cholesterol and increase HDL-cholesterol. Gemfibrozil, but not safflower, can also reduce serum total triglyceride. Cost-benefit and cost-effectiveness were analyzed to demonstrate the pharmacoeconomic evaluation of the physicians’ formulary decision-making in the management of dyslipidemia in Thailand. INTRODUCTION Therapeutic efficacy study of gemfibrozil was compared with safflower (Catharmus tinctorius Linn.) tea in Thai dyslipidemic patients and pharmacoeconomics compared in the management of dyslipidemia. Therapeutic efficacy of five brands of gemfibrozil available in Thailand compared with safflower tea as the alternative therapy in Thai patients who had dyslipidemia. The main outcome measure was the lipid profile: total cholesterol, total triglyceride and HDL-cholesterol. The lifetime cost-effectiveness and cost-benefit of five brands of gemfibrozil and safflower tea for the treatment of dyslipidemia were compared. The main outcome measure was the cost per year of life saved after discounting benefits and costs by 5% annually. The lifetime cost effectiveness of gemfibrozil and safflower for the treatment of primary hyperlipidemia varied according to patient population, the effectiveness of each drug in modifying lipid levels, and price of each drug. The importance of this study was relevant for one part of the health insurance concept to manage Thai health care system. MATERIAL AND METHODS Subjects Patients were recruited from the out patients department of the Sawangdandin Hospital, Sakon-Nakhon Province, Thailand. The inclusion criteria were that subjects have dyslipidemia (type IIa or type IIb), were either male or postmenopausal female aged 35-65 years without liver and kidney dysfunction and have total cholesterol of 200 to 250 mg/dL and total triglyceride 150 to 500 mg/dL. The method and study protocol had received prior ethical approval from Charles Sturt University, Australia and Srinakharinwirot University, Thailand and Sawangdandin Proc. WOCMAP III, Vol.6: Traditional Medicine & Nutraceuticals Eds. U.R. Palaniswamy, L.E. Craker and Z.E. Gardner Acta Hort. 680, ISHS 2005