Alternatives To Thailand: Pharmacy Drug Situation

[Khaeng Mak]

Given the recent immigration rule changes and the impact they have had on my life here in Thailand, I am reading, with interest, the many new posts discussing the ins and outs of alternative retirement destinations.

 

One thing that I do like in Thailand is the fact that I can usually buy the medication that I need from a local Pharmacy without a prescription.

 

This saves me some money but more importantly at my age, it saves me time.

 

I was in a remote area of Malaysia last year and needed some amoxicillin.  It was a massive all day ordeal to sign up at the local clinic, join the massive cue to see a doctor, get the prescription, and then buy the antibiotic.

 

In Thailand I can just walk into any pharmacy and buy a sheet of 10 amoxicillin capsules for 50 baht.

 

I have been here a long time so I am well aware that some drugs require a prescription here also. But for many medications, such as antibiotics and my blood pressure pills, I do not need to go to the doctor first.

 

I would like to discuss whether a prescription is required in the following countries. If you have actual experience please share your knowledge. Perhaps we can create a list. And general comments on the price of drugs (cheaper or more expensive that Thailand) should also prove useful:

 

Malaysia (Prescription required. More expensive)

Indonesia

Philippines

Vietnam

Cambodia

China (Mainland)

Taiwan

 

These are the alternative retirement destinations that are of interest to me.  However, I note that many are discussing South American and Southern European options. Please add those to this discussion if you wish.

 

 

 

[uhuh]

Common antibiotics or blood pressure pills can be bought without prescription in all of these countries. 

Indonesia: what is available maybe very different from what is available in the West (and what you may be used to). Cheap.

Vietnam: it can be very difficult to find a pharmacy.  Stock may be very limited. 

China: the pharmacist will not know the English names of medication. 

Taiwan: more expensive than Thailand (still cheap though) but overall similar situation. 

[Sheryl]

Cambodia is even more liberal than Thailand in terms of what is sold over the counter. BUT care has to be taken to avoid counterfeit drugs and the quality of medical care, when you do need a doctor, is abysmal. Not a good location for an older person ir anyone with chronic medical conditions.

 

Viet Nam is better in that regard but thete too, have to be wary of counterfeit drugs. In fact most of the counterfeits in Cambodia come in from VN.

 

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[Jingthing]

Mexico, Columbia, Argentina, Ecuador and Peru (and no doubt others) -- you can buy meds without scrips but not certain of specific restrictions in specific countries.

[NancyL]

In the Malaysian states in Borneo, I was able to buy blood pressure meds over the counter at a pharmacies.  About the same price as Thailand for generics.  Believe me, I needed them because the extra-salty Malaysian food was driving my BP through the roof.  Difficult to find a good salad, especially in Sarawak.

[Jingthing]

Omg I am so sorry I spelled Colombia wrong. That is a serious offense. Blame it on the software.

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[GinBoy2]

I liked the fact that I could go into a pharmacy and buy drugs without a prescription. 

 

However it fosters a self medication mindset. 

 

I 'thought' I had eczema or psoriasis under my eye, and was buying prescription strength cortisone cream.

 

When the last cream made it super angry, I finally went to a Doctor, where I thought I would just get a prescription for a different cream.

 

Turned out I had Bowens Disease, a mild form of skin cancer.

 

There are reasons, which learned to my cost, about why medication usually requires a Doctor's script! 

[Khaeng Mak]

5 hours ago, GinBoy2 said:

I liked the fact that I could go into a pharmacy and buy drugs without a prescription. 

 

However it fosters a self medication mindset. 

 

I 'thought' I had eczema or psoriasis under my eye, and was buying prescription strength cortisone cream.

 

When the last cream made it super angry, I finally went to a Doctor, where I thought I would just get a prescription for a different cream.

 

Turned out I had Bowens Disease, a mild form of skin cancer.

 

There are reasons, which learned to my cost, about why medication usually requires a Doctor's script! 

Hi.  Thanks very much for your input.  However please keep this thread on track. I do not want it to devolve into a debate about the merits or otherwise of self medication.

 

I am happy to self medicate and have been doing if for decades. But only for minor issues.  I would never move to a country where I would lose a half day of my precious time just to get some antibiotics.

 

I also self medicate my pets. 

[Khaeng Mak]

14 hours ago, Sheryl said:

Cambodia is even more liberal than Thailand in terms of what is sold over the counter. BUT care has to be taken to avoid counterfeit drugs and the quality of medical care, when you do need a doctor, is abysmal. Not a good location for an older person ir anyone with chronic medical conditions.

 

Viet Nam is better in that regard but thete too, have to be wary of counterfeit drugs. In fact most of the counterfeits in Cambodia come in from VN.

 

Sent from my SM-J701F using Thailand Forum - Thaivisa mobile app

 

 

 

 

Are counterfeits a problem here Sheryl?  Cant say I have ever suspected anything I have bought here to be fake.

[Sheryl]

11 hours ago, Khaeng Mak said:

Are counterfeits a problem here Sheryl?  Cant say I have ever suspected anything I have bought here to be fake.

Only in tourist areas and only for certain drugs specifically aimed at tourists e.g. Viagra, Cialis, Xanax etc.  Prescription-only or controlled drugs seemingly sold on the street openly ---> usually fake.

 

Other than this no, not common here.

 

In Camb and VN the fakes are especially the French import name brands as these sell for enough to be worth counterfeiting..

[Khaeng Mak]

33 minutes ago, Sheryl said:

Only in tourist areas and only for certain drugs specifically aimed at tourists e.g. Viagra, Cialis, Xanax etc.  Prescription-only or controlled drugs seemingly sold on the street openly ---> usually fake.

 

Other than this no, not common here.

 

In Camb and VN the fakes are especially the French import name brands as these sell for enough to be worth counterfeiting..

Thanks for that.  So basically if I buy my stuff from a pharmacy and not a hawker or street vendor in tourist trap area not much chance of getting a fake.

[Sheryl]

Correct.

[connda]

It's actually interesting to see what is legal and OTC here but illegal even though the drug is legal and OTC in other countries.  Pseudoephedrine (decongestant) is illegal here without a prescription which doctors here seem reluctant to give you.  Pseudoephedrine is a precursor to methamphetamine and the government is afraid you will take your 30 tablets of Pseudoephedrine, grind them up, and make a few micro-grams of meth out of them even though it completely beyond the capabilities of anyone but hard-core meth cooks (Think Breaking Bad).
Likewise, the mild stimulant, Kratom, isn't even legal to possess or to dispense in Thailand, but it can be openly purchase in the US and other Western countries. 
But, as you said, all sorts of other meds that would initially cost you price of a doctor's visit in the West and other countries are easily available here.  At the end of the day I prefer Thailand over the West in this regard.

[zlodnick]

Do doctors actually give you a prescription you can take to a pharmacy to buy meds?

 

I have always gotten the drugs from the doctor or hospital.

[skatewash]

23 minutes ago, zlodnick said:

Do doctors actually give you a prescription you can take to a pharmacy to buy meds?

 

I have always gotten the drugs from the doctor or hospital.

 They will if you ask.  You pay quite a high premium for drugs dispensed from a hospital (at least a private one, like the Bangkok Hospital group).  There may be times when that convenience (or unavailability elsewhere) makes it worth it, but mostly all my long-term prescriptions are filled outside of a hospital at a local pharmacy (Supercheap in Phuket).  I've wondered if they could be purchased more cheaply from an online source in Thailand but I never really pursued that avenue.

 

I should correct this.  I've never gotten a "prescription" from a doctor, they just write down the name of the drug or tell me the name of the drug and give me dosage instructions.  Sometimes they will even point me to a particular pharmacy or doctor's clinic where the drugs can be purchased.  They mostly understand there's a high markup on the hospital dispensed drugs and so they are pretty cooperative about alternatives especially if they understand you are self-insuring.

[Sheryl]

"Prescriptions" in the sense of a  document complete with doctor license number  that makes it legal for you to purchase a prescription only drug in a pharmacy do not seem to exist here, and very, very few pharmacies stock prescription-drugs with the exception of ED drugs. For those they will accept any sort of note from a doctor.

 

One of the reasons the prescription pad system isn't here, is that almost everything is sold without prescription.

 

Private hospitals do mark up drug prices enormously, so find out what the medication is and buy it yourself at a pharmacy.

[atyclb]

2 hours ago, connda said:

It's actually interesting to see what is legal and OTC here but illegal even though the drug is legal and OTC in other countries.  Pseudoephedrine (decongestant) is illegal here without a prescription which doctors here seem reluctant to give you.  Pseudoephedrine is a precursor to methamphetamine and the government is afraid you will take your 30 tablets of Pseudoephedrine, grind them up, and make a few micro-grams of meth out of them even though it completely beyond the capabilities of anyone but hard-core meth cooks (Think Breaking Bad).
Likewise, the mild stimulant, Kratom, isn't even legal to possess or to dispense in Thailand, but it can be openly purchase in the US and other Western countries. 
But, as you said, all sorts of other meds that would initially cost you price of a doctor's visit in the West and other countries are easily available here.  At the end of the day I prefer Thailand over the West in this regard.

 

i went to a pharmacy in sri lanka looking for a few pseudofeds for a cold and sinus problems and the pharmacist said not available and he was very critical of his government telling me morphine tablets are abundant and over the counter no rx but no relief for sinusitis.

[DJ54]

1 hour ago, skatewash said:

They will if you ask.  You pay quite a high premium for drugs dispensed from a hospital (at least a private one, like the Bangkok Hospital group)

I asked my regular Dr. at hospital And he told me which ones could

be bought at ....which was all but one. At hospital was 22,000 for two months. Now it’s 4,000 a big relief. The other one the hospital pharmacy doesn’t carry but will order for you.

 

China a lot of meds need prescription..... and Visa can be a headache. I lived there 10+ years.

 

The regular Chinese hospitals I went because sore shoulder. I had to get a cortisone shot. See the Dr. given a prescription go downstairs they give you medicine and syringe then you take it

back to Dr. to get shot. 

 

There was an Taiwan/China hospital that was very good but more money 

 

[Khaeng Mak]

Thanks for all the input.  Looks like this thread is heading in a nice and useful direction.

 

A couple of points.

 

1. Yes, never get your pills or creams at the hospital. Especially if it is a private one.  However, in some cases the hospital might have a drug that is not available at a local pharmacy.

 

2. The big Supercheap in Phuket does have a good wholesale pharmacy inside.  But when asking for your drugs the staff will usually give you the most expensive option.  Always ask "mee brand tuug mai". By doing this I recently found a alternative blood pressure med that was nearly half the price of the one I was using.

 

3. There is a secret waterfall with a good swimming hole in my area.  Bit of a ride into the jungle on a motorbike to get there.  Was a beautiful spot for a picnic. A few years back I went there one day with my girl for a picnic and a swim and there was some young guys there cooking up their kratom drink. They were quite shocked when we arrived but they settled down when they saw we were not going to blow the whistle on them. They were lads aged between 12 and 15 I would guess.  It was interesting to see how they made their drink.  It is quiet a process and involved boiling the leaves and then adding coca cola, lots of bottles of cough medicine and then cooling the mixture in ice.  I didn't see them adding any mosquito coils which I read they sometime do. When they were finished they offered me a shot.

 

I have stopped going to that spot because it is now a complete trash dump.  There are HUNDREDS of cough medicine bottles strewn around the ground and in the swimming hole and the broken glass makes it impossible to go for a swim. 

 

Where are these kids getting this many bottles of cough medicine from? 

[Khaeng Mak]

24 minutes ago, atyclb said:

 

i went to a pharmacy in sri lanka looking for a few pseudofeds for a cold and sinus problems and the pharmacist said not available and he was very critical of his government telling me morphine tablets are abundant and over the counter no rx but no relief for sinusitis.

At the onset of any cold and sinus problems I always commence taking CHORPHEN-Y tablets.  They come in a little yellow plastic bottle from the local pharmacy and are as cheap as chips. Work well to avert the symptoms.

[Jlop]

3 hours ago, connda said:

It's actually interesting to see what is legal and OTC here but illegal even though the drug is legal and OTC in other countries.  Pseudoephedrine (decongestant) is illegal here without a prescription which doctors here seem reluctant to give you.  Pseudoephedrine is a precursor to methamphetamine and the government is afraid you will take your 30 tablets of Pseudoephedrine, grind them up, and make a few micro-grams of meth out of them even though it completely beyond the capabilities of anyone but hard-core meth cooks (Think Breaking Bad).
Likewise, the mild stimulant, Kratom, isn't even legal to possess or to dispense in Thailand, but it can be openly purchase in the US and other Western countries. 
But, as you said, all sorts of other meds that would initially cost you price of a doctor's visit in the West and other countries are easily available here.  At the end of the day I prefer Thailand over the West in this regard.

Pseudoephedrine is not available in Philippines either. Phil. pharmacies usually won't accept a prescription for medicine from a doctor in another country (not sure if that works in Thailand). And they have a poor range of OTC choices compared to Thailand. In Philippines, you might have street kids trying to reach into your pocket and rob you while you are at the counter. That happened to me in Manila, but never in Thailand.

 

[Sheryl]

On 2/22/2019 at 1:32 PM, Khaeng Mak said:

Thanks for that.  So basically if I buy my stuff from a pharmacy and not a hawker or street vendor in tourist trap area not much chance of getting a fake.

On the subject of meds sold by street vendors...

 

 

[Khaeng Mak]

4 minutes ago, Sheryl said:

On the subject of meds sold by street vendors...

 

 

Thanks for the post Sheryl.  

 

But I don't envisage that I will ever be in the market for a fake vibrator!

[skatewash]

20 minutes ago, Khaeng Mak said:

...

2. The big Supercheap in Phuket does have a good wholesale pharmacy inside.  But when asking for your drugs the staff will usually give you the most expensive option.  Always ask "mee brand tuug mai". By doing this I recently found a alternative blood pressure med that was nearly half the price of the one I was using.

...

3

Yes, that's the one I meant, the big Supercheap on Thepkrassatri Road.  There is another Supercheap that has a pretty good pharmacy near the Naka Weekend Market (on Wirat Hong Yok Road).  Other smaller Supercheap outlets don't have pharmacy sections as far as I know.

 

I always do a bit of research online before I go.  Look up the drug I've been prescribed by brand name, look for its alternate name, then generic if available.  Finally, you can try Googling "name-of-drug in Thailand" to see if it's sold under a different name in Thailand.  Mostly you will be given the local brand name or generic name by the doctor, but it doesn't hurt to do your own due diligence.  Then I write the full generic name down and in parentheses the local brand name on a piece of paper that I give to the pharmacist.  In my experience, they are well-versed in what they have and are more than willing to look up stuff in a drug reference if they need to. 

I like the system in Thailand.  It puts more responsibility on the patient, but with that responsibility comes more freedom.  Your doctor will discuss the dosage and how to take including basic interactions and side-effects.  In the US the pharmacist might also cover these things, not so much here.  But I think it's the responsible thing to take 30 minutes and read the full data sheet that comes with most medications or look it up online.  After all, who cares about you more than you do?

[Letseng]

2 hours ago, skatewash said:

 They will if you ask.  You pay quite a high premium for drugs dispensed from a hospital (at least a private one, like the Bangkok Hospital group).  There may be times when that convenience (or unavailability elsewhere) makes it worth it, but mostly all my long-term prescriptions are filled outside of a hospital at a local pharmacy (Supercheap in Phuket).  I've wondered if they could be purchased more cheaply from an online source in Thailand but I never really pursued that avenue.

 

I should correct this.  I've never gotten a "prescription" from a doctor, they just write down the name of the drug or tell me the name of the drug and give me dosage instructions.  Sometimes they will even point me to a particular pharmacy or doctor's clinic where the drugs can be purchased.  They mostly understand there's a high markup on the hospital dispensed drugs and so they are pretty cooperative about alternatives especially if they understand you are self-insuring.

IThe hospital pharmacist had quoted me the price for 4 items I was prescribed. I found it outrageous and went to buy it outside. It saved me 120 Bht. Btw, it was a prescroption from Bnh. The "saving" cost me 2 hrs of my time plus taxi fare. A saving isn't always a saving.

[Khaeng Mak]

15 minutes ago, skatewash said:

I like the system in Thailand.  It puts more responsibility on the patient, but with that responsibility comes more freedom.  Your doctor will discuss the dosage and how to take including basic interactions and side-effects.  In the US the pharmacist might also cover these things, not so much here.  But I think it's the responsible thing to take 30 minutes and read the full data sheet that comes with most medications or look it up online.  After all, who cares about you more than you do?

Yes.  A thing one must take care with when self medicating is contraindications.  Reading data sheets and checking online is essential.

[Khaeng Mak]

18 minutes ago, skatewash said:

Yes, that's the one I meant, the big Supercheap on Thepkrassatri Road.  There is another Supercheap that has a pretty good pharmacy near the Naka Weekend Market (on Wirat Hong Yok Road).  Other smaller Supercheap outlets don't have pharmacy sections as far as I know.

When I used to live in Phuket I would go to that smaller Supercheap because the drugs were the same price as the big shop but it was so much more accessible.

 

I have for many years however lived in a very remote rural area.  And to my surprise I have found that the prices of the drugs that I buy from local pharmacies hereabouts are about the same as I was paying at Supercheap.  The take away point here is that pharmacies in Phuket, be they on the street or in a hospital, are price gouging.

[Khaeng Mak]

16 minutes ago, Letseng said:

IThe hospital pharmacist had quoted me the price for 4 items I was prescribed. I found it outrageous and went to buy it outside. It saved me 120 Bht. Btw, it was a prescroption from Bnh. The "saving" cost me 2 hrs of my time plus taxi fare. A saving isn't always a saving.

And sometimes the hospital pharmacy is the only place you can find a drug.

[Khaeng Mak]

Surprising really.  Lots of threads flying at the moment about moving to an alternative retirement destination, but hardly any posts here regarding the availability of drugs.

 

Would seem to be very essential information for elderly expats.

 

But disregarded in favor of discussion of beer and bar girl prices.

[skatewash]

1 minute ago, Khaeng Mak said:

When I used to live in Phuket I would go to that smaller Supercheap because the drugs were the same price as the big shop but it was so much more accessible.

 

I have for many years however lived in a very remote rural area.  And to my surprise I have found that the prices of the drugs that I buy from local pharmacies hereabouts are about the same as I was paying at Supercheap.  The take away point here is that pharmacies in Phuket, be they on the street or in a hospital, are price gouging.

I'm fully prepared to believe that all prices for everything in Phuket are inflated.  ????

 

Someone once posted a pharmacy that did mail order from Bangkok but I haven't been able to find it since.  Some of my prescriptions are incredibly inexpensive, others not so much.