Mandatory drug purchase at hospital

[Trujillo]

When I go to the hospital closest to me (whenever some minor aliment needs care) I always ask that they write the prescription for the medicines and only fill in the hospital the drugs that I can't buy outside. 

 

For example, if paracetamol is prescribed, there is no sense in paying the inflated hospital pharmacy price when you can get it at an outside pharmacy (or even 7-Eleven) for the "actual" price. 

 

This hospital has no qualms about doing this. 

 

However, having recently gone to another large and well-known hospital, I asked for the same drug prescription protocol and was told that I had to buy all the medicines in the hospital pharmacy (at their prices). If I didn't agree, I would not get the prescription. Moreover, the doctor said that I could not even be told the names of the drugs before I paid for them. 

The doctor had prescribed medicine (which I didn't know what it was) for a one month regime. So, thinking on my feet, I asked the doctor if he could prescribe only one week's worth of medicine and I could buy the rest outside. He agreed saying: "If you don't tell anyone. If the administration found out, I'd have to find work at another hospital."

 

The particular drug that I needed cost 4 times less in the outside pharmacy as compared to the price the hospital pharmacy charged me. 

 

It seems to me that the patient should have the choice where he gets his medicines and certainly should be informed during the examination what exactly the doctor wants to prescribe. Some patients have done their homework and are roughly familiar with what medicines might be offered and might have an opinion on this (it is the patient's body, after all). 

 

This also highlights the fact that obscenely high drug prices are one of the key money making ploys of at least some hospitals. 

 

Your thoughts? 

[stubuzz]

I thought this was already agreed that patients did not have to buy from the hospital.

 

Edited August 10, 2019 by stubuzz

[eyecatcher]

I did exactly as you, anticipating a real gouging: my quack suggested a 14 day trial of something I had never heard of.

I said no, 7 days is enough for me to do a thorough internet search on the product.

I was charged 100bt a tab plus 1500bt for a chat.

I found the very same tabs from the excellent pharmacy opposite the MCCormack for 40bt.

Glad I did because they were useless.

Dont under estimate the knowledge a pharmacist has and probably less biased......or rather will offer more choice

[Bill97]

Buy 2 or 3 days worth is enough. Tell them you need to be sure you don’t have a bad reaction to the meds.

 

Any Doc demanding mandatory purchase should be avoided for stupidity.

 

Sent from my iPhone using Thaivisa Connect

 

[elektrified]

I have never heard of that. That's ridiculous. Even C.M. Ram doctors just write down the meds and dosage on a blank paper and stamp their name and license number on it. There are quite a few however that one can not find in any pharmacy.

[NancyL]

I can understand the hospital having a rule about your having to buy a few days supply of a prescribed med so that they have a record in their file for you that you take a certain med in case you show up in their E/R unable to communicate, but anything beyond that is unnecessary.

 

And yes, you can develop an allergy to a new med.  In the U.S. I was prescribed an expensive new heart medicine and broke out in a nasty case of hives two days later.  I called the doctor's office and after consulting the doctor, the physician's assistant said to discontinue the new med and sure enough, the hives went away in half a day.  Nothing was every said about taking another type of med and I was left with nearly a month's supply of an expensive med.

[FolkGuitar]

I would NOT accept any medication from ANY doctor without knowing the name of the medicine. That is absurd! And I find it ludicrous that any physician would even suggest such a thing!  What if you take this medication and develop a severe reaction to it while away from that particular hospital? The first question you (or your conscious relative) will be asked is "Are you taking any medications?" How the hell are you supposed to answer that if your doctor won't tell you its name? To me, this is highly dangerous and tantamount to malpractice!

[scorecard]

6 hours ago, stubuzz said:

I thought this was already agreed that patients did not have to buy from the hospital.

 

Yes, but the media coverage on this is backwards and forwards and it seems no really clear answer.

 

I'm aware of a case where the patient said to the cashier 'I will buy the meds outside' and mentioned what's been in the media indicating 'patient can buy outside'..

 

A senior hospital admin. person came and said 'yes that's true but the patient has to discuss this with the doctor before the consultation starts, and it's up to the doctor to say can or cannot buy the medicines outside'.

 

Patient refused to accept this line from the hospital saying that the fee transaction is between the hospital owner and the patient, not the doctor who is an employee and doesn't make hospital policies on such matters. , eventually patient indicted to call the police and a local TV station. Suddenly admin. guy changed his tune to 'yes can buy outside, please wait'. After 20 minutes wait admin. guy returned with the medicine names all typed beautifully on a hospital letterhead paper and politely asked if the police would be coming.

 

What a mess, as usual. 

 

 

 

 

Edited August 10, 2019 by scorecard

[Sparkles]

23 minutes ago, FolkGuitar said:

I would NOT accept any medication from ANY doctor without knowing the name of the medicine. That is absurd! And I find it ludicrous that any physician would even suggest such a thing!  What if you take this medication and develop a severe reaction to it while away from that particular hospital? The first question you (or your conscious relative) will be asked is "Are you taking any medications?" How the hell are you supposed to answer that if your doctor won't tell you its name? To me, this is highly dangerous and tantamount to malpractice!

I've never experienced or heard of any Dr not advising the name of any medication.I find it hard to believe that any registered Doctor would do that here or in any civilized country. 

[Konini]

5 hours ago, Sparkles said:

I've never experienced or heard of any Dr not advising the name of any medication.I find it hard to believe that any registered Doctor would do that here or in any civilized country. 

They've tried to do it to me a few times.  I wouldn't leave the chair until they told me what they were prescribing and in the end they all did, some very grumpily.  Paracetamol, every single time.  No thanks, got some at home.  Antihistamines. No thanks, plenty at home. Quinine?  I'm allergic to it, so no thanks.  Ibuprofen?  I have a stomach ulcer, so no thanks. 

 

After I had a bit of a funny turn or seizure a few years ago and ended up in ICU overnight at Rajevej, they gave Mr K something for me, I can't remember what, some kind of epilepsy drug.  I was away with the fairies for a couple of days afterwards, mostly sleeping and being woken up to take my tablets.  All of them.  Oops.

 

I was already taking Lyrica (pregabalin) for the electric shocks that have run down my legs since I had back surgery 20 years ago.  Once I was up and about I got on the internet and doctor google told me that under no circumstances should anyone take Lyrica if they were taking the drug he gave me.  Lyrica was originally an anti-epilepsy drug, once in circulation they found an unexpected side effect of it working on neurological pain.  So in effect, for 3 days I was taking 2 very strong anti-epilepsy tablets.  Maybe the reason I have no memory of those 3 days and why I slept so much.

 

Mr K told them I was taking Lyrica and that I'm allergic to quinine and amoxicillin (I'm really glad that he remembered that, bless his little heart). When I went back for a followup, I saw it for myself written down on the notes, so there really is no excuse for that.  If I can find it on google, doctors should be able to find it on the special search site that only doctors can access.  And this wasn't a little meds clashing with each other, it was a really, really serious one.

 

I'm sure that there are some very good doctors here, but they really seem to be few and far between.  I take nothing until I've googled it and found all of the contradictions and if any countries haven't licenced it yet, and my GP is a friend of sorts, if I'm not certain about something I email her with the symptoms and what I think we should take to make it go away and she says yes or no (that's how I know that the meds I was given were a massive problem, she had Mr K being on watch duty for 4 days, he wasn't allowed to leave me on my own at all).  And if it's going to interfere with the Lyrica, it can buggeroff.  13 years I suffered like you couldn't imagine.  Hundreds of tiny electric wires running from my hips down to my feet.  You could actually feel them buzzing if you put your hand on them.  There is no way, under any circumstances, that I will ever stop taking the only thing that takes that buzzing away - it hasn't completely gone, in fact I think it's still buzzing but I just have a dull sensation of it rather than electric shocks now that I've got used to.

[Trujillo]

Quote

I would NOT accept any medication from ANY doctor without knowing the name of the medicine. 

Maybe you don't understand. It's not like the medicines are unmarked and I don't know what I am taking. 

As I posted, in the exam room he would not  -- per hospital requirements NOT because of a single doctor -- tell me the names of the medicines. I had to go to the cashier first and pay, THEN I could pick up the medicines that he prescribed. So I then knew what he'd given me. 

 

I was asked beforehand if I was allergic to any medicines and if I was taking anything. 

 

Edited August 11, 2019 by Trujillo

[Somnambulist]

You can always ask to see the bill before you hand over the money.

Then you can see what the medicine is.  Hand them back the bill, make 

some excuse, and walk away.  Will they be pissed?  Oh, plenty, but who gives AF what some cashier thinks?

[Trujillo]

The problem with that is that you do need to pay for having seen the doctor, and any tests that were conducted. 

 

[DaRoadrunner]

Hospitals and their greed again. The hospital can't force you to buy drugs from them. The Dept of Trade has instructed them to allow patients to buy from a drug store. They are also supposed to post the prices of their drugs. Lots of luck enforcing it though as the penalty fines are too small.

[thaibeachlovers]

On ‎8‎/‎10‎/‎2019 at 8:53 PM, FolkGuitar said:

I would NOT accept any medication from ANY doctor without knowing the name of the medicine. That is absurd! And I find it ludicrous that any physician would even suggest such a thing!  What if you take this medication and develop a severe reaction to it while away from that particular hospital? The first question you (or your conscious relative) will be asked is "Are you taking any medications?" How the hell are you supposed to answer that if your doctor won't tell you its name? To me, this is highly dangerous and tantamount to malpractice!

LOL. That is Thailand. You're lucky if the Dr explains anything.

Re buying the drugs at the hospital; given the cost of seeing a Dr is so cheap, they probably need the pharmacy profits to subsidise the hospital, which I wouldn't gripe about. The cost of seeing a Dr in New Zealand is a rip off, IMO. Over $40 and get so little time that one doesn't even get half way through the problems and told to come back again ( and pay again ).

BTW, $40 is quite low; some places charge over $60. So much for the welfare state in NZ!

[billd766]

I go regularly to a hospital once a month for an FBS, PT and INR test and I NEVER buy drugs from the hospital.

 

I explained to my doctor that as I am paying the bill, I am NOT a patient but a customer for his services. I will listen to his advice and perhaps take it or not, go home and look up on Google the meds he prescribes and buy them from a pharmacy else where for much less than the hospital charges.

 

I remind him that I can walk away and go to a different hospital if I am not happy.

[tonboy]

Recently, after 4 days of hospital and numerous examinations, I have been diagnosed with lung embolism. I was prescribed Pradaxa and bought the first month of supplies, after discharge from the hospital, via the hospital's pharmacy. 7300 thb. Pradaxa is a fairly new means of blood thinners. In the following week we immediately visited a larger drug store and within 2 weeks arranged the papers (license) for the next stock, also one month (60 tablets à 150 mg). 4300 thb. And without further asking for a doctor's prescription. 

[dcnx]

You have to learn how to play the hospital game. 
 

Go to the payment area and asked to see the bill along with a list of medicine. Take a photo of the medication with your phone. Take a couple to be safe in case you get a blurry photo.

 

Hand it back and say you don’t want the medication. If they say anything to  try to sell you, tell them you’re about to walk out and not pay anything if they don’t stop talking and to please deduct the medication from the bill.

 

Pay updated bill and leave.

 

Hospital pharmacies are big time scams here. I’ve NEVER not been able to find what I need in a pharmacy here for a fraction of the cost.

* Don’t be afraid to sit down and research the meds before you pay. You are free to walk away from the counter and sit down to do this. Don’t let them pressure you into ANYTHING. If you do, it’s your own fault.

 

[elektrified]

16 hours ago, dcnx said:

You have to learn how to play the hospital game. 
 

Go to the payment area and asked to see the bill along with a list of medicine. Take a photo of the medication with your phone. Take a couple to be safe in case you get a blurry photo.

 

Hand it back and say you don’t want the medication. If they say anything to  try to sell you, tell them you’re about to walk out and not pay anything if they don’t stop talking and to please deduct the medication from the bill.

 

Pay updated bill and leave.

 

Hospital pharmacies are big time scams here. I’ve NEVER not been able to find what I need in a pharmacy here for a fraction of the cost.

* Don’t be afraid to sit down and research the meds before you pay. You are free to walk away from the counter and sit down to do this. Don’t let them pressure you into ANYTHING. If you do, it’s your own fault.

 

That is not true. Some meds (such as pre-surgery antibiotics) are not stocked in retail pharmacies. Yes, they are expensive - like 400-600 per tablet/capsule but you are usually only dispensed up to 5 of them.

[dcnx]

1 hour ago, elektrified said:

That is not true. Some meds (such as pre-surgery antibiotics) are not stocked in retail pharmacies. Yes, they are expensive - like 400-600 per tablet/capsule but you are usually only dispensed up to 5 of them.

Going into surgery is a different situation, as is taking their medication while you’re recovering after surgery. 
 

I’m talking about standard visits where you have an option.

[Trujillo]

The bill does not list the particular medicines you are being prescribed. 

[NancyL]

5 hours ago, Trujillo said:

The bill does not list the particular medicines you are being prescribed. 

Depends on the hospital.  Went to Bangkok Hospital today for an outpatient appointment.  Prescribed a med not normally available in a retail pharmacy, so I bought it at the hospital.  It was listed on Bangkok Hospital's itemized receipt.  The bit about photographing the receipt and then asking for a redo would have worked (if I wanted to go med shopping in the rain via Grab)

[EricTh]

Profit is more important than Hippocratic Oath nowadays.

 

 

Edited August 14, 2019 by EricTh

[Mark1066]

On 8/11/2019 at 7:04 PM, thaibeachlovers said:

LOL. That is Thailand. You're lucky if the Dr explains anything.

Re buying the drugs at the hospital; given the cost of seeing a Dr is so cheap, they probably need the pharmacy profits to subsidise the hospital, which I wouldn't gripe about. The cost of seeing a Dr in New Zealand is a rip off, IMO. Over $40 and get so little time that one doesn't even get half way through the problems and told to come back again ( and pay again ).

BTW, $40 is quite low; some places charge over $60. So much for the welfare state in NZ!

I’ve never seen a doctor here who wanted to prescribe me medication without telling me what it was (in 16 years), so your “That is Thailand” comment is wide of the mark in my experience. I certainly wouldn’t pay for anything before I knew what it was either. I go to hospitals for medical advice and opinions, not to be told what to do.

[ThaiPauly]

This particular hospital (and we all know which one) charged me 89 baht for an asprin. I was lucky (stupid) enough to buy 2 !!!