cost and availability of medicine in LoS

[spinner2020]

Maybe this has been raised before, but I couldn't find it, so apologies.

 

But I have recently been told I have to take a couple of pills once a day for the rest of my life. I'm not used to being ill, but I have already worked out that Thai hospitals are not good places to buy pills cos they are about five times the price of the local pharmacy. Others tell me Thailand is a cheap place for medicines. I also know via TV comments that importing pills is not an option.

Now, though, I find the pills - nothing very exotic - are waaaaay more expensive here than in (eg) Australia. Atorvastatin 40 (30s): B950 here, $5.99 (B125) via local Oz drugstore. Problem is, you need to go to the quack in Oz first to get a scrip...... Same with UK. The paperwork supplied by my surgeon here (in English) won't work overseas, I'm sure.

Can anyone advise whether I am looking in the wrong place? Like is there a cheap online store in Thailand too? What do others do - pay through the nose? Any advice welcome, as I'm looking at a difference of $750 a year in the case of AU just on these two pills...

[Sheryl]

What is the other medication? You mention only atorvastatin.

 

And can you ask your doctor if you can take simvastatin rather than atorvastatin? Older version of same thing and vastly cheaper. In most people will work just as well.

[ezzra]

This is the lowdown on buying medicines in Thailand, Hospitals: very expensive but you can be assured you're buying the real thing, well, most of the times, Pharmacies: cheaper than hospitals, hit and miss affairs, mostly generic, adulterated, some fakes, risky not really know what you're putting in your mouth, Online: custom tightly control most if not all medicines coming into this country, you'll be either hit with stupid import and tax chargers and sometimes they will ask for stupidly enough, for permits to import medidnices... best to load on medicins where you hail from and make sure you got the doctor prescription with you and even then if you get caught at the custom they could be difficult...

Edited December 27, 2019 by ezzra

[spinner2020]

1 minute ago, Sheryl said:

What is the other medication? You mention only atorvastatin.

 

And can you ask your doctor if you can take simvastatin rather than atorvastatin? Older version of same thing and vastly cheaper. In most people will work just as well.

There's also 'clopidogrel', which costs B650 per pack here or AUD7.99 (B170). I'll try to ask about the alternative, thanks!

And small aspirins - cheap and easy enough here, actually - as opposed to AU where they are treated like some kind of major poison. There's just no sense to all this.

 

[lopburi3]

1 hour ago, ezzra said:

Pharmacies: cheaper than hospitals, hit and miss affairs, mostly generic, adulterated, some fakes, risky not really know what you're putting in your mouth,

Expect you may be fishing in a no fishing hole as Pharmacies are actually very reliable in Thailand and sell brand name as well as generic drugs, mostly at reasonable costs and in factory packaging.  This is not the 1950's where a druggist could adulterate what he put into a capsule and the few fake drugs sold in Thailand are almost always sourced from a street seller rather than a pharmacy.   That said obviously the more expensive the more risk involved - which may make hospitals a bit more competitive for high value drugs, as there markup is often at a much lower percent than for cheap drugs in my experience.

Edited December 27, 2019 by lopburi3

[Sheryl]

Virtually no issue with fake or adulteted drugs in Thai pharmacies .  Sole exception being name brand ED drugs and benzos sometimes sold in pharmscies snd even street vendors in toyrist areas. These may be fake especially any benzis as they ate not legal for other than hospital or clinic.

 

No reason to get any medication at a hospital unless it is one of the small number of drugs not allowed over the counter sale. 

 

 

[Nyezhov]

2 hours ago, Sheryl said:

And can you ask your doctor if you can take simvastatin rather than atorvastatin? Older version of same thing and vastly cheaper. In most people will work just as well.

Off topic, thanks for the reminder, Im getting killed with the cost of Rouvestatin here. I may ask the doc next week.

[Sheryl]

Imported medications cost more in Thailand than in their country of manufacture due to shipping costs plus a significant tariff which is levied. Exception in the case of just a few Indian made generics imported by the Government Phatmaceutical Organization specifically for use in government hospitals. These are not supposed to be commercially sold (though some do make their way onto the shelves)So in some cases meds can be cheaper gotten from Government hospital than a pharmacy.

 

There is no locally made brand of clopidogrel. GPO imports Ceruvin brand from Ranbaxy in India. This would likely be the cheapest brand but you might have to attend a govt hospital to get it (no harm in askling at a pharmacy though). 

 

Next least expensive  would be Apolets brand which is a Canadian made generic. This you can readily find in pharmacies.

 

Atorvastatin has 2 local brands called Atorvin and Chlovas but some people have reported trouble finding them. 

 There are many local brands of Simvastatin amd it is much cheapet. Simvastatin GPO and Bestatin are 2 favored local brands.

[spinner2020]

3 hours ago, Sheryl said:

Virtually no issue with fake or adulteted drugs in Thai pharmacies .  Sole exception being name brand ED drugs and benzos sometimes sold in pharmscies snd even street vendors in toyrist areas. These may be fake especially any benzis as they ate not legal for other than hospital or clinic.

 

No reason to get any medication at a hospital unless it is one of the small number of drugs not allowed over the counter sale. 

 

 

Not worried about fake meds – I use the same pharmacy that has helped us for 20-odd years with hangovers, flu and scraped kids' knees, and (though I know it's tempting fate) I don't think they would cheat us. And of course I would never go for OE rather than generics.

Apart from the eye-watering cost (compared to other countries), what worries me is the 'prescription-only' aspect abroad, because I travel a lot. I have pages of details in English from surgeon and hospital of what they did to me and what they prescribe, but I assume they would be useless overseas, not least because they originate in TH.

Otherwise, the savings on just these two pills per year would pay my fare to Oz to buy them…….

[WayWokeWhiteGuy]

4 hours ago, lopburi3 said:

Expect you may be fishing in a no fishing hole as Pharmacies are actually very reliable in Thailand and sell brand name as well as generic drugs, mostly at reasonable costs and in factory packaging.  This is not the 1950's where a druggist could adulterate what he put into a capsule and the few fake drugs sold in Thailand are almost always sourced from a street seller rather than a pharmacy.   That said obviously the more expensive the more risk involved - which may make hospitals a bit more competitive for high value drugs, as there markup is often at a much lower percent than for cheap drugs in my experience.

 

And my local pharmacist will generally order anything she doesn't stock. Send her a line, she tells me is she has it in stock or can order it, gives me the price, gives me the price of a generic, I tell her yes, she tells me when to come get it.

[uhuh]

Fake medicines - no.

Adulterated medicines - no.

But i remember a study (10 or 20 years ago) about antibiotics that stated that antibiotics in Thailand on average only contain 70% of what's written on the label. 

Add the fact that Thais used to have a much lower body weight than Westerners and the result is that many medications here are given in doses much too low.

A popular example is Amoxicillin, 500mg twice a day.  It's better not to take it at all. 

On the other hand,  it's not unusual to meet a 40kg girl talking 4g paracetamol daily. One can only hope that these tablets contain only 70% of the stated 500mg of paracetamol!

 

[NancyL]

22 hours ago, spinner2020 said:

Not worried about fake meds – I use the same pharmacy that has helped us for 20-odd years with hangovers, flu and scraped kids' knees, and (though I know it's tempting fate) I don't think they would cheat us. And of course I would never go for OE rather than generics.

Apart from the eye-watering cost (compared to other countries), what worries me is the 'prescription-only' aspect abroad, because I travel a lot. I have pages of details in English from surgeon and hospital of what they did to me and what they prescribe, but I assume they would be useless overseas, not least because they originate in TH.

Otherwise, the savings on just these two pills per year would pay my fare to Oz to buy them…….

When we visit our cardiologist at Bangkok Hospital, he prescribes a 10 day dose of our meds, sourced from the hospital pharmacy for two reasons.  First is so they have a record in their system of the meds we take if we're hospitalized, especially in an emergency when a doc may not take the time to read the patient notes from the cardiologist and just looks at the history with the hospital pharmacy.  The second reason is so that when we travel, we can put the replacement meds we buy from the cheaper, retail pharmacy in the packaging supplied by Bangkok Hospital and have appropriate labeling in case we're stopped at an airport.

[spinner2020]

22 hours ago, NancyL said:

The second reason is so that when we travel, we can put the replacement meds we buy from the cheaper, retail pharmacy in the packaging supplied by Bangkok Hospital and have appropriate labeling in case we're stopped at an airport.

Sure, but being new to getting sick, I just assume that a Thai hospital sticker doesn't cut any ice with medical people in developed countries, any more than the pages of op details.

BTW, I was told by my insurer they would pay for first 2 weeks medications, but only if I bought them from the hospital pharmacy (and reclaimed via insurer). I pointed out that they would be paying five times as much but they would not budge.

[Saltire]

I took Atorvastatin for about 8 years but stopped taking them over a year ago. Not because of the cost but after doing some research on current thinking. There is lots of research by reputable medical organisations on line. I am not suggesting you stop of course, that was my decision alone. My regular blood tests show all lipids in the normal range without them.

 

I could get them easily in my local Thai pharmacy and they were the most expensive of my meds at the time, so it's a bonus not taking them.

 

I was also on Clopidrogel, but only for the prescribed 1 year after an angioplasty (3 stents). 

[lopburi3]

1 hour ago, spinner2020 said:

Sure, but being new to getting sick, I just assume that a Thai hospital sticker doesn't cut any ice with medical people in developed countries, any more than the pages of op details.

BTW, I was told by my insurer they would pay for first 2 weeks medications, but only if I bought them from the hospital pharmacy (and reclaimed via insurer). I pointed out that they would be paying five times as much but they would not budge.

Many of the hospitals here are subject to the same reviews and operational standards as those elsewhere and suspect that insurance issue was to help prevent fraud (not taking customers word that medication required but asking it be provided by a local hospital which requires a doctors review).

[dddave]

4 hours ago, Saltire said:

I took Atorvastatin for about 8 years but stopped taking them over a year ago. Not because of the cost but after doing some research on current thinking. There is lots of research by reputable medical organisations on line. I am not suggesting you stop of course, that was my decision alone. My regular blood tests show all lipids in the normal range without them.

 

I could get them easily in my local Thai pharmacy and they were the most expensive of my meds at the time, so it's a bonus not taking them.

 

I was also on Clopidrogel, but only for the prescribed 1 year after an angioplasty (3 stents). 

I also took myself off Atorvastatin 1 year after triple bypass surgery.  Like you, I dug deeply and felt the minus's outweighed the plus's.  My lipids also have remained in the normal range.

My primary care physician in the US left me on Clopidiogrel for more than a year. A friend who's a retired pulmonologist convinced me to get in touch with him and ask if I could cease taking it. It is a blood thinner and in the long run can lead to hemorrhaging and other nasty complications. Primary care Doc. wasn't even aware I was still on it. "Yes, by all means.  Stop taking it."   

 

Don't ever assume your doctor is "on top" of your meds. Be pro-active and ask for periodic reviews.

[spinner2020]

4 hours ago, lopburi3 said:

Many of the hospitals here are subject to the same reviews and operational standards as those elsewhere and suspect that insurance issue was to help prevent fraud (not taking customers word that medication required but asking it be provided by a local hospital which requires a doctors review).

 

Don't be so condescending: the insurer presumably requires to know the meds are genuine, otherwise they could be on the wrong end of a big lawsuit.

But regardless of 'standards', I'll bet the paperwork from the hospital in BKK will be useless in eg AU or UK.

[Sheryl]

10 hours ago, spinner2020 said:

Sure, but being new to getting sick, I just assume that a Thai hospital sticker doesn't cut any ice with medical people in developed countries, any more than the pages of op details.

 

 

She was not referring to medical personnel. She was referring to customs officials/airport police who might want to know what loose pills are/suspect them of being a banned substance.. Having them in a labelled prescription bottle from a hospital is indeed a good idea.

 

But for what it is worth in my experience a doctor in the west would indeed be interested in/want to see medical records from Thailand if a patient of theirs had been treated there. I have had lab results, scans etc from Thailand accepted and uploaded into my medical records in the US. Never an issue and no reason why there should be. And they would certainly be interested to know the names of meds you were given in Thailand.

 

If what you mean is that a script from Thailand is not a legal presecription in the West, of course not and equally so vice versa. Though few meds here require a script.