Rheumatoid Arthritis Thread

[wtboatr]

Can anyone recommend a rheumatologist in Bangkok?  I'm sure I'm not the only one here that suffers from this painful, join-wrecking condition. 

 

I'm aware that Bumrumgrad and Samitivej Hospitals have rheumatologists on staff.  However, it seems overkill for me to go to a hospital for my chronic condition.  I'm hoping for a recommendation to a small clinic that specialized in rheumatology.  I assume the costs to visit the clinic for regular evaluations and prescriptions would be lower as well.

 

Also, if anyone is willing to share what rheumatoid arthritis medication they are prescribed, it would be benefit me to know what my available options are in Thailand.

 

Thank you,

[findlay13]

I was diagnosed with Rheumatoid Arthritis on my last trip.I was assuming it was gout[You know what they say about assuming.] I was prescribed all the drugs that I am now taking in Australia[Prednisolone,Arava,Methotrexate]. Seeing the Specialist wasn't expensive but the drugs were. That's where they make their money..I'm not in BKK so can't advise.I'd just bite the bullet and see a specialist.After a visit or two you can "self-medicate" if you wish????

[BritManToo]

9 hours ago, wtboatr said:

Also, if anyone is willing to share what rheumatoid arthritis medication they are prescribed, it would be benefit me to know what my available options are in Thailand.

Self prescribed, cannabis 0.5gm smoked every evening before bed, the 24/7 pain in my knuckles has almost completely gone and I can now open twist top bottles by hand again.

 

Cost was 450bht for 100gm of brick, works out at around 2bht/day.

Edited October 26, 2022 by BritManToo

[Retdent]

My type of Rh A was described as “dry rot”.  I got up to experimental drug stage of treatment, nothing worked, and the risks of the experimental meds outweighed the potential advantages. I had 2 choices as I saw it, lay in bed and be miserable with the pain or make myself walk through the pain barrier, (for me 1 3/4hrs), that set me up with minimal discomfort for a few days. Have being doing regular exercise now for 11 years and generally all OK. A move to Thailand from Tasmania probably also helped. 

[Sheryl]

2 hours ago, BritManToo said:

Self prescribed, cannabis 0.5gm smoked every evening before bed, the 24/7 pain in my knuckles has almost completely gone and I can now open twist top bottles by hand again.

 

Cost was 450bht for 100gm of brick, works out at around 2bht/day.

I suspect you have osteoarthritis not rheumatoid arthritis.

 

RA is a very specific and complex autoimmune disease. Not to be confused with age related arthritis.

[Sheryl]

OP: In Bangkok clinics are licated within hospitals. Indeed,  outpatient clinics in hospitals are far busier/more heavily utilized than the inpwtient sections.

 

A better way to understand it is that hodpitals here are actually medical centers containing a large network of outpatient clinics as well as separate hospital facilities.

 

You will need to see a rheumatologist at a hospital outpatient clinic. You will not find a stand alone clinic for this in Bangkok.

 

Bumrungrad foes ondeed have the best selection of rheumatolohists. I recommend one of these 

 

https://www.bumrungrad.com/en/doctors/Porawat-Makornwattana

 

https://www.bumrungrad.com/en/doctors/Supat-Thongpooswan

 

https://www.bumrungrad.com/en/doctors/Sutthi-Thampakkul

 

You can save money by doing lab tests at a lab and bringing redults with you. Reliable Bangkok labs include:

 

https://pathlab.co.th/

 

 

https://www.brianet.com/

 

 

Any over the counter drugs should be bought at a pharmacy not the hospital. However with RA most meds are restricted and have to come from hospital.

 

 

 

 

[HarrySeaman]

When I developed rheumatoid arthritis in 2011 I got to the stage where my Thai wife had to help me dress because my shoulders wouldn't bend and my hands wouldn't close beyond a claw.  My cardiologist recommended I go to WIROAJ SUKARASOJI, MD., who is a rheumatologist at Ramkhamhaeng University Hospital in Bangkok.  I couldn't have asked for better care or a better doctor.

 

Rheumatoid arthritis is a autoimmune disease where the body mistakenly attacks the joints as though they are foreign bodies.  Initially I was prescribed chloroquinine, which Dr. Wiroaj Sukarasoji explained was an immune system moderator.  This medicine was then freely available and dirt cheap at pharmacies.  The chloroquinine plus rehabilitation restored full mobility in about 3 to 4 months. 

 

Later I accidentally overdosed on chloroquinine and developed an allergy, which presented as dry itchy skin.  Dr. Wiroaj Sukarasoji switched me to Hydroxychloroquine Sulfate (Plaquenil) which I am still taking two days out of every three 11 years later.  I occasionally have a few twinges of pain from the ankle I broke in 2000 (which still has the pen and screw inserted to to hold it in place) but then I simply take a Hydroxychloroquine Sulfate (Plaquenil) tablet every day for 5 days before skipping a day.  Normally I then go back to my regular schedule of tablets for two days and one day without.  The pain has never continued beyond a second 5 day sequence.

 

Unfortunately false information that Hydroxychloroquine Sulfate (Plaquenil) could be use to treat Covid-19 was distributed by science and medically ignorant politicians in the USA and a run on the drug resulting in many who needed not being able to obtain it.  This run on obtaining chloroquinine or  Hydroxychloroquine Sulfate (Plaquenil) then snowballed worldwide. 

 

To make sure that chloroquinine and Hydroxychloroquine Sulfate (Plaquenil) was available to those who really needed it medically many governments, including those of the USA and Thailand, made these drugs available only by prescription.  In Thailand it is only available from hospital pharmacies.  The result is that either of these two drugs now cost far more than in the past.

 

Please give thanks to the science and medical ignorant politicians for screwing the common man once again and make sure you help get them reelected so that they can screw the common man in some other new way.

Edited October 26, 2022 by HarrySeaman

[WebGuy]

My mother in Europe hs it as well. She has her terapy. She is coming to see me soon. Could someone advise where I should take here to help her a bit? Anything oriental except grass (which we plan to do as well)?

[Sheryl]

15 minutes ago, WebGuy said:

My mother in Europe hs it as well. She has her terapy. She is coming to see me soon. Could someone advise where I should take here to help her a bit? Anything oriental except grass (which we plan to do as well)?

Assuming you mean rheumatoid arthritis - and not osteoarthritis (the more common kind, associated with age) there are no specific Thai treatments for this, it is managed same as in the west. and Cannabis is unlikely to help.

[SunsetT]

27 minutes ago, WebGuy said:

My mother in Europe hs it as well. She has her terapy. She is coming to see me soon. Could someone advise where I should take here to help her a bit? Anything oriental except grass (which we plan to do as well)?

I wanted to click the 'confused' emoji for this post but, along with 'sad', both negative emojis have been removed! Why? Must we only respond positively to posts on Aseanow??? This smacks of censorship and authoritarianism! Is Prayut an Aseanow shareholder?

Edited October 26, 2022 by SunsetT

[RayOday]

I risk cultural and personal blowback from this post yet I would like to share my personal experience. My advice is only a suggestion and is not intended to influence your own judgement. Your own care is between you and your chosen medical professional.

I am over 65. I exploded 2 lumbar disks in 1996 doing deadlifts. As I have aged my lumbar discs  have been affected by spinal stenosis and arthritis. I have avoided surgery by choice after consulting with many doctors and feeling comfortable with a sports orthopedist at Stanford University Dr. Jeffrey Saal, SOAR Redwood City, CA.                I learned over the years to manage pain through movement and medicine. The medicines were Celoxicib NSAID (genetic sold as Zobrex in TH), Tolperisone (CNS muscle relaxant), and if necessary, Prednisone.

I am currently taking no medicine and occasionally I am a bit stiff yet no need for meds.            How have I gone the last 5 years without any medication? I tried a new approach to health and it appears to be effective for me.

1. Extreme limitation on carbohydrates. Carbohydrates covert to sugar and adds to insulin resistance and later, if predisposed, to type 2 diabetes and inflammation. I strive for almost zero since most foods contain carbs. That means no bread or wheat products. If I eat wheat, it is without gluten. I used to eat a lot of carbs for marathon training yet I no longer feel the need. 

2. Zero processed foods

3.Maintain a healthy gut biome. Meds adversely affect the gut biome. Eat and drink a fair amount of fermented foods. Beer is fermented yet the beneficial bacteria is destroyed. Think yogurt, kefir, kombucha, sauerkraut, kimchi, Yakult 

The fermented foods must come from the refrigerated section. If not refrigerated the good bacteria is destroyed. 

4. No seed oils which promote inflammation. Olive oil, avocado oil, lard, tallow is ok. Beware of the last 2 if you have lipid issues. 

6. All protein is good. I eat eggs often for breakfast and switch off to fried tofu in place of eggs 2-3x per week. Grass fed beef is better than grain fed beef and no farm raised salmon only wild fish. Sardines are excellent sources of Omega 3 which supports inflammation reduction. 

All vegetables are good. Make sure that many are colorful. Dark green vegetables like kale, broccoli, and spinach are particularly good. Potatoes are a starch hence convert to sugar and hence inflammation. 

7. Drink sufficient water daily

8. No sugar except in good whole fruit. Beware of fruit juices. Orange juice contains more sugar than a coke. Both are bad. No artificial sweeteners as recent research has shown a negative effect in the gut. Insulin resistance, gut biome, and inflammation are related. 

9. I drink coffee, tea, Yerba Mate but not after 1600 to maintain quality sleep. 

10. I strictly limit alcohol but don't stress the occasional drink. I smoke strong weed within reason.              11. Try to get 8 hours of sleep that matches your circadian rhythm. In the morning within 30 minutes of waking look at the sky for a few minutes. It helps to reset your circadian clock. Same at sundown. (research the neuro science)

12. Since I am retired and have time, I walk at least 10k steps per day on a weekly average and do resistance training at least a half hour per day with strict form and tempo.

13. I take supplements and I am hesitant to recommend any except 2.  Supplements are unregulated and there are many brands with poorly sourced ingredients, inaccurate percentages or volumes. Many supplements come in different formulations. Some are more bioavailable than others. I encourage you to do your own research. As an example research the  bioavailability of the different formulations of Magnesium.         I only use supplements which are independently assayed brands. They cost a lot more yet are cheaper than medicine and illness. Available in Thailand at Lazada & Shoppe. 

Multivitamin -  Pure Encapsulations 1 Multi. 

Omega 3 - Carlson's (Beat all competing brands in freshness and purity. Rancid oils and heavy metals promote inflammation.)

Thorne Research is a good brand as well yet even more expensive. 

This is a brief overview of my discipline and I no longer need any medicines for pain, inflammation, or arthritis except in rare instances. The idea is to eliminate sources of chronic inflammation, support a healthy gut biome, and promote  efficient metabolism.

I have science backed peer reviewed research papers which helps my understanding. Here are a few practitioners I find value in learning from: 

-Dr. Brian Stanfield - NZ YouTube and https://drstanfield.com/

 

- Dr. Andrew Huberman U.S. Stanford University, https://hubermanlab.com/, YouTube, Podcast

 

-Dr. Rhonda Patrick            U.S. Salk Institute

https://www.foundmyfitness.com/ Podcasts

 

- Dr Sten Ekberg U. S. YouTube 

 

and many more. 

 

I don't stress any of these protocols. I follow them daily and make choices without sweating whether the choice is good or bad. I prefer good choices. I occasionally drink. I smoke quality weed. I sometimes break the rules because I know what works for me. My inflammation markers are very low and they were once off the charts. I now believe the adage, better to eat your food like medicine rather than eating medicine as food. 

I realize my advise may be viewed as radical. I have always challenged accepted beliefs, and in this case, it has enhanced my well being. My weight per BMI and waist to hip ratio is optimal, my lipid profiles are very good without meds (I was on statins for 20 years due to a family predisposition to atherosclerosis). YMMV

p.s.

If you review this with your M.D. realize many have varying degrees of training in nutrition, neurobiology, and gerontology. I would be shocked if they would disagree with most of what I have written. 

 

Best of luck

 

This mornings breakfast. 

 

 

 

 

 

 

 

Edited October 26, 2022 by RayOday

[WebGuy]

33 minutes ago, Sheryl said:

Assuming you mean rheumatoid arthritis - and not osteoarthritis (the more common kind, associated with age) there are no specific Thai treatments for this, it is managed same as in the west. and Cannabis is unlikely to help.

Yes, rheumatoid arthritis for sure. I am aware what she is going through. A very mean disease. She stopped taking pills last year because they do not help her pain and she takes those steroids (if I am right). Then she jumped to some Swiss research program to try with that and it helped a bit.

 

I do not know what I could do for her here that can't be done back in the West.

 

Those balms helped her a bit before.

[Denim]

4 hours ago, BritManToo said:

cannabis 0.5gm smoked every evening before bed

Do you mean half a gram ?

[WebGuy]

25 minutes ago, RayOday said:

I risk cultural and personal blowback from this post yet I would like to share my personal experience. My advice is only a suggestion and is not intended to influence your own judgement. Your own care is between you and your chosen medical professional.

I am over 65. I exploded 2 lumbar disks in 1996 doing deadlifts. As I have aged my lumbar discs  have been affected by spinal stenosis and arthritis. I have avoided surgery by choice after consulting with many doctors and feeling comfortable with a sports orthopedist at Stanford University Dr. Jeffrey Saal, SOAR Redwood City, CA.                I learned over the years to manage pain through movement and medicine. The medicines were Celoxicib NSAID (genetic sold as Zobrex in TH), Tolperisone (CNS muscle relaxant), and if necessary, Prednisone.

I am currently taking no medicine and occasionally I am a bit stiff yet no need for meds.            How have I gone the last 5 years without any medication? I tried a new approach to health and it appears to be effective for me.

1. Extreme limitation on carbohydrates. Carbohydrates covert to sugar and adds to insulin resistance and later, if predisposed, to type 2 diabetes and inflammation. I strive for almost zero since most foods contain carbs. That means no bread or wheat products. If I eat wheat, it is without gluten. I used to eat a lot of carbs for marathon training yet I no longer feel the need. 

2. Zero processed foods

3.Maintain a healthy gut biome. Meds adversely affect the gut biome. Eat and drink a fair amount of fermented foods. Beer is fermented yet the beneficial bacteria is destroyed. Think yogurt, kefir, kombucha, sauerkraut, kimchi, Yakult 

The fermented foods must come from the refrigerated section. If not refrigerated the good bacteria is destroyed. 

4. No seed oils which promote inflammation. Olive oil, avocado oil, lard, tallow is ok. Beware of the last 2 if you have lipid issues. 

6. All protein is good. I eat eggs often for breakfast and switch off to fried tofu in place of eggs 2-3x per week. Grass fed beef is better than grain fed beef and no farm raised salmon only wild fish. Sardines are excellent sources of Omega 3 which supports inflammation reduction. 

All vegetables are good. Make sure that many are colorful. Dark green vegetables like kale, broccoli, and spinach are particularly good. Potatoes are a starch hence convert to sugar and hence inflammation. 

7. Drink sufficient water daily

8. No sugar except in good whole fruit. Beware of fruit juices. Orange juice contains more sugar than a coke. Both are bad. No artificial sweeteners as recent research has shown a negative effect in the gut. Insulin resistance, gut biome, and inflammation are related. 

9. I drink coffee, tea, Yerba Mate but not after 1600 to maintain quality sleep. 

10. I strictly limit alcohol but don't stress the occasional drink. I smoke strong weed within reason.              11. Try to get 8 hours of sleep that matches your circadian rhythm. In the morning within 30 minutes of waking look at the sky for a few minutes. It helps to reset your circadian clock. Same at sundown. (research the neuro science)

12. Since I am retired and have time, I walk at least 10k steps per day on a weekly average and do resistance training at least a half hour per day with strict form and tempo.

13. I take supplements and I am hesitant to recommend any except 2.  Supplements are unregulated and there are many brands with poorly sourced ingredients, inaccurate percentages or volumes. Many supplements come in different formulations. Some are more bioavailable than others. I encourage you to do your own research. As an example research the  bioavailability of the different formulations of Magnesium.         I only use supplements which are independently assayed brands. They cost a lot more yet are cheaper than medicine and illness. Available in Thailand at Lazada & Shoppe. 

Multivitamin -  Pure Encapsulations 1 Multi. 

Omega 3 - Carlson's (Beat all competing brands in freshness and purity. Rancid oils and heavy metals promote inflammation.)

Thorne Research is a good brand as well yet even more expensive. 

This is a brief overview of my discipline and I no longer need any medicines for pain, inflammation, or arthritis except in rare instances. The idea is to eliminate sources of chronic inflammation, support a healthy gut biome, and promote  efficient metabolism.

I have science backed peer reviewed research papers which helps my understanding. Here are a few practitioners I find value in learning from: 

-Dr. Brian Stanfield - NZ YouTube and https://drstanfield.com/

 

- Dr. Andrew Huberman U.S. Stanford University, https://hubermanlab.com/, YouTube, Podcast

 

-Dr. Rhonda Patrick            U.S. Salk Institute

https://www.foundmyfitness.com/ Podcasts

 

- Dr Sten Ekberg U. S. YouTube 

 

and many more. 

 

I don't stress any of these protocols. I follow them daily and make choices without sweating whether the choice is good or bad. I prefer good choices. I occasionally drink. I smoke quality weed. I sometimes break the rules because I know what works for me. My inflammation markers are very low and they were once off the charts. I now believe the adage, better to eat your food like medicine rather than eating medicine as food. 

I realize my advise may be viewed as radical. I have always challenged accepted beliefs, and in this case, it has enhanced my well being. My weight per BMI and waist to hip ratio is optimal, my lipid profiles are very good without meds (I was on statins for 20 years due to a family predisposition to atherosclerosis). YMMV

p.s.

If you review this with your M.D. realize many have varying degrees of training in nutrition, neurobiology, and gerontology. I would be shocked if they would disagree with most of what I have written. 

 

Best of luck

 

This mornings breakfast. 

 

 

 

 

 

 

 

Thank you very much for sharing very personal context. Undoubtfully you have invested lots of effort and patience in this repertoire but it can keep you away from all thise pills. I sincerely admire what you do and will share this with her.

[Sheryl]

17 minutes ago, WebGuy said:

Yes, rheumatoid arthritis for sure. I am aware what she is going through. A very mean disease. She stopped taking pills last year because they do not help her pain and she takes those steroids (if I am right). Then she jumped to some Swiss research program to try with that and it helped a bit.

 

I do not know what I could do for her here that can't be done back in the West.

 

Those balms helped her a bit before.

There is nothing you can do for her here that can't be done in the West. Indeed, there are moreo ptionsi n the West.

 

Make sure she brings enough of the steroids with her as they cannot be bought from a pharmacy. Also any other meds she is taking from the research program- these might not even be available here.

 

Some people find that warmer weather reduces RA flares but for others it is the exact opposite. So cannot predict how coming here will affect her symptoms.

[owenm]

RA is a very painful auto immune disease particularly if left untreated. I have had RA for more than 10 yrs, and when correctly treated can lead to remission or semi normality. 

 

It is crucial to have regular blood tests every 3-4 mths to check on CRP levels and liver function levels, which can show normal results when your medication is under control for your particular condition. 

 

I am taking Hydroxacloriquin 200mg daily (same as Plaquinel), Methotrexate 1x a week, with Folic Acid 5mg daily 6x weekly, but not on Methatrexate day. Arava can be taken 3x a week if still not under control. Unfortunately taking these meds can also lead to ED.. The magic med that works wonders for severe RA sufferers is a biologic drug called Humira, which is sold in pen form for self injection fortnightly in the West but in Thailand with the hotter climate, performs equally taken only monthly. 

 

Humira isn't avail in Thailand as I was bringing over from AUS every 6-8 mths. PBS price AU$42 per month, normal price around AU$1600. Very expensive but works wonders. Must be refrigerated which isn't easy when bringing into Thailand on long flights but with cooler packs can do and maintain low temps. 

 

Seeing a rheumatoligist at Siriraj Hosp in Bkk which does bloods in 2 hrs and reasonable pricing.. 

[Mark Nothing]

I completely eliminated my excruciatingly painful joint pain a few years ago by analyzing what I was doing to cause it.  And then quit doing what was causing it.

 

The culprit to most ailments is either what you are eating or what is eating at you.

 

In my case, I overwhelmed my body with inorganic mineral sediment in denatured food and water, which overwhelmed the elimination process causing the sediment to deposit to my joints causing pain.  So I switched to drinking distilled water and a diet with more fruits and salads which led to losing weight which helped too..

 

Controlling your mental state is a critical part of a healthy body functioning, which becomes disabled when under emotional turmoil like stress, worry, anxiety, marital disharmony to name a few.  Because of this the denatured food can not be eliminated as efficiently, and builds up leading to joint pain.  So I reduced as many agitations as possible and developed hobbies to increase pleasure and harmony.

 

This process worked for me.  It has been years with no joint pain at all.

 

Good luck fixing your joint pain.

 

 

[wtboatr]

Thank to everyone for commenting on my post regarding living with rheumatoid arthritis in Thailand.

 

For the past several years I've been taking the biologic drug Humira.  It's works great!  However, this drug is not available in Thailand, and even if it were, it would be too expensive for me to purchase.  This drug costs over $6,000 USD in the states.  If it were not for health insurance, I would not have had the pleasure of injecting myself every 2 weeks to control my RA.

 

I'm planning on moving full time to Thailand in 17 months so I must find a way to stop the pain and destruction to my body without the use of expensive biologics.  4 months ago, I stopped taking all my RA medications.  It looks like things were going to be ok, but as the drugs slowly left my body, all my joint pain and disabilities slowly returned.  I'm talking about finger, hand, shoulder, hips, knees, foot, and toes all in chronic or acute pain.  It's a terrible place to be.

 

I've been trying to fight this disease by following a low carb diet and exercise.  My diet is that of keto.  I'm practically a ketovore now, as I've been attempting to eliminate anything that can cause inflammation and painful flareups.  I was hopeful that diet could solve the problem, but I'm starting to lose faith that diet alone can manage the pain and damage to my body.  I've watched a lot of YouTube videos of people reducing RA by following a carnivore diet.  Everybody is different though and what works for one person may not work for another.

 

I've started to take a DMARD drug called Leflunomide.  It's relatively cheap, about $150 USD.  Form what I've read, it's available in Thailand.  At this time, I actually don't know if it will work. It'll take a few months to find out. 

 

I can't take methotrexate as it makes me nauseous.  Even worse for me is  Hydroxychloroquine.  That drug makes me so ill that I can't get out of bed.  Methotrexate and Hydroxychloroquine work well for many people with RA, but not for me as I can't deal with the nauseous side effects.

 

My goal is to take a cheap DMARD drug in the US, that's also available in Thailand so when I move there permanently, I can continue with the same drug and not be miserable in my new home country while I experiment with new medications.  Some of these medications can take months to take effect.  For instance, it took me 4 months on methotrexate for the drug to take effect and my join pain to subside.

 

Thank you for the rheumatologist recommendations.  I'll get in touch with at least one of them on my next trip so I can discuss my situation and available medications in Thailand.

 

If anyone can share the costs to see a rheumatologist, the cost of lab test, and the cost of their medications, I would be grateful.

 

In the meantime, I'll keep the carbs down as low as possible, consume zero sugar, take my vitamins, especially vitamin D, eat high quality fats and proteins, and exercise daily.  I know this definitely helps. 

 

If Leflunomide works for me, I'll be satisfied with the quality of my health.  I'll experiment in a few of years to see if I can live without it and protect my liver from the damage caused by DMARD's.

 

Once again, thank you for all your responses.

 

 

[Why Me]

23 minutes ago, wtboatr said:

For the past several years I've been taking the biologic drug Humira.  It's works great!  However, this drug is not available in Thailand, and even if it were, it would be too expensive for me to purchase. 

I have psoriasis and psoriatic arthritis (the latter fortunately not severe as yet) and have had terrific results for my skin with the biologic Cosentyx (secukinumab) branded Scapho in Thailand. It's expensive but not crazy expensive.: 6,911 b. for 150 mg. (vial or prefilled syringe) at a government hospital and 8,955 b. for 150 mg. from Novartis directly (with their buy 3 get 1 free promo). So you might want to check with your doc if Cosentyx might work for you. In which case, you might want to complete the loading phase in the States.

[Why Me]

13 hours ago, Sheryl said:

Assuming you mean rheumatoid arthritis - and not osteoarthritis (the more common kind, associated with age) there are no specific Thai treatments for this, it is managed same as in the west. and Cannabis is unlikely to help.

Hi Sheryl, interjecting a hopefully related question: who's a good doctor in Bkk to see for psoriatic arthritis?

[Lorry]

13 hours ago, owenm said:

Humira isn't avail in Thailand

 

3 hours ago, wtboatr said:

Humira.  It's works great!  However, this drug is not available in Thailand

Adalimumab is avalable in Thailand, brandnames Hulio, Hyrimoz et al.

[wtboatr]

7 hours ago, Why Me said:

the biologic Cosentyx (secukinumab) branded Scapho in Thailand. It's expensive but not crazy expensive.: 6,911 b. for 150 mg. (vial or prefilled syringe) at a government hospital and 8,955 b. for 150 mg. from Novartis directly (with their buy 3 get 1 free promo). So you might want to check with your doc if Cosentyx might work for you. In which case, you might want to complete the loading phase in the States.

I did a quick search for Cosentyx prices in the USA.  The cost is over $6,000 USD per month!  It's amazing how much cheaper the same drug is in Thailand.  This is good news.  I'll ask my rheumatologist about prescribing this biologic during my next appointment in December. 

 

Thank you!

[wtboatr]

5 hours ago, Lorry said:

Adalimumab is avalable in Thailand, brandnames Hulio, Hyrimoz et al.

That's good news.  Humira (Adalimumab) is an amazing biologic for rheumatoid arthritis as well as other diseases.  My insurance pays well over $6,000 per month for this drug as long as I live in the US.  However, my Blue Cross insurance plan provides no coverage outside the USA.

 

Any idea how much Hulio & Hyrimoz cost in Thailand?  A Google search yields no results.  If I'm able to obtain this bio-similar at a reasonable cost, it may be an option that will save me a lot of suffering and truly prolong my life.

Edited October 27, 2022 by wtboatr

[Lorry]

 

[Why Me]

9 hours ago, wtboatr said:

It's amazing how much cheaper the same drug is in Thailand. 

It's even cheaper in India. Apparently patients in S and SE Asia pick up multiple doses in India to take home. Of course, with biologics you need to be sure of refrigeration and backup.

[wtboatr]

I got some information on obtaining a bio-similar of Humira (Adalimumab) in Thailand.

 

Hyrimoz, Hulio, & Exemptia, 40 mg/0.8 ml prefilled syrige is about 8600 baht when purchased from private hospitals and about 4500 baht when purchased from government hospitals.

 

Seeing that the cost is about half when procured from a government hospital, do you think I can have a prescription ordered from a rheumatologist at private hospital then pick it up the medication at a pharmacy at a government hospital? 

 

I need two doses per month so the cost from a private hospital would be about $450 per month.  The cost to obtain the medication from a pharmacy at a government hospital would be about $250 per month.  Both prices are far cheaper than the USA.  It would be nice to save the $200 per month if possible.

[Sheryl]

On 11/1/2022 at 12:12 AM, wtboatr said:

 

Seeing that the cost is about half when procured from a government hospital, do you think I can have a prescription ordered from a rheumatologist at private hospital then pick it up the medication at a pharmacy at a government hospital? 

 

 

No, you cannot do this. Hospital pharmacies (private and government) serve only patients at their specific hospital i.e. dispense medications ordered by a doctor at that hospital. They do nto fill outside prescriptions.

 

You will have to see a rehuamtologist at the government hospital to get the medication there.

[Sheryl]

On 10/27/2022 at 12:19 AM, Why Me said:

Hi Sheryl, interjecting a hopefully related question: who's a good doctor in Bkk to see for psoriatic arthritis?

Same doctors listed in my post of Oct 26

[ace]

Hello 

 

resurrecting this topic for question: Has anyone experience of bringing Humira into Thailand? I have a number of letters (gp, rheumatologist, and Thai doctor) to show it is a prescribed medication. I’ve contacted the airline. I can’t get through to the Thai embassy as I run out of minutes waiting in the phone queue. I know adamulib isn’t a restricted drug on Thai fda website.

Am I missing anything, do I need further permissions?

I will be on a tourist visa, august. Just concerned about getting in trouble at Bkk airport.

[Sheryl]

28 minutes ago, ace said:

Hello 

 

resurrecting this topic for question: Has anyone experience of bringing Humira into Thailand? I have a number of letters (gp, rheumatologist, and Thai doctor) to show it is a prescribed medication. I’ve contacted the airline. I can’t get through to the Thai embassy as I run out of minutes waiting in the phone queue. I know adamulib isn’t a restricted drug on Thai fda website.

Am I missing anything, do I need further permissions?

I will be on a tourist visa, august. Just concerned about getting in trouble at Bkk airport.

It is not a restricted drug and you will have no problems as long as you have proof of prescription and quantities are consistent with personal use for a month or so.

 

Odds are you won't even be checked but if you are, this fully meets requirements.

 

Technically the rule on quantity now is 30 day supply (used to be 90) but this does not seem strictly enforced as on gas it looks consistent with personal use.