Overuse Of Antibiotics Blamed On Free Health Schemes

[george]

Overuse of antibiotics blamed on free health schemes

BANGKOK: -- The government has been urged to introduce co-payment for the national health scheme in a bid to reduce an "overuse of medicine".

The Pharmaceutical Research and Manufacturers Association (PReMA) says Thais spent more than Bt17 billion buying antibiotics at drug stores and hospitals last year.

"A co-payment system for the healthcare scheme would help patients buy medicine more rationally," PReMA head Teera Chakajnarodom said.

Speaking at a press conference, Teera said a report by the research agency IMS showed Bt99 billion was spent in Thailand on medicine to treat 17 non-communicable diseases. Of this, the sum spent on antibiotics, was the highest with Bt17 billion.

This was caused by health schemes which allow people get medicine without paying for it.

There are three healthcare schemes that provide free medicine - the National Health Security Office (NHSO)'s universal health scheme; the scheme run by the Social Security Office; and the medical benefits scheme run by the civil servants' service agency.

More and more people were more asking for free medicine from hospitals since former health minister Mongkol na Songkhla abolished the Bt30 fee for universal healthcare.

"People go to hospitals and ask for medicine even if they just have the flu. Some people, particularly in rural areas, also invite their relatives to receive medicine at hospitals even if their friends or relatives are not ill," he said. "Meanwhile, medicines are irrationally prescribed by doctors."

Teera believed that making patients partly pay for the health scheme would make them think more carefully about their spending, particularly when buying medicines.

"People will think again and again before they will spend their money to buy drugs particularly unnecessary drugs such as antibiotics," he said.

However, he said the government also should launch an alternative channel to enable patients to buy medicines under the three healthcare schemes - either from hospitals or drug stores.

"This would help patients determine the quality of medicine that they want to use, between those used in hospital or on sale in drug stores," he said.

-- The Nation 2009-03-27

[malcolmswaine]

For sure ... those pharmacists hand out antibiotics like sweets. They seem to have no conception of what happens to people's immune systems after being prescribed a 3 week course of Bactrim every time they get the sniffles!

[Beacher]

Instead of looking at the real problem of poorly trained and educated doctors, the Thai members of government once again bury their heads in the sand while pointing the finger in the wrong direction.

Well before the 30 baht health scheme, Thai doctors were in the habit of prescribing multiple medications for everything. It has always been a standing joke amongst my friends that after leaving the doctor's office, you went through the 8, 9, 10 or so prescriptions and tried to decide which one or two you should really take. They don't seem to understand the dangers of overusing medicine or sometimes even how it should be used. I once went to get some excess wax removed from inside my ears, and the the doctor prescribed a product called Waxsol. I'm familiar with the product and understood my need to use it. What was strange, though, was that the doctor prescribed two bottles and told me to put it in each ear everyday for two weeks. I've never heard of anyone using it for more than a couple of days. Sure enough, when I got home and opened a box of Waxsol, there was a sheet of paper with instructions for how to use the product. In very large block letters that took up 1/3 of the page was a strong warning that said, "WARNING - DO NOT USE THIS PRODUCT FOR MORE THAN 3 CONSECUTIVE DAYS". What a F---ing quack! If I hadn't seen the warning given by the manufacturer, who knows what long-term problems or permanent damage I would have experienced.

Edited March 27, 2009 by Beacher

[h90]

For sure ... those pharmacists hand out antibiotics like sweets. They seem to have no conception of what happens to people's immune systems after being prescribed a 3 week course of Bactrim every time they get the sniffles!

Also common to stop Antibiotics as soon they feel better, when the feel worse they take it again.

That's exactly the way to breed resistant bacterias.

[wasabi]

I think the copay system is not a bad idea and might help the problem at least from the patient end. I bet there are some extremely strong bacterium floating around in Thailand due to the abuse and overuse of Antibiotics.

Antibiotics are not the harmless little helper pills many people and doctors think they are. There can be serious side effects aside from the danger of weakening your immune system.

[yumidesign]

Instead of looking at the real problem of poorly trained and educated doctors, the Thai members of government once again bury their heads in the sand while pointing the finger in the wrong direction.

Well before the 30 baht health scheme, Thai doctors were in the habit of prescribing multiple medications for everything. It has always been a standing joke amongst my friends that after leaving the doctor's office, you went through the 8, 9, 10 or so prescriptions and tried to decide which one or two you should really take. They don't seem to understand the dangers of overusing medicine or sometimes even how it should be used. I once went to get some excess wax removed from inside my ears, and the the doctor prescribed a product called Waxsol. I'm familiar with the product and understood my need to use it. What was strange, though, was that the doctor prescribed two bottles and told me to put it in each ear everyday for two weeks. I've never heard of anyone using it for more than a couple of days. Sure enough, when I got home and opened a box of Waxsol, there was a sheet of paper with instructions for how to use the product. In very large block letters that took up 1/3 of the page was a strong warning that said, "WARNING - DO NOT USE THIS PRODUCT FOR MORE THAN 3 CONSECUTIVE DAYS". What a F---ing quack! If I hadn't seen the warning given by the manufacturer, who knows what long-term problems or permanent damage I would have experienced.

If i am prescribed anything by dr. or pharmacy in Thailand i always go straight to the 'puter and check MIMS Asia (you have to rigester, just say you are med student) or Mayo Clinic for informatuon about the condition and drug info. and then decide to buy or not

[webfact]

For sure ... those pharmacists hand out antibiotics like sweets. They seem to have no conception of what happens to people's immune systems after being prescribed a 3 week course of Bactrim every time they get the sniffles!

BACTRIM for those who want to learn about the danger!

Thanks to the OP to mention Bactrim

Edited March 27, 2009 by webfact

[astral]

For sure ... those pharmacists hand out antibiotics like sweets.

They seem to have no conception of what happens to people's immune systems after being prescribed a 3 week course of Bactrim every time they get the sniffles!

3 weeks of antibiotics????????

More like 3 days, which can leave you with a resistant bug.

[katasyd]

Why can't the Thai's overuse contraception medicine?

Then the stupid gene would be contained.

[TAWP]

Why can't the Thai's overuse contraception medicine?

Then the stupid gene would be contained.

Because only the educated use contraceptives properly in the first place...

[londonthai]

Overuse of antibiotics blamed on free health schemes

BANGKOK: -- The government has been urged to introduce co-payment for the national health scheme in a bid to reduce an "overuse of medicine".

The Pharmaceutical Research and Manufacturers Association (PReMA) says Thais spent more than Bt17 billion buying antibiotics at drug stores and hospitals last year.

"A co-payment system for the healthcare scheme would help patients buy medicine more rationally," PReMA head Teera Chakajnarodom said.

This was caused by health schemes which allow people get medicine without paying for it.

There are three healthcare schemes that provide free medicine - the National Health Security Office (NHSO)'s universal health scheme; the scheme run by the Social Security Office; and the medical benefits scheme run by the civil servants' service agency.

More and more people were more asking for free medicine from hospitals since former health minister Mongkol na Songkhla abolished the Bt30 fee for universal healthcare.

"People go to hospitals and ask for medicine even if they just have the flu. Some people, particularly in rural areas, also invite their relatives to receive medicine at hospitals even if their friends or relatives are not ill," he said. "Meanwhile, medicines are irrationally prescribed by doctors."

Teera believed that making patients partly pay for the health scheme would make them think more carefully about their spending, particularly when buying medicines.

"People will think again and again before they will spend their money to buy drugs particularly unnecessary drugs such as antibiotics," he said.

However, he said the government also should launch an alternative channel to enable patients to buy medicines under the three healthcare schemes - either from hospitals or drug stores.

"This would help patients determine the quality of medicine that they want to use, between those used in hospital or on sale in drug stores," he said.

from the sound of the article it's more about saving money by government than about health.

it's not a patient, who decides, what medicine will be used, but doctors - blaiming patients is poitless. Anyway, majority do have to pay full money for medicines, those 3 schemes cover minority.

what is worrying as well, that hospitals might start using cheaper, inadequate medicines and reduce a choice for doctors to match illness with the best drug. Only those with money will be able to afford the best medicines, so it's going to be a step back from only recently introduced affordable national health care.

of course there is a great problem with overusing medicines in thailand, but it's doctors and pharmacists who push them without thinking about the consequenses and not educating patients about choises

[sriracha john]

The Pharmaceutical Research and Manufacturers Association (PReMA) says Thais spent more than Bt17 billion buying antibiotics at drug stores and hospitals last year.

"A co-payment system for the healthcare scheme would help patients buy medicine more rationally," PReMA head Teera Chakajnarodom said.

Speaking at a press conference, Teera said a report by the research agency IMS showed Bt99 billion was spent in Thailand on medicine to treat 17 non-communicable diseases. Of this, the sum spent on antibiotics, was the highest with Bt17 billion.

This was caused by health schemes which allow people get medicine without paying for it.

Instead of looking at the real problem of poorly trained and educated doctors, the Thai members of government once again bury their heads in the sand while pointing the finger in the wrong direction.

PReMA is not the government.

The other parts of your post are accurate. Mis-prescribing antibiotics has been going on by un-knowledgeable and/or unethical medical practitioners for the 40 years I've been in and out of SE Asia.

[noahvail]

<snipped>

However, he said the government also should launch an alternative channel to enable patients to buy medicines under the three healthcare schemes - either from hospitals or drug stores.

"This would help patients determine the quality of medicine that they want to use, between those used in hospital or on sale in drug stores," he said.

-- The Nation 2009-03-27

Uhmmmm...does mean there's a different 'quality of medicine' at a drug store as opposed to a hospital's pharmacy?

Which one has the better quality????

And, just for laughs - who's watching for counterfeit meds from China?

[Minus]

Thai "doctors" ( and specially the ones at BNH and Bumgurngrad) , obviously never had to take the Hypocrate's oath.

They are just pimps of the pharmaceutical companies.

Shameful pimps trying to make their pathetic quota .

[DP25]

it's not a patient, who decides, what medicine will be used, but doctors - blaiming patients is poitless.

I don't think that's entirely true, patients do share the blame. Many Thais go to the hospital over the slightest case of the sniffles, stomach ache, minor cough, or headache, and they are expecting multiple medications when they walk out. A lot of Thais I know are going to the hospital pretty much every month over extremely mild conditions, and most foreigners I know haven't been for years.

And while doctors overprescribe, it doesn't matter in the end because you can buy any antibiotic in Thailand without a prescription. You just walk in and tell them what you want, and many people self diagnose and do exactly that. Ridiculously cheap medication and virtually unlimited and unsupervised access to it, it's no surprise that so many new strains of disease are coming out of Asian region.

[DP25]

A few weeks ago a friend of mine had a stomach ache. So she went to the pharmacist and told the symptoms, and walked out with multiple bags of anti biotics. No testing, nothing. It cleared up the next day on it's own, as it obviously would, so the remaining medication was thrown out. Simply ridiculous.

[henryalleman]

Why the government launch a big campaign to tell the public that Antibiotics are completely useless against viruses, the are only useful against bacteria,

So you can't cure the flue or a cold with Antibiotics.

And even so important is to forbid that Doctors and Hospitals selling medicines.

Doctors and hospitals hurting themselves to reduce the use of medicines, because its a big money maker for them.

Antibiotics, sleeping pills and so on, should only be available when you have an prescription from a Doctor and get them in licensed pharmacies.

Edited March 27, 2009 by henryalleman

[brahmburgers]

Thai "doctors" ( and specially the ones at BNH and Bumgurngrad) , obviously never had to take the Hypocrate's oath.

They are just pimps of the pharmaceutical companies.

Shameful pimps trying to make their pathetic quota .

I agree with all the posts preceding mine in this thread. I've had live-in Thai girlfriends (one at a time ), and each time they get the slightest hint of something (sniffles or headache, whatever) - bam - it's off to the clinic or hospital. Inevitably, there will be a bunch of pills prescribed, of dubious value, with at least one set of pills being antibiotics. And just as inevitably, the friend will do them for a day or so, until the symptom lessens, and then quit - thereby making it possible for a more virulent form (of whatever she may have had) to develop.

When I've gone to the hospital, a few times during the past several years, the Thai doc (usually a young unsmiling gob just out of school), will prescribe about 5 sets of pills. I won't know until I go to the window to pay.

Just so everyone reading this knows: it's perfectly alright to gently refuse any pills you don't want, or don't think you need. Each time I've done that, whatever person happens to be dispensing the pills gives me a grin which seems to say, "you farang are a bit odd in not following convention as all Asians do, and it seems you're seeing right through the 'peddle as many pills as possible' scam of this hospital I'm working for."

[Shazza]

The only way we knew about all this stuff in New Zealand was education... once the masses were educated, then the doctors couldn't prescribe antibiotics when not needed...my son gets just about every bug that goes around... recently he was super sick with high temps and my merebaan was really stressed out as I didn't take him right away to the doctor.... I did need to in the end and he did need antibiotics and he did get better...

How can we help to educate Thai people about these things? Included on my list would be how can we also educate them about green issues?

These things took a generation or two in New Zealand before the general public got on board... I guess they'll take that long here as well...

[Loaded]

It's an Asian-wide problem. However, the Chinese are far from stupid and they also prescribe at the drop of a chopstick; so, and I'm playing devil's advocate here: does the over prescription of antibiotics actually create super resistant bugs? Is there any truely independent evidence to show this?

Could it be that our Pharmaceutical industry, which seems to have taken control of the US health system at least, not want us to be cured so that we buy their other products? IE the products that treat symptoms and don't offer cures. We are told there is no cure for AIDS, but millions are spent on research and billions earned from treatments. Is there any actual research into a cure?

[henryalleman]

Why the government launch a big campaign to tell the public that Antibiotics are completely useless against viruses, the are only useful against bacteria,

So you can't cure the flue or a cold with Antibiotics.

And even so important is to forbid that Doctors and Hospitals selling medicines.

Doctors and hospitals hurting themselves to reduce the use of medicines, because its a big money maker for them.

Antibiotics, sleeping pills and so on, should only be available when you have an prescription from a Doctor and get them in licensed pharmacies.

Of course the first sentence should start with

Why the government DO NOT launch..........

[h90]

Why the government launch a big campaign to tell the public that Antibiotics are completely useless against viruses, the are only useful against bacteria,

So you can't cure the flue or a cold with Antibiotics.

And even so important is to forbid that Doctors and Hospitals selling medicines.

Doctors and hospitals hurting themselves to reduce the use of medicines, because its a big money maker for them.

Antibiotics, sleeping pills and so on, should only be available when you have an prescription from a Doctor and get them in licensed pharmacies.

For the first sentence: It seems to be complete unknown even to doctors. Whenever I start telling that I see on big ?????????????

At the last sentence: I don't think it is OK to treat adults like little children. You can't protect them against themself.

[harrry]

A few weeks ago a friend of mine had a stomach ache. So she went to the pharmacist and told the symptoms, and walked out with multiple bags of anti biotics. No testing, nothing. It cleared up the next day on it's own, as it obviously would, so the remaining medication was thrown out. Simply ridiculous.

Yes it was ridiculous to through the medicine away

All antibotics should be taken for a full course. All that the ridiculous person has done is to add to the immunity of the bug and mnean an importantantibiotic doesnt work so well any more.

[h90]

A few weeks ago a friend of mine had a stomach ache. So she went to the pharmacist and told the symptoms, and walked out with multiple bags of anti biotics. No testing, nothing. It cleared up the next day on it's own, as it obviously would, so the remaining medication was thrown out. Simply ridiculous.

Yes it was ridiculous to through the medicine away

All antibotics should be taken for a full course. All that the ridiculous person has done is to add to the immunity of the bug and mnean an importantantibiotic doesnt work so well any more.

that is also unknown in Thailand! With either eating antibiotics just 2 days or eating it 3 month every second day.....

I anyway doubt that the stomach ache came from bacteria, so wrong to start with the antibiotics. I am not sure if it is wrong to stop antibiotics if you DON'T have an infection???

[henryalleman]

Thai "doctors" ( and specially the ones at BNH and Bumgurngrad) , obviously never had to take the Hypocrate's oath.

They are just pimps of the pharmaceutical companies.

Shameful pimps trying to make their pathetic quota .

I think they where mixed-up they thought they vowed the Hypocritical oath.

[henryalleman]

It's an Asian-wide problem. However, the Chinese are far from stupid and they also prescribe at the drop of a chopstick; so, and I'm playing devil's advocate here: does the over prescription of antibiotics actually create super resistant bugs? Is there any truely independent evidence to show this?

Yes, I'm resistant to some Anti-Biotics. And this created a huge problems a few years ago when I had to have an major surgery. I had to go to hospital ten day's prior to the operation to be bombed(words of the Doctor) with the strongest Anti-Biotic available on the market, to kill the bacteria. He told me frankly if this didn't succeed I could prepare myself to say goodbye with my family. He also said that this would create an extremely high risk during surgery.

Could it be that our Pharmaceutical industry, which seems to have taken control of the US health system at least, not want us to be cured so that we buy their other products? IE the products that treat symptoms and don't offer cures. We are told there is no cure for AIDS, but millions are spent on research and billions earned from treatments. Is there any actual research into a cure?

There is no cure against AIDS ,only a coctail to prevent further infections, so you can have a normal productive lif. But you are still carrier of the bacteria and can infect other people.

[h90]

It's an Asian-wide problem. However, the Chinese are far from stupid and they also prescribe at the drop of a chopstick; so, and I'm playing devil's advocate here: does the over prescription of antibiotics actually create super resistant bugs? Is there any truely independent evidence to show this?

Yes, I'm resistant to some Anti-Biotics. And this created a huge problems a few years ago when I had to have an major surgery. I had to go to hospital ten day's prior to the operation to be bombed(words of the Doctor) with the strongest Anti-Biotic available on the market, to kill the bacteria. He told me frankly if this didn't succeed I could prepare myself to say goodbye with my family. He also said that this would create an extremely high risk during surgery.

you are hopeful resistant against the antibiotics, as they shall not kill you, but the problem is you had resistant bacterias inside (and they sometimes even share information with others). Usually the way is simply to use other antibiotics. But since some years there are a few bacterias around who can manage all of them. There are still ways around but less and less and it gets more and more expensive.

Could it be that our Pharmaceutical industry, which seems to have taken control of the US health system at least, not want us to be cured so that we buy their other products? IE the products that treat symptoms and don't offer cures. We are told there is no cure for AIDS, but millions are spent on research and billions earned from treatments. Is there any actual research into a cure?

There is no cure against AIDS ,only a coctail to prevent further infections, so you can have a normal productive lif. But you are still carrier of the bacteria and can infect other people.

HIV is a virus

[brahmburgers]

There are probably lots of stories like this, but I recall reading one about 10 years ago about a young gal in the States who got her ears pierced. Her earlobe infection didn't respond to any of the antibiotics at her hospital, and the infection spread. Finally, some exotic expensive and rare new antibiotic was found, that fixed her up. I think the rare antibiotic was synthesized from compounds in a sea slug, can't recall for sure.

There are an ongoing stories of prisoners being released from Russian jails (as a matter of them completing their sentences), however some/many have TB that doesn't respond to any of the antibiotics on hand. There are social workers in NYC (among other places) whose job it is to go around to homeless and junkies to make sure they're taking their prescribed antibiotics for full term.

SARS may make the headlines today, but future headlines will be runaway infections which don't respond to antibiotics - infections which once were relatively easy to keep under wraps, but which, in the near future, will spread like wildfire.

Edited March 28, 2009 by brahmburgers

[Loaded]

There are probably lots of stories like this, but I recall reading one about 10 years ago about a young gal in the States who got her ears pierced. Her earlobe infection didn't respond to any of the antibiotics at her hospital, and the infection spread. Finally, some exotic expensive and rare new antibiotic was found, that fixed her up. I think the rare antibiotic was synthesized from compounds in a sea slug, can't recall for sure.

There are an ongoing stories of prisoners being released from Russian jails (as a matter of them completing their sentences), however some/many have TB that doesn't respond to any of the antibiotics on hand. There are social workers in NYC (among other places) whose job it is to go around to homeless and junkies to make sure they're taking their prescribed antibiotics for full term.

SARS may make the headlines today, but future headlines will be runaway infections which don't respond to antibiotics - infections which once were relatively easy to keep under wraps, but which, in the near future, will spread like wildfire.

SARS was a scam. More people were dying of reactions to paracetamol in the countries 'infected' by SARS but Rumsfeld's shares in the company providing the vaccine made him a fortune. Same with the bird flu 'scare'. Just a strategy for the chicken industry to be consolidated into the hands of then Thaksin friend and associate CP.

Problem - Reaction - Solution

A scare is created by the criminals who run this world; people demand a reaction by their trusted 'democratic' governments; the solution is happily accepted by the masses and the masses are shafted again. You can transpose this template onto the Iraq or Afghanistan wars and 9/11.

[henryalleman]

It's an Asian-wide problem. However, the Chinese are far from stupid and they also prescribe at the drop of a chopstick; so, and I'm playing devil's advocate here: does the over prescription of antibiotics actually create super resistant bugs? Is there any truely independent evidence to show this?

Yes, I'm resistant to some Anti-Biotics. And this created a huge problems a few years ago when I had to have an major surgery. I had to go to hospital ten day's prior to the operation to be bombed(words of the Doctor) with the strongest Anti-Biotic available on the market, to kill the bacteria. He told me frankly if this didn't succeed I could prepare myself to say goodbye with my family. He also said that this would create an extremely high risk during surgery.

you are hopeful resistant against the antibiotics, as they shall not kill you, but the problem is you had resistant bacterias inside (and they sometimes even share information with others). Usually the way is simply to use other antibiotics. But since some years there are a few bacterias around who can manage all of them. There are still ways around but less and less and it gets more and more expensive.

Could it be that our Pharmaceutical industry, which seems to have taken control of the US health system at least, not want us to be cured so that we buy their other products? IE the products that treat symptoms and don't offer cures. We are told there is no cure for AIDS, but millions are spent on research and billions earned from treatments. Is there any actual research into a cure?

There is no cure against AIDS ,only a coctail to prevent further infections, so you can have a normal productive lif. But you are still carrier of the bacteria and can infect other people.

HIV is a virus

English is not my native language therefore the mistake I made. Of course I was meaning that I had an bacteria who was resistant against almost Anti-biotics. Thats why I got Baxter's 24 hours a day during 10 day's before they could perform surgery.

I knew that HIV is a virus, but I was too pre-occupied with bacteria to notice that I typed a mistake.