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Thinktank Says Thai Hospitals Overcharge For Medicine


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Thinktank says hospitals overcharge for medicine

By The Nation

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Hospitals have usually sold medicines at a rate much higher than actual cost, according to a study by the Thailand Development Research Institute (TDRI).

The study said each paracetamol tablet, for example, was available at just Bt1 at general drugstores but inpatients and outpatients at hospitals have usually been required to pay at least Bt10 per tablet and Bt3 respectively.

"Inpatients have been charged more because they are unable to refuse the medicines given to them," the study pointed out.

According to the study, although most outpatients have bought medicines prescribed by doctors from hospitals they are visiting, they still have the choice of not accepting the medicine if the price is too high. Therefore, the hospitals have tended to charge them less when compared with inpatients.

The TDRI forwarded the study's findings to the Department of Intellectual Property (DIP) earlier this year.

The study recommended that the government lay down an efficient system for monitoring medicine prices at both state and private hospitals to prevent unfair pricing and to encourage efficient drug prescription.

"The government needs to pay special attention to private medical facilities that have now eaten two thirds of the medical cost in the country," the study said.

It also suggested that the government consider taking necessary actions in ensuring that the price of patent medicines is not too high.

Some foreign countries have already proceeded through available legal channels in tackling the problem of expensive patent medicines. Nongovernmental organisations in South Africa, for instance, called on the country's trade competition commission to take action against GlaxoSmithKline in 2002 for charging too high for its Aids drugs. In the end, the patent owner agreed to let three local drug manufacturers churn out similar drugs to help patients in South Africa and nearby countries.

"Laws about trade competition and monopoly can be invoked to ensure that the medicine price is not too high," the study said.

According to the study, the government has suffered direct consequences from the unnecessarily high medicine prices. As the government has paid medical facilities based on services given to civil servants and their family members, it has shouldered a huge cost. The ComptrollerGeneral's Department has to reimburse money for these medicalservice providers.

In 2005, the total reimbursement amount stood at around Bt30 billion. However, the figure has soared, to more than Bt60 billion last year.

According to the ComptrollerGeneral's Department, up to Bt 40billion were for medicines.

The huge amount of money spent on medicines has raised concerns that the medicalservice providers might have deliberately prescribed unnecessarily expensive medicines for patients.

Widespread arguments are that hospitals have to charge high for medicines because they need money to offset heavy burden from the government's universal healthcare scheme.

The scheme basically has offered free treatments for more than 45million people. Apart from their heavy workloads, state hospitals have limited budgets also because the government has provided perhead subsidies, not fees for service.

However, a recent seminar was told that the Public Health Ministry's remaining cash amount had increased over the past several years. In 2002, the year universal healthcare was introduced, the remaining cash amount was at Bt14.6 billion. Last year, the remaining cash amount was at Bt42.96 billion.

The TDRI, therefore, has questioned whether the state hospitals are really operating at a loss. It also pointed out that even if the state hospitals had suffered from financial losses, it was not right to prescribe unnecessary drugs.

"All medicines have side effects," it said.

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-- The Nation 2010-07-16

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This is very old news for any patient treated in a hospital. I hope that those in an outpatient situation, capable of getting their own medication, get a script or note of the name of the medication from the physician to obtain the medication from a pharmacy outside the hospital. The mark up on medications within the hospital situation is a bloody disgrace. And over-prescription would have me suspect that physicians are on a kickback but would I suggest that???

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There is a cost to physically dispense the medication. There is also a cost associated with maintaining an inventory. Dispensing medications in a hospital is a time consuming process with alot of manual labour that only adds to the costs. The markups on medication adminstered in a hospital are used to help cover the costs of having a hospital that is open and staffed 24/7. Before anyone flies off the handle, consider this: You know the local pharmacy where you can buy the drugs for next to nothing? Ask them how much they would charge to have a doctor write a prescription, deliver it to the pharmacy and then have the pharmacy prepare one or two tablets to be delivered to your bedside by an RN, who would then supervise the dosing.

The markups referenced in the article are insignificant compared to what patients pay in other countries without a government drug plan. It is not unusual for some drugs in the USA to have a 1000% markup. There are however downsides to having a generous drug plan and France illustrates this best. France has a population that is clueless to the costs of drugs since the drugs are covered in large part by the national health plan and/or by supplementary insurance which almost 9 out of 10 people have. The result is that the French spend more on expensive proprietary brands, bypassing generics, and there is a greater likelihood to prescribe drugs in France then there is elsewhere in the EU and North America. When no cost attaches to something, the option is abused.

Yes, Thai hospitals take advantage of a situation. We know that. It is what happens in this part of the world. Personally, I find it repugnant, but we all know that the private healthcare system is run on a for profit basis. It would be great if there was a public drug plan, but who would pay for it? Does anyone think Mr. Abhisit could get away with raising taxes on his supporters to pay for the scheme?

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It's a blatant scam by the hospitals. They are exploiting sick people. It's so obvious that there was no need for a "Thinktank" to be revealing this.

Hospitals, as respected institutions of society on which many people's lives are dependent on every day, should be upholding ethical practices.

I felt so disgusted when I compared the prices of medicine that I had bought in a hospital with prices in Boots pharmacy. From then whenever I visit a doctor in a hospital I tell the doctor that I will buy the medicine outside.

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Bangkok Hospital Phuket was going to charge me about twice the price of my local pharmacy for the same drug, outpatient. I got a bit angry with the doctor there as well. I guess Thais never question a doctor. She was a bit taken aback by my questioning her. And then got a bit rude to me, which doesn't fly with an American that is taught to ask questions of their doctor and be informed. At that point I told her to give me all the test results, paid the bill and never went back there.

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The only reason I pay the price for prescription drugs in hospitals is because I an not so sure id the drug I am buying at the outside phamarcy is the real thing. I suppose that is the case also in the hospitals. I would like to be sure due to my condition that I am being supplied with the correct drugs and not a copy from a Third World country.

What pharmacy can you trust in Thailand?? Boots?

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Oh, surprise, surprise.

A bunch of people sit around a table and tell us something we all already knew. The ability for the pooyai to state the bleeding obvious is quite astonishing. Next headline "Thinktank issues ineffective recommendations for changes to laws to prevent medicine overcharging."

What next. Thinktank says police are corrupt?

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<br>There is a cost to physically dispense the medication. There is also a cost associated with maintaining an inventory. Dispensing medications in a hospital is a  time consuming process with alot of manual labour that only adds to the costs. The markups on medication adminstered in a hospital are used to help cover the costs of  having a hospital that is open and staffed 24/7.  Before anyone flies off the handle, consider this: You know the local pharmacy where you can buy the drugs  for next to nothing?  Ask them how much they would charge to have a doctor write a prescription, deliver it to the  pharmacy and then have the pharmacy prepare one or two tablets to be delivered to your bedside by an RN, who would then supervise the  dosing.<br><br> The markups referenced in the article are insignificant compared to what patients pay in other countries without a government drug plan. It is not unusual for some drugs in the USA to have a 1000% markup. There are however  downsides to having a generous drug plan and France illustrates this best.  France has a population that is clueless to the costs of drugs since the drugs are covered in large part by the national health plan and/or by supplementary insurance which almost 9 out of 10 people have. The result is that  the French spend more on expensive proprietary brands, bypassing generics, and  there is a  greater likelihood to prescribe drugs in France then there is elsewhere in the EU and North America. When no cost attaches to something, the  option  is abused.<br><br>Yes, Thai hospitals take advantage of a situation. We know that. It is what happens in this part of the world. Personally, I find it repugnant, but we all know that the private  healthcare system is run on a for profit basis. It would be great if there was a public drug plan, but who would pay for it? Does anyone think Mr. Abhisit could   get away with raising taxes on his supporters to pay for the scheme?<br>
<br><br>The main issue with this is that everyone uses blister packed medicines. If they used bulk pack as they do in other countries the cost would come down radically. They would still need a pharmacist to assure reasonable safety. I had heart surgery 2 weeks ago to place a stent in the heart. That bill was over 300K THB. With charges like 110 baht for a pair of non-sterile rubber gloves is a joke. That would buy a whole box. So on pharmacy, they are making big money. But as mentioned the patient has the right of refusal. Try and buy your schedule II drugs like Xanax, hydrocodone, etc., at your corner drug store. <br><br>Old news but what can you do?<br><br><br>
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The only reason I pay the price for prescription drugs in hospitals is because I an not so sure id the drug I am buying at the outside phamarcy is the real thing. I suppose that is the case also in the hospitals. I would like to be sure due to my condition that I am being supplied with the correct drugs and not a copy from a Third World country.

What pharmacy can you trust in Thailand?? Boots?

You seem to imply that Thailand is not a third world country.........

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LOL, i am not sure if the article is about gov hospitals or private.

Bangkok Hospital charges 300% more for the medicine then any other pharmacy

Pattaya Memorial charges 200% then an expensive pharmacy

This is why when you go see doctor with sore throat you come out with 10 different tablets and your doctors fee is 600 but your medicine is 1500 baht.

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There is a cost to physically dispense the medication. There is also a cost associated with maintaining an inventory. Dispensing medications in a hospital is a time consuming process with alot of manual labour that only adds to the costs. The markups on medication adminstered in a hospital are used to help cover the costs of having a hospital that is open and staffed 24/7. Before anyone flies off the handle, consider this: You know the local pharmacy where you can buy the drugs for next to nothing? Ask them how much they would charge to have a doctor write a prescription, deliver it to the pharmacy and then have the pharmacy prepare one or two tablets to be delivered to your bedside by an RN, who would then supervise the dosing.

The markups referenced in the article are insignificant compared to what patients pay in other countries without a government drug plan. It is not unusual for some drugs in the USA to have a 1000% markup. There are however downsides to having a generous drug plan and France illustrates this best. France has a population that is clueless to the costs of drugs since the drugs are covered in large part by the national health plan and/or by supplementary insurance which almost 9 out of 10 people have. The result is that the French spend more on expensive proprietary brands, bypassing generics, and there is a greater likelihood to prescribe drugs in France then there is elsewhere in the EU and North America. When no cost attaches to something, the option is abused.

Yes, Thai hospitals take advantage of a situation. We know that. It is what happens in this part of the world. Personally, I find it repugnant, but we all know that the private healthcare system is run on a for profit basis. It would be great if there was a public drug plan, but who would pay for it? Does anyone think Mr. Abhisit could get away with raising taxes on his supporters to pay for the scheme?

Seven years ago I was paying about 1/4 here in Chiang Rai from the drug store for my prescription drugs then the US.

Just got another yearly oder it is now up 200% in Baht from 7 years ago, the same I can now buy at Costco in the US

for 1/2 then I pay here because they went generic there. Everyone is different but this true in my case.

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.

"What pharmacy can you trust in Thailand?? Boots?"

Yes, Boots is good but expensive for some meds.

I've found Fascino to be the best -- reasonable prices and they give you an additional 5% discount if you have one of their discount cards.

One very well known hospital prescribed over 9000 Baht of imported meds for me -- When I asked the doctor if the generic version sold at Fascino was equal to the import, he just stared at me. I asked again if it would be OK to buy the generic and he finally answered "That's not good for the hospital!"

I went to Fascino and the prescription cost less than 3000 Baht.

.

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This is very old news for any patient treated in a hospital. I hope that those in an outpatient situation, capable of getting their own medication, get a script or note of the name of the medication from the physician to obtain the medication from a pharmacy outside the hospital. The mark up on medications within the hospital situation is a bloody disgrace. And over-prescription would have me suspect that physicians are on a kickback but would I suggest that???

As one who has to take regular medication and used to buy from the Hospital pharmacy until I found out from a friendly employee that the mark up to outpatients is around 300%, I now buy from a local pharmacy at the real price and save a lot of money over a year.

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After some high costs from Rama IX hospital (Thaksin being part owner) and the same from Piyavate (some more heavy involvement in Thai Rak Thai) I bypassed the system of a nurse taking you down to the 'Pharmacy'. I collected the prescriptions and headed out the door to their surprise. Cost was less than half at the local medical dispensary compared to the last batch! But if Thaksin is involved in the hospitals nothing would surprise me that they are scamming - probably by instruction as they have a captive audience! ph34r.gif

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There is a cost to physically dispense the medication. There is also a cost associated with maintaining an inventory. Dispensing medications in a hospital is a time consuming process with alot of manual labour that only adds to the costs. The markups on medication adminstered in a hospital are used to help cover the costs of having a hospital that is open and staffed 24/7. Before anyone flies off the handle, consider this: You know the local pharmacy where you can buy the drugs for next to nothing? Ask them how much they would charge to have a doctor write a prescription, deliver it to the pharmacy and then have the pharmacy prepare one or two tablets to be delivered to your bedside by an RN, who would then supervise the dosing.

The markups referenced in the article are insignificant compared to what patients pay in other countries without a government drug plan. It is not unusual for some drugs in the USA to have a 1000% markup. There are however downsides to having a generous drug plan and France illustrates this best. France has a population that is clueless to the costs of drugs since the drugs are covered in large part by the national health plan and/or by supplementary insurance which almost 9 out of 10 people have. The result is that the French spend more on expensive proprietary brands, bypassing generics, and there is a greater likelihood to prescribe drugs in France then there is elsewhere in the EU and North America. When no cost attaches to something, the option is abused.

Yes, Thai hospitals take advantage of a situation. We know that. It is what happens in this part of the world. Personally, I find it repugnant, but we all know that the private healthcare system is run on a for profit basis. It would be great if there was a public drug plan, but who would pay for it? Does anyone think Mr. Abhisit could get away with raising taxes on his supporters to pay for the scheme?

Well said. Also can you purchase just two tablets from your druggist. If time was money how much would it cost to go to the drug store and are they open at three in the morning. Also do they have what you need? I take vitamin b3 and it was hard to find a supplier for it. Even when I did it was watered down.

That being said ten times the drug store price is uncalled for. Also I might add it works both ways I tried to buy a drug there and they told me I would have to get a prescription for it.

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<BR>
<BR>This is very old news for any patient treated in a hospital. I hope that those in an outpatient situation, capable of getting their own medication, get a script or note of the name of the medication from the physician to obtain the medication from a pharmacy outside the hospital. The mark up on medications within the hospital situation is a bloody disgrace. And over-prescription would have me suspect that physicians are on a kickback but would I suggest that???<BR>
<BR><BR>As one who has to take regular medication and used to buy from the Hospital pharmacy until I found out from a friendly employee that the mark up to outpatients is around 300%, I now buy from a local pharmacy at the real price and save a lot of money over a year.<BR>

Yes, it is very old news and has been talked about earlier on Thai.Visa.com. Me myself is having blodpressure-medicine and first times I paid at RAM and Ruampaet hospital (Chaiyaphum) round 1.800 baht monthly. I than read Thaivisa.com, and went to the local drugstore at BIG C and paid 750 baht for exact the same medicine and quantity.

Glegolo

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Yes, hospitals do sell drugs significantly more expensively than most pharmacies. They also prescribe a lot drugs that are unnecessary or ineffective, often without discussing treatment options with the patient. On the other hand their charges for consultations with doctors are incredibly low by most international standards. A consultation with a consultant surgeon in London or New York will cost you at least B10,000, compared to only about B600 in a Bangkok private hospital and most other hospital fees are a lot lower. Personally I would rather see the doctors getting a fairer rate and the hospitals charging less for the drugs. Hospital costs of dispensing are also higher than outside pharmacies as they have to stock everything and have pharmacists available all hours, whereas pharmacies can easily just say "Mai mee" and close at night and for holidays. Sometimes private hospital doctors quietly tell outpatients to buy expensive drugs outside without a scrip to save the money but most Thai patients are clueless about drugs and have to be given them in the hospital.

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Bangkok Hospital Phuket was going to charge me about twice the price of my local pharmacy for the same drug, outpatient. I got a bit angry with the doctor there as well. I guess Thais never question a doctor. She was a bit taken aback by my questioning her. And then got a bit rude to me, which doesn't fly with an American that is taught to ask questions of their doctor and be informed. At that point I told her to give me all the test results, paid the bill and never went back there.

Most but not all have the little God complex here how dare you ask me anything.

Went one time in the evening to an Eye doctor here to his private clinic at night

had itchy eyes he was the same way, just to keep my wife happy kept my mouth shut ended up paying 800 Baht for eye drops and 30 red pills. Did not help, went to Overbrook Hospital here in Chiang Rai saw a very nice lady doctor

she looked at the eye drops and pills asked my wife who I saw shook her head, I paid 650 Baht for the red pills they where vitamin pills I have an allergy got some drops paid less then 100 Baht for them. 3 days later I was fine.

When I complained to several people here, was told that doctor loves money.

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This is very old news for any patient treated in a hospital. I hope that those in an outpatient situation, capable of getting their own medication, get a script or note of the name of the medication from the physician to obtain the medication from a pharmacy outside the hospital. The mark up on medications within the hospital situation is a bloody disgrace. And over-prescription would have me suspect that physicians are on a kickback but would I suggest that???

It is also old news that equipment that has to be prescribed will often go through a company that is associated with the hospital where you were treated. Getting a prescription for the equipment so as to go elsewhere is very difficult and foreigners run into the usual problem of how to assert themselves without becoming angry and without letting the Thai doctor lose face.

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Bangkok Hospital Phuket was going to charge me about twice the price of my local pharmacy for the same drug, outpatient. I got a bit angry with the doctor there as well. I guess Thais never question a doctor. She was a bit taken aback by my questioning her. And then got a bit rude to me, which doesn't fly with an American that is taught to ask questions of their doctor and be informed. At that point I told her to give me all the test results, paid the bill and never went back there.

Most but not all have the little God complex here how dare you ask me anything.

Went one time in the evening to an Eye doctor here to his private clinic at night

had itchy eyes he was the same way, just to keep my wife happy kept my mouth shut ended up paying 800 Baht for eye drops and 30 red pills. Did not help, went to Overbrook Hospital here in Chiang Rai saw a very nice lady doctor

she looked at the eye drops and pills asked my wife who I saw shook her head, I paid 650 Baht for the red pills they where vitamin pills I have an allergy got some drops paid less then 100 Baht for them. 3 days later I was fine.

When I complained to several people here, was told that doctor loves money.

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<br>Bangkok Hospital Phuket was going to charge me about twice the price of my local pharmacy for the same drug, outpatient. I got a bit angry with the doctor there as well. I guess Thais never question a doctor. She was a bit taken aback by my questioning her. And then got a bit rude to me, which doesn't fly with an American that is taught to ask questions of their doctor and be informed. At that point I told her to give me all the test results, paid the bill and never went back there.<br>
<br>I took my pregnant wife to the doctor who had run out of supplements he wanted to prescribe so I asked for the name of them because I wanted to check what was in them on the internet to see if they were similar to a supplement my mother had recommended. He didn't like that at all and asked my wife "why does the ferrang think he has the right to question my decision?" His attitude was as if he was the boss and I was working for him, not the other way round, so how dare I question his authority. He probably thought I would buy them from the pharmacy at a fraction of the price which must have got his goat, but that wasn't my intention at all. He lost us as a client that day and our new doctor is very helpful, the consultation is twice as long and you can ask him what you want for the same price so the old doctors arrogance turned out to be a god send!<br><br>
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The only reason I pay the price for prescription drugs in hospitals is because I an not so sure id the drug I am buying at the outside phamarcy is the real thing. I suppose that is the case also in the hospitals. I would like to be sure due to my condition that I am being supplied with the correct drugs and not a copy from a Third World country.

What pharmacy can you trust in Thailand?? Boots?

Did you know that there are hospitals associated with pharmacy manufacturing in Thailand ???

read : http://www.phuket-health-travel.com/hospital.htm

What does this mean???

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There is a cost to physically dispense the medication. There is also a cost associated with maintaining an inventory. Dispensing medications in a hospital is a time consuming process with alot of manual labour that only adds to the costs. The markups on medication adminstered in a hospital are used to help cover the costs of having a hospital that is open and staffed 24/7. Before anyone flies off the handle, consider this: You know the local pharmacy where you can buy the drugs for next to nothing? Ask them how much they would charge to have a doctor write a prescription, deliver it to the pharmacy and then have the pharmacy prepare one or two tablets to be delivered to your bedside by an RN, who would then supervise the dosing.

The markups referenced in the article are insignificant compared to what patients pay in other countries without a government drug plan. It is not unusual for some drugs in the USA to have a 1000% markup. There are however downsides to having a generous drug plan and France illustrates this best. France has a population that is clueless to the costs of drugs since the drugs are covered in large part by the national health plan and/or by supplementary insurance which almost 9 out of 10 people have. The result is that the French spend more on expensive proprietary brands, bypassing generics, and there is a greater likelihood to prescribe drugs in France then there is elsewhere in the EU and North America. When no cost attaches to something, the option is abused.

Yes, Thai hospitals take advantage of a situation. We know that. It is what happens in this part of the world. Personally, I find it repugnant, but we all know that the private healthcare system is run on a for profit basis. It would be great if there was a public drug plan, but who would pay for it? Does anyone think Mr. Abhisit could get away with raising taxes on his supporters to pay for the scheme?

Well said. Also can you purchase just two tablets from your druggist. If time was money how much would it cost to go to the drug store and are they open at three in the morning. Also do they have what you need? I take vitamin b3 and it was hard to find a supplier for it. Even when I did it was watered down.

That being said ten times the drug store price is uncalled for. Also I might add it works both ways I tried to buy a drug there and they told me I would have to get a prescription for it.

Would you have the same opinion if you would work in thailand and receive thai salary??? Do you think thais would buy their medicine in your country on their holiday?? You have to see the whole picture. It not not about tourists buying their meds cheaper in thailand than in their own country.

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Not only with medicines.

It is also well know (well kept secret) that some doctors, serving public hospitals, ask for a kick -back (through their private clinics) to put the patient on the list for an (hart) operation.

Otherways they find plenty of excuses not to operate even if there is a risk for the patient.

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Bangkok Hospital Phuket was going to charge me about twice the price of my local pharmacy for the same drug, outpatient. I got a bit angry with the doctor there as well. I guess Thais never question a doctor. She was a bit taken aback by my questioning her. And then got a bit rude to me, which doesn't fly with an American that is taught to ask questions of their doctor and be informed. At that point I told her to give me all the test results, paid the bill and never went back there.

Most but not all have the little God complex here how dare you ask me anything.

Went one time in the evening to an Eye doctor here to his private clinic at night

had itchy eyes he was the same way, just to keep my wife happy kept my mouth shut ended up paying 800 Baht for eye drops and 30 red pills. Did not help, went to Overbrook Hospital here in Chiang Rai saw a very nice lady doctor

she looked at the eye drops and pills asked my wife who I saw shook her head, I paid 650 Baht for the red pills they where vitamin pills I have an allergy got some drops paid less then 100 Baht for them. 3 days later I was fine.

When I complained to several people here, was told that doctor loves money.

You think its bad, try this for a size. Recently had bike accident. After few weeks still had pain in my chest and thought it was broken ribs. Turned out to be just a very hard hit in the chest. I explained to Doc i had high blood and pressure and allergy to many things. While there they checked my blood pressure and it was very high. So he prescribes me 500 baht medicine.

i got home and had a bad feeling so decided to google it. Every page i opened had a huge warning

-If known to suffer from high blood pressure -DO NOT TAKE

-If known to suffer from allergic reactions-DO NOT TAKE.

I went back and told the moron about this, his response was, Oh yeah but allergic reaction is not in every person, some have some do not. And if i am like this, it will be hard for me to live in any country in the world and hard to have an accident.

Have accident? i was not planning to have any more. What kind of moronic escuse was that?

PS. In the same hospital few years ago, my pregnant GF was given medication without even asking her if she was allergic. Same evening she had an allergic reaction and i almost lost her and the baby, lucky i was home and managed to get her to the hospital on time(her throat swelled up and could not breath)

PPS. That same medicine was selling at local pharmacy for 200 baht

Edited by kuffki
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.

"What pharmacy can you trust in Thailand?? Boots?"

Yes, Boots is good but expensive for some meds.

I've found Fascino to be the best -- reasonable prices and they give you an additional 5% discount if you have one of their discount cards.

One very well known hospital prescribed over 9000 Baht of imported meds for me -- When I asked the doctor if the generic version sold at Fascino was equal to the import, he just stared at me. I asked again if it would be OK to buy the generic and he finally answered "That's not good for the hospital!"

I went to Fascino and the prescription cost less than 3000 Baht.

Fascino are very good, they changed their name recently here in Chiang Rai to something else.

They always look up the prescription on computer and if they don't have it in stock, they will order it immediatly.

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