Thinktank Says Thai Hospitals Overcharge For Medicine

[Robby nz]

Dont know which hospitals the posters on this thread have been going to, suspect the expensive private ones.

I have used Phramongkutklao the milatery hospital and in the course of over a year of treatment they have run out of the drug I required several times and they have sent me with a perscription to a pharmacy and the prices have been exactly the same as the hospital charged.

If you go to a private hospital you will pay more for everything, they have to make a profit.

[DP25]

These people would have a heart attack if they ever got a bill from a US hospital

[Jirapa]

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?

Everything I've ever bought in a Thai pharmacy has always done the job and the generic drugs are just as good. Creating new drugs is a real science however copying them is as easy as making a Zerox (slight exaggeration). Cuba make copies of all drugs and export them around the world to countries who can't afford the brand names and without such copies there'd be a lot more dead people in the world. The kind of drugs your referring to are often peddled on the streets of third world countries as drugs such as HIV antiviral which are nothing more than a bit of chalk in a capsule but in the pharmacies of Thailand you should be alright. Drugs are cheap and available here so a black market in bogus pharmaceuticals isn't that viable.

[kuffki]

Dont know which hospitals the posters on this thread have been going to, suspect the expensive private ones.

I have used Phramongkutklao the milatery hospital and in the course of over a year of treatment they have run out of the drug I required several times and they have sent me with a perscription to a pharmacy and the prices have been exactly the same as the hospital charged.

If you go to a private hospital you will pay more for everything, they have to make a profit.

So you saying pharmacy's do not make profit?

Pharmacy's are private owned and if anything pay more for the products then the hospital.

Not to mention hospitals get loads of medicine free from the company's

[Jirapa]

These people would have a heart attack if they ever got a bill from a US hospital

We're not in America? I come from a country where hospitals are free and medication very cheap or free but I have no complaints about the prices here, private or government take your pick. Of course nothing is free as we pay taxes for the privilege of "free healthcare" but no complaints with that either. The money has to come from somewhere!

[Evilbaz]

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-he...om/hospital.htm

What does this mean???

You may well find that the doctors own the hospital pharmacy so they have a financial interest in over-prescribing relatively ineffectual drugs - particularly non-script medications.

Happens in many countries.

[brianbiegler]

wow. insightful article. if you didn't already know this you must live under a rock.

tomorrow...... "hot stinky exhaust choking ride in tuk tuk costs more than air conditioned taxi over same distance."

followed by.... " no need meter 400 baht good for you good for me", not really good for you.

[jonw8uk]

It's not just the drugs.

I went to the Sukhumvit Skin Hospital to see about getting a small wart lasered, on my forehead.

A very simple and quick procedure; numb the area, wait 5 mins, cut it off. 10 minutes max.

I had actually called them before to get an idea of price, and the reply then was 1500 - 3000b depending on size, number etc

I was ok with up to 3000b, this is still expensive really, but I'm thinking, well, it's on my forehead, I want minimal scarring etc, I'll pay more for a 'better' doctor.

During the consultation the doctor starts asking things like, how long have you lived in Thailand? What do you do for a living? (an income assessment...)

I leave the room, the doctor calculates his price, and a nurse comes over and tell's me it will be 7000b!

Needless to say, I went elsewhere, and got it done for 300b at a clinic on Ratchada.

[RigPig]

These people would have a heart attack if they ever got a bill from a US hospital

Don't worry Obama will soon fix that !!!

Then you will all be shopping for "generic" drugs too and probably buying for them in Thailand

[mark2552]

What is so unusal about Hospitals over charging patients in every country...Hey they have make a profit....if they gouge their patients...so what!

Patients bring they own drugs and pain killers and they own bandages etc.

[Insight]

It's not just the drugs.

I went to the Sukhumvit Skin Hospital to see about getting a small wart lasered, on my forehead.

A very simple and quick procedure; numb the area, wait 5 mins, cut it off. 10 minutes max.

I had actually called them before to get an idea of price, and the reply then was 1500 - 3000b depending on size, number etc

I was ok with up to 3000b, this is still expensive really, but I'm thinking, well, it's on my forehead, I want minimal scarring etc, I'll pay more for a 'better' doctor.

During the consultation the doctor starts asking things like, how long have you lived in Thailand? What do you do for a living? (an income assessment...)

I leave the room, the doctor calculates his price, and a nurse comes over and tell's me it will be 7000b!

Needless to say, I went elsewhere, and got it done for 300b at a clinic on Ratchada.

Not in the least bit surprising. Mrs Insight - who works for a company which supplies medical equipment to Thai hospitals - tells me many doctors in these so-called 5* hospitals (Bumrungrad, Asok Skin Hospital, BNH? - although I've never felt "gouged" there) receive commission from the hospital for the operations they "sell" to patients. Am not sure if the same applies to prescriptions however.

It's a practice which is ethically absurd IMHO, but this is just scratching the surface. Many Thai doctors are up (down) there with the police and politicians when it comes to integrity.

[antony77]

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???

The private hospitals charge three times the price for medicine compared with the Chinese wholesale pharmacies. They tend to prescribe brand medicine instead of generic. Bangrumrod charged me 900 baht for a brand name anti biotic that cost only Bt 40 for a generic one. Even the Hua Hin public hospital charged me Bt 3000 for brand name drug that was available out side for Bt600 (same brand name).

As an inpatient I bring with me to hospital a huge range of medicine. Lots of paracetamol and different anti-biotics; a thermometer and an urinal.!

Boots charges 600% profit on many medicines. EG Miricid Bt135 a packet of 10 versus Bt25 from the wholesale chemist.

Fascino about 50% over wholesale chemist.

It should be obligatory for all medicines to be labeled with a controlled price,

[PingManDan]

Farangs over charged at hospitals LOL as if we didn't already know this, hel_l we are over charged for everything because we are just farangs. The old double standard, thai price and foreigner price:angry:, from using the toilet, to golf green fees, so why not this !

[jfchandler]

A couple of observations here:

1. As a general rule, prescriptions notwithstanding, the cost of medical care here in Thailand is certainly far more affordable than in the U.S., as is medical insurance... So overall, it's hard to complain too much.

As to quality, for routine medical things, I think the care here at the private hospitals generally is going to be as good as what people might expect to get in the U.S. In my experience in my home country, they have a lot of technology and access to new drugs and specialists and such. But that doesn't mean you're going to get good or competent care, more likely, an indifferent 10 mins and out the door.

2. I have an acquaintance who works for private hospitals here in BKK. After reading the article above, I asked that person: When the doctors here prescribe a medicine, do they end up getting a cut of the cost of the prescription. My acquaintance said NO.... the doctor gets a share of the doctor's fee (with the other part going to the hospital). But my friend said the doctor typically doesn't share in the revenue from the hospital prescriptions.

3. No doubt, the general notion reported in the study about hospitals jacking up the price of presciptions, both for inpatients and outpatients, is correct, as everyone here pretty much already knew. For me, I always wait to get the billing statement at the cashier, and then look at the medicine prescribed and the cost. If it's a small amount, I'll let the hospital prescribe. But if it's any kind of hefty amount, I'll often decline and simply take the invoice showing the medicine/strength/quantity and head to my local pharmacy.

The other issue about that to consider is, if you're care is being covered by medical insurance, then that insurance is going to cover the cost of the hospital-issued medicines...but not if you go on your own and buy at the local pharmacy. So when the insurance is covering, I'm gonna leave it between the hospital and the insurance company.

4. Lastly, and this was a bit of a surprise for me, I've been told that at least at the private hospitals in BKK (and presumably outside), there is a standard double-pricing scheme for farangs vs. Thais - needless to say, Thais are charged the regular price...and farang automatically charged a markup, for the same treatment.

[zakk9]

Why don't more foreigners who live here permanently use public hospitals? They are not as luxurious as the private ones, but the medical standard is mostly good and the prices of medicines often lower than in the pharmacies. The private ones, although better equipped, will often give you the treatment that is the most profitable to them, not necessarily what is the most useful for the patient.

[jfchandler]

Re public hospitals, I'm guessing it has to do with a couple factors (right or wrong):

1. Greater likelihood of English speaking staff in the privates.

2. Greater likelihood of avoiding a long wait for appointment upon arrival in the privates.

3. Perhaps a feeling that the hospital building environment/atmosphere has some relation to the quality of care.

[Jingthing]

I think this tank was paid to much for "finding" the obvious.

I have been thinking. Public toilet facilities get dirty and require frequent cleaning. Where do I collect my check?

[anon467367354]

over charging for pharmaceuticals? what a novel concept! just another cheap shot kick at someone that is already down. Go figure. Still the mark- up is nowhere near as high as in the "developed" USA.

Edited July 16, 2010 by gr8fldanielle

[Neonben]

  

My insulin pen broke so needed a new one, in the past i was charged 2500 baht but when i went to BKK hospital they said this pen has been discontinued and waiting for delivery of a new model, because it was discontinued they thought it made it rarer and tried charging me 4200 baht. I bought one from U.K. on auction site for 1.90 with shipping came to 300 baht.<br>  Imagine being charged more for an old model T.V. or anything else.<br><br>  You allways hear how doctors are so clever, not in Thailand.<br>

[slapout]

I think a lot of the medicine sold in Thailand is supplied by Chinese companies. Chinese supplied/manufactured medicine is being questioned at present, as to actual content by some groups/individuals. Not surprising considering what they added to baby formula a short time back. I know the Chinese are capable when they want to be and they manufacture consumer products for the rest of the world. In my experience they seem to make several grades of the same product, with the lowest grade, being a 6 month throw away. Hope this thinking has not crossed over to their medicinal batch mixing. I think country of origin is to be marked on medicines, but could be wrong.

[jfchandler]

I just looked at two presciptions I had at home... both had a "manufactured by" text printed on the container box... One said Bangkok, Thailand. The other, a generic antibiotic, said Slovenia...

[sirchai]

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.

It’s not just the prices for medicine. I had a motorcycle accident last September and had to see the doctor in a hospital located in the Lower North east every month.

I do have insurance but sometimes I had to pay for unnecessary X-rays, Calcium and other nonsense, the insurance company should cover. (Guess they did!)

Time to wake up for all doctors, nurses and politicians involved.

My wife was born 23 km away in a village which belongs to the city we’re living. She has to pay the full bill here, I just don’t get it. To ask questions why it is like this is like running against a wall full of ignorance.

[Jirapa]

It's not just the drugs.

I went to the Sukhumvit Skin Hospital to see about getting a small wart lasered, on my forehead.

A very simple and quick procedure; numb the area, wait 5 mins, cut it off. 10 minutes max.

I had actually called them before to get an idea of price, and the reply then was 1500 - 3000b depending on size, number etc

I was ok with up to 3000b, this is still expensive really, but I'm thinking, well, it's on my forehead, I want minimal scarring etc, I'll pay more for a 'better' doctor.

During the consultation the doctor starts asking things like, how long have you lived in Thailand? What do you do for a living? (an income assessment...)

I leave the room, the doctor calculates his price, and a nurse comes over and tell's me it will be 7000b!

Needless to say, I went elsewhere, and got it done for 300b at a clinic on Ratchada.

Good for you! What's income got to do with any surgery major or minor. I had a wart on my arm and plucked it out with a scalpel and a pair of pliers and no scar but on my face I'd pay 300B and more. 7000 is taking the urine!

[MAJIC]

So now the Think Tank is telling us something that Farangs have known for years,we are being ripped off big time,and the Medicine is only part of the Scam.

Common practice is: 1.Get your Prescription.... 2.Pay for it 1st ...3.Check it out,and find you dont need half of it.

Not unusual to have 24 hours in Hospital and have a bill for 10,000 to 12,000 baht.

My Wife had a minor problem,got admitted at 2am,the Doctor didnt arrive until 9-20 am,got discharged at 11-0am,and billed for 10,400 baht.rip off?........always has been in Thailand!

Edited July 16, 2010 by MAJIC

[hoaker]

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.

Sorry people, the government are to busy trying to oust each other, they have no time for the people or controlling the price of pharmaceutical drugs. Not only are prescription drugs being overcharged but doctors are also overdiagnosing you, and it seems all they want to do is put you on the operating table so they can charge you those surgical fees in addition to the expensive medicine. My suggestion, get to know a doctor friend or get a second opinion, but who knows the doctors could be in collusion...Ethics is hard to find here even in doctors.....

[TheBarbarian]

Medicins are seldom overpriced, except for the very few top hospitals. There is a far more worrisome situation though. Pharmaceuticals are paying doctor heavy bonuses to poison their patients and overmedicate them. They get offered overseas trips, holidays and hards cash. The government will not do anything about it, after all it is led by a PM whose parents are MD's and made a lot of money from the practice. By the way other undeveloped countries when it comes to healthcare like the USA have the very same problem. Overpricing and overmedication is rife.

[mazeltov]

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.

...

Quite right.

I could also imagine that the hospital has a greater stock of all kinds of different medicine available, medicine you will not find in the boots shop or at the pharmacy down the road, who will just sell the most commonly requested kind of medicine, but not stock something very expensive medicine on the shelves for some rare medical condition, but the hospital will have it. medicine has a expiration date, that makes seldom requested medicine for some rare medical condition to an economical risk. A pharmacy needs to make profit to stay in business will not take that risk. With the higher price for a paracetamol the hospital covers the expenses to keep that other things in stock.

Selling the medicine in the hospital for a higher price is not a scam of a corrupt salesman who wants to get quick rich, but to keep the system hospital running they need to make somehow money. If the hospital would sale its medicine for the same price than a cheap pharmacy, the patients would have to pay higher prices for all the other services and treatments.

Complaining about the price for medicine is short-sighted. In a restaurant you also pay more for a drink than you would pay in the supermarket.

[silk]

These people would have a heart attack if they ever got a bill from a US hospital

This is why thai people on holiday in the US do not go to a US hospital (to avoid a heart attack)

[silk]

These people would have a heart attack if they ever got a bill from a US hospital

We're not in America? I come from a country where hospitals are free and medication very cheap or free but I have no complaints about the prices here, private or government take your pick. Of course nothing is free as we pay taxes for the privilege of "free healthcare" but no complaints with that either. The money has to come from somewhere!

Please explain in which country you pay for your health insurance, where hospitals and medications are free.

Does one need to be a resident there? How to proceed to get these advantages???

Hope you can enlighten us here in the forum

[Jimi007]

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.

...

Quite right.

I could also imagine that the hospital has a greater stock of all kinds of different medicine available, medicine you will not find in the boots shop or at the pharmacy down the road, who will just sell the most commonly requested kind of medicine, but not stock something very expensive medicine on the shelves for some rare medical condition, but the hospital will have it. medicine has a expiration date, that makes seldom requested medicine for some rare medical condition to an economical risk. A pharmacy needs to make profit to stay in business will not take that risk. With the higher price for a paracetamol the hospital covers the expenses to keep that other things in stock.

Selling the medicine in the hospital for a higher price is not a scam of a corrupt salesman who wants to get quick rich, but to keep the system hospital running they need to make somehow money. If the hospital would sale its medicine for the same price than a cheap pharmacy, the patients would have to pay higher prices for all the other services and treatments.

Complaining about the price for medicine is short-sighted. In a restaurant you also pay more for a drink than you would pay in the supermarket.

Of course a hospital will have narcotics and other drugs you cannot buy at the local pharmacy as they are controlled. But, my local Thai pharmacist went to one of the top universities in the US for pharmacology and can order anything other than regulated drugs for half the price. But the point is, as the article states:

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.

So, what is there to argue about? This is not about some farangs, it's about Thai people in Thailand... Up to you if you like to throw away your money here...

Edited July 16, 2010 by Jimi007