Thinktank Says Thai Hospitals Overcharge For Medicine

[Deeral]

I don't usually agree with the statement "you get what you pay for" - but sometimes it's tempting.

[p_brownstone]

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.

The Doctor may not receive a cut from the Hospital but they most definitely get commission from the Importer / Distributor.

I have a neice who works for a large such Company and her job is to visit Doctors in their Hospitals and persuade them to prescribe certain medicines - based on their records of what was prescribed over a certain period they receive substantial commission.

The Importer / Distributor also adds significant mark-up to pay for other perks they give to the Doctors; for example my neice is taking a group of more than 20 Doctors to Bhutan next week - all expenses paid by her Company.

Patrick

[Bagwan]

When I first met my wife several years ago I quickly became very concerned for her health. She voluntarily went to a local clinic and returned with iron tablets. The following morning despite her protests I dragged her to a certain Pattaya hospital. She was soon diagnosed as having TB and I was advised that she should be admitted immediately.  Later that day after further tests were carried out I was told that she was HIV positive and had several other nasties - thanks to her brutal and errant husband. I was asked if  I was going to pay the bills and when I asked what would happen if I demurred, was blithely told that they would discharge her.  A death sentence!

It was 5 months before the TB was cured and then treatment for HIV could begin. A course of treatment for 28 days was charged at 2800 baht. I learned soon afterwards that the medicine, produced by the Government Pharmaceuticfal Organisation, was bought  in at 1200 baht.  So the unit cost  of collecting the medicine, storing and dispensing it was 133.3% of manufacturing it? I don't think so. We  went to another Pattaya hospital where the same medication was dispensed for 1700 baht.

Tests over the next two years showed that she was responding to treatment without any side effects and then a doctor suggested that she discontinue treatment  to prevent the virus mutating. This was against everything that I had read up and so we decided to obtain a second opinion. I asked for a copy of all her records and did the same at the original hospital and off we went to what proclaims itself to be the best in Thailand. After hearing our story and perusing the records that we had presented  the specialist doctior, without any examination said that to his experienced eyes her current medication was poisoniong her and that it must be changed immediately. When I queried this he offered an explanation which we fully accepted. A series of tests confirmed his opinion. A different course of treatment was prescribed which cost 5200 baht for a 28 days supply - plus 1000 baht for a 10 minute consultation. 

Things went smoothly for about 3 years when it became obvious that the doctor, whose expertise and manner I have no qualms about at all, became a little too greedy if not avaricious, andI I queried some additional charges. His attitude was that we could always go elsewhere. We did.

We now consult a farang doctor specialising in HIV and AIDS. He is extremely thorough being holistic in approach and tests for all the things that statistics show may endanger my wife's wellbeing, cervical HPV's for example. He has an arrangement with the first local hospital that we consulted who make substantial discounts on the tests that he specifies e.g. 250 baht for a chest Xray..  He told me that in his opinion that there are only about 12 doctors in Thailand that he considers competent in his specialisation. Since he operates under the banner of a registered charity, the charges for the necessary medications are 8000 baht for a six months supply.  He makes no charge for his services but provides a large jar into which people can put whatever they can afford. Needless to say that we contribute appreciately more than we were being gouged by 'Thailand's finest'.

My advice to those who have a blind faith in the expertise of Thai doctors is to make sure that their life insurance premiums are fully paid up. I suggest that when presented with a bil to note the name of any medication and then hurry home to consult credible sites on the Internet to make sure that it all makes sense. Only then, after checking, should the medication be collected and paid for, or if you of that mind, purchased from a reliable pharmacy. Some may phoo hoo such a practice and suggest that I suffer from paranoia, but they might give some thought to regarding how professional and educational qualifications are  obtained in Thailand and how the developed world rate them, as well as the venal practices of most private hospitals. 

 

 

 

[Wozzit]

The Importer / Distributor also adds significant mark-up to pay for other perks they give to the Doctors; for example my neice is taking a group of more than 20 Doctors to Bhutan next week - all expenses paid by her Company.

Patrick

To be fair, this is standard practice for drug companies in many parts of the world. It is not restricted to Thailand.

[dumball]

So , it took a whole panel of Thai specialists to discover that hospitals overcharge for medication , amazing Thailand , whilst how many on the forum became aware of that fact by merely visiting a hospital ?

Stories about Thai doctors calling for uneccessary treatments seem to be popular on this forum , please allow me to relate my experience in BNH hospital .

I was admitted for my second heart attack and given unbelievable treatment in an absolutely spotless UCI ward by a caring staff , that goes to daily bed baths and massage for stiffening muscles . The doctor , during his consultation , asked who had put me on my medication , standard procedure in Canada I told him , this is your cocktail to keep you alive . He told me he had changed my medication whilst in his care to what was better suited to my particular case , he also told me that if I followed certain guidlines I could most likely come off of all medication and feel healthier , in a period of approx 6 months I was medication free and have been so for 6/7 years thus far . When I visit Canada , my long time doctor finds it hard to believe all my tests come out okay and my BP is an amazing 120/60 , I have been living in Cambodia for 5 years + with a Cambodian wife who watches my diet well , we have daily sex(with org's) with no medical assisstance , no medication , only vit B complex and Advil for aches and pains . I am 77 years of age but do not feel or act it , not all Thai hospitals are only after your dollar .

[Deeral]

THe problem with the drug companies is that they are desperate to sell.

They will give backhanders to anyone who recommends their drugs over another companies - I doubt if many doctors would put their hands up to that anyway.

the other side is that doctors don't keep up to date with trials etc of new medicines and have a tendency to accept the claims of the companies selling the drugs - these have been demonstated on many occasions to be wildly inaccurate and biased in favor of the companies own brands.

in truth most dioctors simply don't have the time to go through all the research on a "new" drug so it's very tempting to believe the rep from the drug company - especially if you earn extra cash in doing so.

This isn't a Thai only thing - it happens all over the world...... BUT in many countries the checks and measures to counter this are effective and "Mordre wol out"....I'm afraid this is not usually the case in Thailand

[Deeral]

<br>So , it took a whole panel of Thai specialists to discover that hospitals overcharge for medication , amazing Thailand , whilst how many on the forum became aware of that fact by merely visiting a hospital ? <br><br> Stories about Thai doctors calling for uneccessary treatments seem to be popular on this forum , please allow me to relate my experience in BNH hospital .<br><br> I was admitted for my second heart attack and given unbelievable treatment in an absolutely spotless UCI ward by a caring staff , that goes to daily bed baths and massage for stiffening muscles . The doctor , during his consultation , asked who had put me on my medication , standard procedure in Canada I told him , this is your cocktail to keep you alive . He told me he had changed my medication whilst in his care to what was better suited to my particular case , he also told me that if I followed certain guidlines I could most likely come off of all medication and feel healthier , in a period of approx 6 months I was medication free and have been so for 6/7 years thus far . When I visit Canada , my long time doctor finds it hard to believe all my tests come out okay and my BP is an amazing 120/60 , I have been living in Cambodia for 5 years + with a Cambodian wife who watches my diet well , we have daily sex(with org's) with no medical assisstance , no medication , only  vit B complex and Advil for aches and pains . I am 77 years of age but do not feel or act it , not all Thai hospitals are only after your dollar .<br>

<br><br>I'm certainly not basing my opinion on one visit to a hospital - I grew up in a medical family and all things medical were the typical tea-time chatter.<br><br>I also have read a lot about health care in Thailand by practitioners, the media and personal experience. Only if you put it all together do you start to get a holistic view - and it's NOT good.<br><br>You have shown two things.<br><br>firstly that you were unaware that the medication you were already taking was not the only way to treat your condition. - so you were in fact receiving treatment that may have been inappropriate - but like most patients you were unaware of this.<div><br>secondly, when you leave a hospital - because you are feeling better - you now feel that the new medication is the ONLY one for you....you also jump to the conclusion that your hospital system, doctor etc etc are all without fault.<br>just because the country is literally littered with "satisfied" customers, it doesn't mean that all is well in the Thai healthcare system - in fact quite apart from the obvious cases were things have gone wrong there may be many, many "satisfied" customers who despite being apparently OK have received treatment that was unnecessary , inappropriate or downright wrong.<br><br>Many patients actually improve on their own and then attribute their recovery wrongly to the treatment they have been having. This is especially common amonst those taking "alternative" therapies.<br><br>We can be pretty sure - though never 100% - that you have received beneficial treatment at the hands of your doctor - we can't be sure that every patient's treatment will be so successful even at the hands of the same Doctor. - there simply isn't the information available in Thailand.

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Edited July 21, 2010 by Deeral

[snooky]

Don't know if it's considered off topic but I wonder if some of the more computer literate folks on here could set up some kind of a poll as to quality of service, various fees, doctor's expertise (to the best of their knowledge) and overall rating,

It would be interesting so long as only folks who have had experience here in Thailand would comment. There are many who either can't afford the insurance even with sufficient funds to live here or, like myself, are too old to buy insurance here so we could profit by others experience.

Edited July 21, 2010 by snooky

[Deeral]

"quality of service, various fees, doctor's expertise (to the best of their knowledge) and overall rating,"

It would be impossible to get anything but a purely subjective response to those questions as the majority of respondents wouldn't know a stethoscope from and endoscope so would not be in a position to. comment.

You might ask simpler questions.

Were you happy when you left the hospital?

Were you cured?

Were you actually sick in the first place - (they might not be able to answer that one - as sometimes they don't realise until the doctor tells them.....

are you dead?

....however none actually give an insight into the way that Thai hospitals are given free rein to do what they bloody well like without any recourse to explanation or accountability.

[Peterphuket]

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.

That's funny I had the same experience at the same hospital, and when compare with 10 years ago they triple al the prices, medicines or visit's that dos'nt matter.

[crazydrummerpauly]

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?

Hi,

with regard to feeling that drugs bought in hospital are safe - on BBC tv there has been a series

called 'Fake Britain'. In a recent episode they took completely authentic-looking drugs to a pathology

lab, and discovered that fake drugs are being prescribed and supplied inside the British National Health

Service. Cosmetically, these drugs were so good that even pharmacists were fooled. The reason this

is happening? - ORGANISED CRIME on an international scale makes 10 times more on fake meds

than they do on narcotics. Conclusion: every time we take a medicine, we're playing Russian roulette

with our health, and in some cases our very survival. Great.

Edited July 25, 2010 by crazydrummerpauly

[asiawatcher]

Interesting that drugs in Thailand OTC are about 10% of that in UK, US and Australia even at retail. Makes one wonder...

[KKK]

There is a cost to physically dispense the medication. There is also a cost associated with maintaining an inventory.

This should cost the hospital no more than it does at an outside pharmacy. Fascino don't charge extra for handing you the medicine or maintaining their inventory do they! Hospitals charge you for every thing (doctor, nurse, etc etc) so there is no justification to bump the price of medicine to cover something they haven't charged you for because your bill will already itemize everything in detail.

[KKK]

Interesting that drugs in Thailand OTC are about 10% of that in UK, US and Australia even at retail. Makes one wonder...

Drug companies charge according to what the market can bear. Thailand having a much lower GDP than the west pays less for its medicine and the drug company still makes a profit on the item. What probably doesn't get paid for by Thailand is a share of the cost to discover the drug in the first place. The west seems to bear most of that.

I just wish Microsoft would do the same. Most of their products cost more here than in the west. No wonder there is so much piracy.

[coma]

No shit. And what about how willing the doctors are at prescibing a patient humpteen million types of medication for IMO purely financial gain. Unless you are about to drop dead go to a small pharmacy yourself.