Thai Health Ministry To Probe Into Massive Overprescription

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SPECIAL REPORT

Probe into massive overprescription

By Pongphon Sarnsamak

The Nation

Public Health Ministry will send its inspectors to work with Comptroller General Department's staff to investigate the state's hospitals nationwide where spend a lot of money on prescription unnecessary and expensive drugs.

The ministry's deputy permanent secretary Dr Pornthep Siriwattanarangsand said this collaboration would help Comptroller General Department could identify the real causes of the irregular spending on medical expenditure of each hospital.

"The Public Health Ministry's inspectors and Comptroller General Department's staff will examine the spending on prescription and other factors that cause the rising of hospital's medical expenditures," he said.

Previously, the Comptroller General Department has identified 34 hospitals across the country that had filed reimbursement claims for drugs worth about Bt13 billion from October 2008August 2009. About Bt8 billion or 66 per cent of the cost of hospital drugs was for unnecessary and expensive drugs not on the National Essential Drug List. But a few number of 34 hospitals were hospitals under the Public Health Ministry, Pornthep added.

"Those doctors who intend to prescribe too many drug to patient with irrational use will be face disciplinary punishment and hospital will be suggested to return money to Comptroller General Department," he said.

Meanwhile, Medical Service Department's director general Dr Rawat Wisarutwet said his agency is now studying the way to control the relationship between doctor at state hospitals and pharmaceutical company after found that some doctors had prescribed a lot brand named drugs to patient with irrational use.

"The department is now trying to encourage doctor to follow the pharmacotherapy guideline by using drug under the national drug list before prescribes the drug outside the list," he said.

"Doctor should prescribe drug outside the list when patient appears medical indication," he added.

Following the Comptroller General Department earlier had announced that it would not allow members of the civil servant medical benefit scheme to be reimbursed of glucosamine, as the department considered that it gave no benefit as an arthritis treatment.

Public Health Minister Jurin Laksanawisit said the Comptroller General Department should ask the ministry before issue its announcement as the ministry has been working closely with patients.

He said he had instructed Medical Services Department to conduct a study about the benefit of four drugs not allowed for reimbursement by the ComptrollerGeneral's Department glucosamine, chondroitin sulphate, diacerein, and hyaluronan.

The department had already sent this study to him and now he handed this study to Food and Drug Administration (FDA) to examine these drug's indications that they should be continued the registration or withdrawn from FDA's drug registration.

When FDA finishes its examination, it will send the recommendation to Comptroller General Department to make any decision whether to allow or not allow civil servant to reimburse these drugs, Jurin said.

However, FDA's secretary general Pipat Yingseri said glucosamine has been registered as drug more than 20 years.

[hoaker]

Isn't Glucosamine a supplementary drug and not used for medical treatment?. Its hard to believe the minsitry of health can't tell the difference.

[Boss]

QUOTE :

"Those doctors who intend to prescribe too many drug to patient with irrational use will be face disciplinary punishment and hospital will be suggested to return money to Comptroller General Department," he said.

Hardly any Doctor in this country will escape this "disciplinary punishment"

Have you ever seen the "arsenal" of drugs sold by the doctors to treat a common cold ? ( usually 5-6 different completely unnecessary drugs)

[Valentine]

I remember my early days in Thailand & watching kids walk out of a clinic with several bottles of coloured water where cheap paracetamol would have sufficed. It only served to give a warm fuzzy feeling to the parents & to the clinic's coffers.

It never ceases to amaze me at the way people rort the system. Going out of their way to get prescription drugs in order to sell should be some kind of criminal misappropriation & the miscreants charged accordingly. It will be interesting to see how long it takes for the doctors to close ranks on this as I am sure many of them are guilty of getting commissions for prescribing certain drugs. BTW the English in that article is deplorable.

[tragickingdom]

No need for a probe. Just like in the USA laws should be changed when it comes to healthcare. Each and every doctor accepting money, holidays or any other gift from pharmaceutical countries should be fined triple the amount that they receive. pharmaceutical companies paying out any form of bribe should be fined 20% of their worldwide turnover. I bet the practice is soon over.

[cheeryble]

Have you ever seen the "arsenal" of drugs sold by the doctors to treat a common cold ? ( usually 5-6 different completely unnecessary drugs)

....naturally including the anti flatulent!

I remember my early days in Thailand & watching kids walk out of a clinic with several bottles of coloured water where cheap paracetamol would have sufficed. It only served to give a warm fuzzy feeling to the parents & to the clinic's coffers.

Perhaps they're more brilliant than us and know the placebo affect in all it's glory.

Are you aware a red pill cures better than a green one?

A BIG red pill is even better.

An EXPENSIVE FOUL TASTING red pill is even better!!!

Someone should just produce these at a baht a go.

Cheeryble

[cheeryble]

Frankly an intelligent person-in-charge would get immediate consultation from the British NHS managers.

They have been extremely effective at weeding out useless from useful drugs and have funded metastudies themselves, saving billions.

Cheeryble

[BangkokDennis]

I learned quickly from personal experience after moving to Bangkok that Hospitals here grossly overcharge for drugs, bandages, etc. While I regularly use Samitivej for their doctors whose charges are quite reasonable, I always ask the doctor to give me a written perscription for any medicine so I can then buy outside the hospital. This solves most of the overcharging problem.

As an experiment one time I asked the doctor what Samitivej charges were for Allopurinol which has many local generic suppliers in Thailand. He checked on his computer for the hospital pharmacy drug list and found the only version that Samitivej carried was the imported brand name version Zyloric at a charge of 10X what I pay in local drug stores on Sukhumvit Road.

I find it amazing that in a country so strongly nationalistic as Thailand where locally made products are so favored over imports, that in the case of drugs the local manufacturers are actually discriminated against by what should be their biggest customers, the major hospitals. At the same time the government rails against the rising cost of health care when they turn a blind eye to this most obvious cause.

Clearly a lot of tea money must be changing hands for this situation to exist.

[TheyCallmeScooter]

Thai doctors are prescribing unnecessary drugs to increase revenue?

I'm shocked, shocked to discover such a thing is going on in these fine establishments.

[cheeryble]

I learned quickly from personal experience after moving to Bangkok that Hospitals here grossly overcharge for drugs, bandages, etc. While I regularly use Samitivej for their doctors whose charges are quite reasonable, I always ask the doctor to give me a written perscription for any medicine so I can then buy outside the hospital. This solves most of the overcharging problem.

I always ask for a prescription too and buy down the road......but what is overcharging?

The Ram Group for example has what seem high medicine prices but they have very low consultations and they get a share of non-payments too.

If you look at their financial details which are publicly available for investors their profits are perfectly normal and reasonable. There are enormous overheads in one of these places. Do you expect them to make a lower ROE than any other business?

Cheeryble

ps: don't get me started about the US criminal medical system

Edited February 16, 2011 by cheeryble

[Bagwan]

Something that tees me off is the wall to wall state of the art TV's in practically every room in some hospitals.

[cheeryble]

Something that tees me off is the wall to wall state of the art TV's in practically every room in some hospitals.

??

[TheyCallmeScooter]

Something that tees me off is the wall to wall state of the art TV's in practically every room in some hospitals.

??

The comfortable beds really get at his goat, as well. Although they may be conducive to the healing process, his cot in Nam did him just fine when he took one from Charlie.

[tim armstrong]

No need for a probe. Just like in the USA laws should be changed when it comes to healthcare. Each and every doctor accepting money, holidays or any other gift from pharmaceutical countries should be fined triple the amount that they receive. pharmaceutical companies paying out any form of bribe should be fined 20% of their worldwide turnover. I bet the practice is soon over.

Tragic, agree with the sentiment, but the pharmas are just too influential.If they can elect US presidents then Thailand is a pushover. But 60% unnecessary prescriptions!!! I don't entirely blame the doctors, as they are not generally well paid here, but are well trained. It must be hard for those who are genuinely dedicated to medicine to refuse the offers.

In Oz, a psychiatrist friend of mine used to get regular offers from companies to be flown, with his wife to Europe for the weekend ! just to go to a company sponsored 2 hr lecture, and of course free wining and dining and accomodation.

The few remaining large drug companies have budgets larger than many countries, and the movies fairly accurate.eg 'The constant Gardener'.

[jimbeam1]

Last time I went to a hospital for mt Sinuses, I came out rattling.

jb1