Will Need To Have My U.S. Medicare Drugs Sent To Thailand

[Lopburi99]

I'll finally be returning to LOS in a couple of months. As of the first of the year I have been enrolled in a Medicare Advantage Blue Cross Network HMO, had a complete physical and several procedures. Now it turns out I need a number of meds on an ongoing basis (Plavix, Zocor, and about 4-5 others). These drugs are expensive so it looks like I will be best off financially by keeping my Part D coverage in effect and have the meds sent to me in Thailand.

Anybody doing this presently? Does it all work ok? Can the scripts still be filled in the U.S. without me physically being there? Does the shipping work reliably? Any problems with postal handling or restrictions on incoming meds (packages being searched, etc)? Maybe some drugs I can purchase low cost in Thailand -- all that remains to be determined.

Any comments on your experiences having meds sent will be appreciated!

[Lefty]

I am pretty much in same situation as you. I take drugs for heart,blood pressure colestrol etc and have Medicare part "D".I don't bother with trying to get drugs thru Part D" as drug prices in Thailand are much cheaper than USA. e.g. generic ZOCOR $5 or so a month. Mailing drugs from U.S. is an ify proposition at best.

Regards,

Lefty

[BuckarooBanzai]

Plavix 75mg at 2,500 baht per month (28 pills) would be worth the postage.

[jazzbo]

Patent on brand-name 'Plavix' (Clopidogrel bisulfate) expires in November 2011 and there are plenty of generics in the waiting if not already available in Thailand.

[Sheryl]

Clopidogrel (generic name for plavix) is also currentkly available as Apolets, made by a Canadian firm specializing in generic equivalents, and as Pidogen, made locally by Silom Medical. Anyone know the prices of either of these? Bound to be less than Plavix.

OP, the most reliable means of sending meds (or anything else for that matter)by mail to LOS is to have them first sent to a friend or relative back home and have them repackage and mail via ordinary air mail. However, I have had reports of people being unable to arrange this because their pharmacy would not issue the drugs to other than the patient, or because friends/family were told by the US postal service that they could not mail pharmaceuticals, or something to that effect. Although plenty of people do so.

In addition, in cases where a local generic equivalent is available the postage will often cost more than just buying the drug here. Obviously depends on exactly what medication you are on.

Should note that in many cases, a doctor will have prescribed one form of a class of drugs which is either unavailable or expensive in Thailand, but that there are other drugs in the same family which are available and would serve the same purpose. Hence before leaving the US, you should determine all this and ask your doctor about possible prescription change. Obviously, your doctor does not have any idea what is and is not available in Thailand, and if he's like many physicians he may not have given much thought to cost implications when he selected the specific drug he prescribed.

Statins are a case in point. Many people end up with expensive new statins prescribed which they either cannot get here or cannot afford, when an older one might do the trick. which is not to say that there are never good medical reasons to select a newer over an older drug in a particular class. Sometimes there are..and sometimes it has more to do with sales pitches from pharmaceutical reps. Or, the advantage of the newer drug over older ones may be real but quite small and nowhere near worth the difference in cost. Obviously this is something you need to discuss with your physician, and you should do this now, while you're home. Then you'll know if in fact you need something not inexpensively available in LOS.

In terms of statins, the ones made locally are: simvastatin and atorvastatin. Zocor = simvastatin so you're in luck there.

Post what other meds you are on and will advise re their availability here.

Meanwhile if anyone has a price on Apolets of Pidogen, please share.

[chiang mai]

Boots sells a generic for around Baht600, made by a Canadian firm, was going to try but became nervous when a trusted pharmacist friend pointed out that generics are typically only 70% efficacy of the original to qualify, figured I'd wait until I saw my cardio again and asking him.

[BuckarooBanzai]

Boots sells a generic for around Baht600, made by a Canadian firm, was going to try but became nervous when a trusted pharmacist friend pointed out that generics are typically only 70% efficacy of the original to qualify, figured I'd wait until I saw my cardio again and asking him.

chiang mai - 600 Baht for 14 pills which is the standard Plavix packaging?

Thanks Sheryl for the good info!

[chiang mai]

Boots sells a generic for around Baht600, made by a Canadian firm, was going to try but became nervous when a trusted pharmacist friend pointed out that generics are typically only 70% efficacy of the original to qualify, figured I'd wait until I saw my cardio again and asking him.

chiang mai - 600 Baht for 14 pills which is the standard Plavix packaging?

Thanks Sheryl for the good info!

It's been some time since I asked so I would need to check again, I believe it was Baht 600 for 28 but don't quote me - Plavix however is Baht1,350 for 14 throughout most of Thailand although maybe Baht100 cheaper in some places. I do recall there's a distributor/wholesaler in BKK where bulk Plavix can be obtained much more cheaply, unsure of the name however, anyone?

[Mrjlh]

I suggest this. There are several companies that provide an US mailing address such as PakMail, Postnet, just to name two. There are others I'm sure. Find one that allows for forwarding mail overseas, most do. They also fill in the customs tag for you but you need to tell the the value of the package. You'll know that by which medication/s is being sent to you. Once you set up the stateside address, have all your med's sent to there. Then forwarded to your Thai address. You will need to leave a method of payment usually a credit card for the extra cost of shipping and handling. Plus its a simple way of tracking cost.

In the long run this is the simplest and cheapest method. . Have people at mail center always put your Thai phone number on the outside of the package. Packages can't always be tracked after they leave US. Better and cheaper than UPS or Fed EX. Also takes about 2 weeks to get some times faster.

Been doing it almost 5 years now and never a problem. In fact, the owner and I exchange emails often. Lets me know when he sends mail and I let him know when I get it. We are on such good terms, I can even ask him to go next door to shopping center to buy and send items I can't get here if I really need something. He just charges my card. Piece of cake.

[powderpuff]

I use usglobalmail.com excellent service at $150.00 per year plus postage fees of course.

[meatboy]

i need 5diff.meds.every day,what i done before i came to los.i got a private cert.from my doc.for 18months supply and brought them with me,just runout so i found an wholesale pharmacy who was pretty reasonable,as follows, 100amlodipine=300bht. 100bisoprolol fumerate=600bht. 90perindopri [coversyl]=1425 100simvastatim=500bht. so the prices are not to bad,knowing what i know about shipping and customs i personally would not get any sent over,i need these for life plus warfarin so i would not worry because if the pharmacy over here hasnt got them they will order for you and give you the price before.

[BuckarooBanzai]

i need 5diff.meds.every day,what i done before i came to los.i got a private cert.from my doc.for 18months supply and brought them with me,just runout so i found an wholesale pharmacy who was pretty reasonable,as follows, 100amlodipine=300bht. 100bisoprolol fumerate=600bht. 90perindopri [coversyl]=1425 100simvastatim=500bht. so the prices are not to bad,knowing what i know about shipping and customs i personally would not get any sent over,i need these for life plus warfarin so i would not worry because if the pharmacy over here hasnt got them they will order for you and give you the price before.

meatboy - a little confused on your post - is the wholesale pharmacy you mention in Thailand and if so can you provide more information about it? Thanks.

[meatboy]

i need 5diff.meds.every day,what i done before i came to los.i got a private cert.from my doc.for 18months supply and brought them with me,just runout so i found an wholesale pharmacy who was pretty reasonable,as follows, 100amlodipine=300bht. 100bisoprolol fumerate=600bht. 90perindopri [coversyl]=1425 100simvastatim=500bht. so the prices are not to bad,knowing what i know about shipping and customs i personally would not get any sent over,i need these for life plus warfarin so i would not worry because if the pharmacy over here hasnt got them they will order for you and give you the price before.

i live in korat bb so if you are near let me know and i will give you the info,there was also some good info in this forum for bkk.

meatboy - a little confused on your post - is the wholesale pharmacy you mention in Thailand and if so can you provide more information about it? Thanks.

[Lopburi99]

Clopidogrel (generic name for plavix) is also currentkly available as Apolets, made by a Canadian firm specializing in generic equivalents, and as Pidogen, made locally by Silom Medical. Anyone know the prices of either of these? Bound to be less than Plavix.

<snip>

In terms of statins, the ones made locally are: simvastatin and atorvastatin. Zocor = simvastatin so you're in luck there.

Post what other meds you are on and will advise re their availability here.

Meanwhile if anyone has a price on Apolets of Pidogen, please share.

I am also on Lisinipril, Metroprolol Tartr, Wellbutrin and Androgel 5 gm packets.

Edited April 26, 2011 by Lopburi99

[Lopburi99]

<snip>

OP, the most reliable means of sending meds (or anything else for that matter)by mail to LOS is to have them first sent to a friend or relative back home and have them repackage and mail via ordinary air mail. However, I have had reports of people being unable to arrange this because their pharmacy would not issue the drugs to other than the patient,

<snip>

I've been wondering about that. I'll first ask at the neighborhood CVS and if they resist I'll get my meds by mail order (sent to my daughter's U.S. address for repackaging. In fact, I think mail order often allows a 90 day supply to be ordered which would be ideal.

[Lopburi99]

I'm reminded of a related question. I understand Blue Cross will pay for emergency treatment anywhere in the world. So if I had severe chest pains I could go to Bumrungrad and receive emergency surgery or a stent and BCBS would cover all charges? I will call BCBS and inquire further but I was wondering if anybody has placed such a claim and had it paid?

[InterestedObserver]

I'll finally be returning to LOS in a couple of months. As of the first of the year I have been enrolled in a Medicare Advantage Blue Cross Network HMO, had a complete physical and several procedures. Now it turns out I need a number of meds on an ongoing basis (Plavix, Zocor, and about 4-5 others). These drugs are expensive so it looks like I will be best off financially by keeping my Part D coverage in effect and have the meds sent to me in Thailand.

I'm reminded of a related question. I understand Blue Cross will pay for emergency treatment anywhere in the world. So if I had severe chest pains I could go to Bumrungrad and receive emergency surgery or a stent and BCBS would cover all charges? I will call BCBS and inquire further but I was wondering if anybody has placed such a claim and had it paid?

Medicare, Parts A, B, C or D, is not available for US citizens living overseas. Your Medicare Advantage Blue Cross Network HMO is only available within a limited geographic location close to where you live in the US. Limited emergency treatment is available while on a short trip such as vacation. So if you are retired and living in Thailand you are out of luck.

[Lopburi99]

I'll finally be returning to LOS in a couple of months. As of the first of the year I have been enrolled in a Medicare Advantage Blue Cross Network HMO, had a complete physical and several procedures. Now it turns out I need a number of meds on an ongoing basis (Plavix, Zocor, and about 4-5 others). These drugs are expensive so it looks like I will be best off financially by keeping my Part D coverage in effect and have the meds sent to me in Thailand.

I'm reminded of a related question. I understand Blue Cross will pay for emergency treatment anywhere in the world. So if I had severe chest pains I could go to Bumrungrad and receive emergency surgery or a stent and BCBS would cover all charges? I will call BCBS and inquire further but I was wondering if anybody has placed such a claim and had it paid?

Medicare, Parts A, B, C or D, is not available for US citizens living overseas. Your Medicare Advantage Blue Cross Network HMO is only available within a limited geographic location close to where you live in the US. Limited emergency treatment is available while on a short trip such as vacation. So if you are retired and living in Thailand you are out of luck.

I figured that was too good to be true. Next year I may drop the Plan C and D but keep the Part B in any case. Assuming I could make it in time, I would return to the U.S. for treatment of something major or for extended treatment. Since I have limited funds and can't self-insure in Thailand, I don't see any other option. Actually though, if the $USD completely craps out I may have no choice but to return to live in the U.S. anyway. I could get a fiancée visa. There is also the possible option of living in Canada (I am a dual citizen) where health care is free and bringing my fiancée there. Complicated, but at least a possible option.

[Sheryl]

I am also on Lisinipril, Metroprolol Tartr, Wellbutrin and Androgel 5 gm packets.

Lisinopril = avauilable in locally made generic equivalent, brand names Lispril, Lisir

Metoprolol = ditto but too many brands to list

Your problem will be with the Wellbutrin and Androgel.

Buproprion (Wellbutrin) is available here only as the smoking cessation product Quomem. It is 150mg and sustained release form. I think that 3 of these might be equivalent to 450 mg of Wellbutrin XL but am not sure and you should definitely ask your doctor. If you are on a non-sustained release form of Wellbutrin (i.e. regular Wellbutrin rather than Wellbutrin XL) then this is not at all the same. Quomem is an import and thus costly so it would be worth the postage for you to get this sent here, but do also ask your doctor about whether you can safely substitute Quomem in case you are ever in a pinch supply-wise. As I am sure you know, sudden discontinuation of this is unwise.

AFAIK there are no brands of testosterone gel (Androgel) licensed for sale in Thailand. There are testosterone capsules and depot (long-acting)injections, but not the gel. There is a definite advantage to using a topical form versus oral and also vs the depot injections (the latter produce wide flunctuations in blood levels) injections are not very practical for long term therapy. So it would be worth having this shipped to you.

Based on your age and meds, I hope you have had a recent stress test and thorough physical. You do not want to end up having to have stent placement or other cardiac surgery here uninsured, and when the need for such arises one is not well advised to take a long flight home. Even at a government hospital, cost is going to be over $4,000 and may easily exceed $10,000 if multiple stents are required. Problem being the cost of the stents themselves.And this is assuming smooth sailing. In the event of an acute event requiring emergency care, ICU stay etc you are easily looking at >$50,000 -- and obviously in such circumstances will nto be fit to fly home. Same would apply if in a major accident, not an infrequenct occurrence given the way people drive here.

Being uninsured, you will need to rely on either government hospitals or large non-profits for your medical care so take that into account when deciding where to live. Best government hospitals are in Bangkok, Chiang Mai, Kon Khaen, Songhkla. government hospitals below the provincial level are definitely to be avoided, and the provincial level ones vary.

You should also plan on "self-insuring" by putting money aside in an account just for this purpose. Not less than 1 million baht would be best (that's over $30,000 and the dollar seems to be sinking fast against the baht). A long-term deposit is fine just as long as you can access it reasonably fast in an emergency.

[Lopburi99]

Thanks for that information Sheryl. I already have my stents in, thanks to a stress test which I failed. I'll be using mail order prescription 90 day fills then having my daughter repackage and ship them. It is good to know the important ones are available there (Plavix, Zocor, Wellbutrin) in case there is a shipping problem or glitch.

Re Wellbutrin, I do take 150 mg SR (2/day) so the Quomem will work in a pinch.

Edited April 27, 2011 by Lopburi99

[lopburi3]

I'm reminded of a related question. I understand Blue Cross will pay for emergency treatment anywhere in the world. So if I had severe chest pains I could go to Bumrungrad and receive emergency surgery or a stent and BCBS would cover all charges? I will call BCBS and inquire further but I was wondering if anybody has placed such a claim and had it paid?

It may vary by policy held but my BCBS (has nothing to do with Medicare) pays overseas and only out of pocket was the normal $250 per admission.

[BuckarooBanzai]

Just picked up the Plavix (clopidogrel hydrogen sulfate) generic Apolets (clopidogrel bisulfate) by Berlin Pharmaceutical and what a deal. Box of 30 pills for 900 baht vs. 14 pills Plavix for 1,250-1,350 baht.

[Lopburi99]

I'll finally be returning to LOS in a couple of months. As of the first of the year I have been enrolled in a Medicare Advantage Blue Cross Network HMO, had a complete physical and several procedures. Now it turns out I need a number of meds on an ongoing basis (Plavix, Zocor, and about 4-5 others). These drugs are expensive so it looks like I will be best off financially by keeping my Part D coverage in effect and have the meds sent to me in Thailand.

I'm reminded of a related question. I understand Blue Cross will pay for emergency treatment anywhere in the world. So if I had severe chest pains I could go to Bumrungrad and receive emergency surgery or a stent and BCBS would cover all charges? I will call BCBS and inquire further but I was wondering if anybody has placed such a claim and had it paid?

Medicare, Parts A, B, C or D, is not available for US citizens living overseas. Your Medicare Advantage Blue Cross Network HMO is only available within a limited geographic location close to where you live in the US. Limited emergency treatment is available while on a short trip such as vacation. So if you are retired and living in Thailand you are out of luck.

IO, I believe this not to be accurate. According to my research, everybody signed up with Blue Care Network HMO [in Michigan anyway] has automatic emergency and urgent care coverage anywhere in the world and with no travel length restriction. If the hospital won't bill Blue Cross directly a reimbursement is applied for (a simple one-page form to be included with the receipts). BTW, somebody here said Bumrungrad will bill Blue Cross I believe. I can provide links if anybody wants, or reference MiBCN.com. For those of us enrollees traveling back to the states from time to time I don't see the residency issue being a problem.

BTW, there is no restriction of "limited geographic location area close to where somebody lives [in the U.S]" language that I could find. Not relevant in my situation but perhaps for others.

[Lopburi99]

Just picked up the Plavix (clopidogrel hydrogen sulfate) generic Apolets (clopidogrel bisulfate) by Berlin Pharmaceutical and what a deal. Box of 30 pills for 900 baht vs. 14 pills Plavix for 1,250-1,350 baht.

That's great to know! Somebody here mentioned the efficacy of generics can be up to only 70% compared to brand name and therefore was reluctant to substitute them. I wonder if there is some way for us to verify Berlin's Apolets are the same potency as or very very close to that of Plavix? I just had my drug emitting stents put in and the first few months of Plavix (plus aspirin) are critical.

Edited May 7, 2011 by Lopburi99

[Sheryl]

If a drug contains exactly the same chemical substances and of the same dose it's efficacy will be identical.

The only way it would not would be if it did not in fact contain its stated ingrediants.

I believe some of the Thai manufacturers are more reliable than others. GPO brand is always reliable and; might be wise to avoid where possible very small private manufacturers.

Perhaps some other posters could mention some local private manufacturers of good reputation, I know I have seen this here before.

Personally never had a problem with locally made generics.

[Lopburi99]

Well, I've been back here since August 1 and have had two shipments sent to me since. U.S. Priority Mail Flat Rate ($20) took 16 days, Global Express Flat Rate ($30) took about 11.

I also found the generic Plavix here for 900 baht/30 day supply and bought some in case a shipment comes late or something happens.

The shipping of meds from the U.S. to here is working out well, but it is a pain for my daughter. I need to make a decision soon about my Medicare Part D prescription drug plan for 2012, which plan, which company, or perhaps no drug coverage at all. As that decision gets worked on I can evaluate the cost effectiveness of possibly buying everything here by substituting one med for another or eliminating one. All but one med, Ranexa, are available here and affordable. It is not clear I really need the Ranexa, checking with my Dr on that.

[Backwoods]

Just picked up the Plavix (clopidogrel hydrogen sulfate) generic Apolets (clopidogrel bisulfate) by Berlin Pharmaceutical and what a deal. Box of 30 pills for 900 baht vs. 14 pills Plavix for 1,250-1,350 baht.

That's great to know! Somebody here mentioned the efficacy of generics can be up to only 70% compared to brand name and therefore was reluctant to substitute them. I wonder if there is some way for us to verify Berlin's Apolets are the same potency as or very very close to that of Plavix? I just had my drug emitting stents put in and the first few months of Plavix (plus aspirin) are critical.

I take 8 different meds in the eve as well as 2 during the morning and cost of all is just Over $3000THB. I was told by Cardiologist to use brand name Plavix, as some have different buffers, lisinapril I use is Lispil, motopolol tartrate is beta Lok ZOK, and simvastatin is called Zimmex.!

[Backwoods]

Just picked up the Plavix (clopidogrel hydrogen sulfate) generic Apolets (clopidogrel bisulfate) by Berlin Pharmaceutical and what a deal. Box of 30 pills for 900 baht vs. 14 pills Plavix for 1,250-1,350 baht.

That's great to know! Somebody here mentioned the efficacy of generics can be up to only 70% compared to brand name and therefore was reluctant to substitute them. I wonder if there is some way for us to verify Berlin's Apolets are the same potency as or very very close to that of Plavix? I just had my drug emitting stents put in and the first few months of Plavix (plus aspirin) are critical.

I take 8 different meds in the eve as well as 2 during the morning and cost of all is just Over $3000THB. I was told by Cardiologist to use brand name Plavix, as some have different buffers, lisinapril I use is Lispil, motopolol tartrate is beta Lok ZOK, and simvastatin is called Zimmex.!

By the way Just had my ICD replaced At Praham 9 and insuranced was billed 620,000 THB, Bangkok Hospital quoted me 1,000,000 THB for same proceedure. I have Medicare part A&B and its useless outside of USA. Luckily I have others that will work here as a lot of Hospitals will bill insurance for you, but you must pay up front and collect from Insurance after!! If Medicare finds out you are using an alternate address you will have problems, also some meds are restricted on mailing, just be carefull!

[Lopburi99]

I take 8 different meds in the eve as well as 2 during the morning and cost of all is just Over $3000THB. I was told by Cardiologist to use brand name Plavix, as some have different buffers, lisinapril I use is Lispil, motopolol tartrate is beta Lok ZOK, and simvastatin is called Zimmex.!

Good to know those other brand names, I take the same meds except for Ranexa which I plan to discontinue because I don't have an angina problem and it is damned expensive. Re: Plavix, I had planned on using the generic for 900 baht/month so I will need to research more if other cardiologists also suggest avoiding the generic. Anybody have any info to offer here? Also regarding shipping, the post office told my daughter not to indicate medicine on the customs form because medicine supposedly shouldn't be shipped overseas.