Hello,

To try and reduce my monthly expenditure I am trying to find out if there are alternatives or generics for the following three medications:

Micardis 80 mg

Nexium 20 mg

Crestor 20 mg

I have been to several pharmacies up our way in Ubon Ratchathani and they basically say there is nothing available. One pharmacy sold me a very cheap cholesterol medication. I showed it to my cardiologist and he basically said its very cheap and not very potent.

Is there also a way that this medicine can be purchased online and shipped to Thailand cheaply and if so, what tax/duty implications are there. My country of origin is Australia where I can buy these medications cheaper than here on the Pharmaceutical Benefits Scheme.

Thanks in advance.

Your problem is that you are on the newest versions of a statin, Angiotensin II inhibitor and PPI.

Newer is not necessarily better, but it is certainly more expensive since still under patent hence no local generics.

Some Thai doctors are unduly influenced by drug companies.

IMO would make more sense to at least first try with older versions of these three drug types, e.g.:

statin - simvastatin (probably what the pharmacist sold you, and perfectly "potent") or atorvastatin

Angiotensin II inhibitor -- losartan

PPI - omeprazole

All of the above are available in very inexpensive locally made generics. If after a trial of treatment with these, one is not working well for you (or causing unacceptable side effects) then moving up to a newer more expensive drug may be justified but it would not be normal practice to start immediately on them (and is certainly not cost effective).

I am not suggesting though that you make this change on your own, discuss it with your doctor. But be clear to him that cost is a constraint, you are paying out of pocket for this and need to find less expensive alternatives, and ask him specifically whether you can try the alternatives suggested above. And if not, why not.

Thanks Sheryl for you informative reply. I will speak to my cardiologist about your suggestions. He speaks quite good English. I have also been recommended to a GP style doctor here in Ubon who apparently speaks perfect English for advice about the Nexium and Crestor alternatives.

Thanks again

Your problem is that you are on the newest versions of a statin, Angiotensin II inhibitor and PPI.

Newer is not necessarily better, but it is certainly more expensive since still under patent hence no local generics.

Some Thai doctors are unduly influenced by drug companies.

IMO would make more sense to at least first try with older versions of these three drug types, e.g.:

statin - simvastatin (probably what the pharmacist sold you, and perfectly "potent") or atorvastatin

Angiotensin II inhibitor -- losartan

PPI - omeprazole

All of the above are available in very inexpensive locally made generics. If after a trial of treatment with these, one is not working well for you (or causing unacceptable side effects) then moving up to a newer more expensive drug may be justified but it would not be normal practice to start immediately on them (and is certainly not cost effective).

I am not suggesting though that you make this change on your own, discuss it with your doctor. But be clear to him that cost is a constraint, you are paying out of pocket for this and need to find less expensive alternatives, and ask him specifically whether you can try the alternatives suggested above. And if not, why not.

I would find the Thailand government pharma to me very reliable: Government Pharmaceutical Organization (GPO). I use Losartan from GPO everyday. I know others, with very serious life-threatening chronic illnesses, who rely on GPO products. They have a wide range of them and I think you can order online for shipping within Thailand: www.intergpomed.com/‎

Yes, I agree that GPO is a most reliable and affordable source. OP first needs to get his meds switched to brands GPO makes, however, as he is currently on patented imports.