Medicine prices in hospitals vs pharmacies

[KittenKong]

I've always known that medicine costs can vary from pharmacy to pharmacy and tend to be higher if bought directly from the hospital (and this can apply anywhere that doesnt have price control on medicines, not just in Thailand), but having never needed any medicine on a regular basis before I didn't realise how big the difference could be here.

An example of two very common drugs, both identical brands and strengths, bought on the same day this month:

30 days supply in the pharmacy of Phyathai hospital in Sri Racha: 979 Baht

60 days supply in Fascino Pattaya: 306 Baht

That's a 639% markup in the hospital which seems excessive to say the least.

I will be checking other local hospitals to see what my consultations and treatment would have cost there, based on which I may review where I go. I certainly will check prices before getting any medicine from any hospital pharmacy again.

[richard_smith237]

I've also observed this huge mark-up...

My standard reply: I won't purchase the Medicine from the Hospital Pharmacy because the price is too high, please tell me what I need and I will get it from an outside Pharmacy.

I have no issue with being open and honest about why I don't wish to purchase from the Hospital Pharmacy.

Purchasing direct from an outside Pharmacy does become a little more difficult if the substance is controlled more tightly.

[Guderian]

Bangkok Hospital in Pattaya is guilty of this. The orthopaedic surgeon I see there told me that he can give me a prescription for the (very common) medicine I needed and I could get it from the hospital pharmacy, but he said that they charge far too much and it was better for me if I went to an outside pharmacy as it would save money. Refreshingly honest.

[Langsuan Man]

Bangkok Hospital in Pattaya is guilty of this. The orthopaedic surgeon I see there told me that he can give me a prescription for the (very common) medicine I needed and I could get it from the hospital pharmacy, but he said that they charge far too much and it was better for me if I went to an outside pharmacy as it would save money. Refreshingly honest.

Especially since there are two private pharmacies next to BPH on the same side of Sukumvit, to the South is a branch of Fascino and to the North is another private pharmacy

[ThaiBob]

All private hospitals view their pharmacies as cash cows. I buy my medicines outside the hospital. Unfortunately there are some medications that only the hospital can sell.

[craigt3365]

Bangkok Hospital in Pattaya is guilty of this. The orthopaedic surgeon I see there told me that he can give me a prescription for the (very common) medicine I needed and I could get it from the hospital pharmacy, but he said that they charge far too much and it was better for me if I went to an outside pharmacy as it would save money. Refreshingly honest.

Especially since there are two private pharmacies next to BPH on the same side of Sukumvit, to the South is a branch of Fascino and to the North is another private pharmacy

One of the best I've found is just past the flyover as you are headed south on Suk. Left side. A few hundred meters down from the flyover. I've found some items there are as much as 1/3rd less than Fascino.

[BruceMangosteen]

Anyone know what is considered a script from a Doctor and if you have one, where you can get things filled such as sleeping pills and high level(meaning they relieve pain) pain medicines? Also there is a lack of availability of certain blood pressure medications at the various pharmacies who will in many cases reccomend another they have in stock which as informed people know may not be the best choice etc..

[JSixpack]

Anyone know what is considered a script from a Doctor and if you have one, where you can get things filled such as sleeping pills and high level(meaning they relieve pain) pain medicines? Also there is a lack of availability of certain blood pressure medications at the various pharmacies who will in many cases reccomend another they have in stock which as informed people know may not be the best choice etc..

Sounds like you're mainly looking for meds that are only available in a hsp pharmacy, prescribed by a hsp doc.

Clinics sometimes have the stronger stuff and the docs there may dispense it. Probably cheaper than a hsp pharmacy, but more expensive than Fascino etc.

Anybody who has a blood pressure problem should have the sense to know exactly which medicine(s) he needs for it as recommended by a heart specialist.

Edited November 21, 2013 by JSixpack

[BruceMangosteen]

In all fairness to the hard working staff at the hospitals, they often either have instructions or simply do it, fill the order from the Doctor with name brand drugs, not generics we may often compare prices to. As an example, Cipro and as I mentioned elsewhere, some widely produced blood pressure medications. Not to digress, but your payment method also could have a impact. Insurance paying, government paying(and government hospital), or you a farang paying cash. I know for a fact certain brand name drugs are not dispensed to those on Government insurance plans. Generic for one type of patient, brand for another. Lastly, when someone turns 50, she starts to wonder and worry about such things and the safety of same. Which brings me to "Obamacare" and the question what drugs are covered under same, if any?

[Gone]

Bangkok Hospital in Pattaya is guilty of this. The orthopaedic surgeon I see there told me that he can give me a prescription for the (very common) medicine I needed and I could get it from the hospital pharmacy, but he said that they charge far too much and it was better for me if I went to an outside pharmacy as it would save money. Refreshingly honest.

Especially since there are two private pharmacies next to BPH on the same side of Sukumvit, to the South is a branch of Fascino and to the North is another private pharmacy

One of the best I've found is just past the flyover as you are headed south on Suk. Left side. A few hundred meters down from the flyover. I've found some items there are as much as 1/3rd less than Fascino.

I think you are talking about "D-Pharmacy" who used to be just South of Pattaya Klang on Sukhumvit and are now located where you say. They are great and sell generic brands very cheap and normally you do not need a script. They also have a decent supply of hospital equipment same as Fascino and hearing aids etc. That's where I used to get all my dad's expensive hospital perscribed medicines and saved a fortune !

[KittenKong]

In all fairness to the hard working staff at the hospitals, they often either have instructions or simply do it, fill the order from the Doctor with name brand drugs, not generics we may often compare prices to. As an example, Cipro and as I mentioned elsewhere, some widely produced blood pressure medications. Not to digress, but your payment method also could have a impact. Insurance paying, government paying(and government hospital), or you a farang paying cash.

I was very careful to compare identical products and identical payment methods (cash).

I fully expected a mark-up of perhaps 30% or even 50% at the hospital, but not 639%. To me this seems just plain dishonest and it will probably cost my hospital one long-term customer.

At no point did I blame the counter staff or nurses or physicians who evidently are not responsible for setting the prices and are just doing their job.The management is entirely to blame.

[BruceMangosteen]

I was very careful to compare identical products and identical payment methods (cash).

I fully expected a mark-up of perhaps 30% or even 50% at the hospital, but not 639%. To me this seems just plain dishonest and it will probably cost my hospital one long-term customer.

Please tell us what the medication was. Without that information, "something wrong" with your example as Dr. Lee would say. To also repeat, there is often a "Thai" price and a "Farang" price at even the top hospitals aka most expensive ones. Bangkok Pattaya is an example of one of the "top" with tiered pricing on at least services and tests.

[ThaiBob]

In all fairness to the hard working staff at the hospitals, they often either have instructions or simply do it, fill the order from the Doctor with name brand drugs, not generics we may often compare prices to. As an example, Cipro and as I mentioned elsewhere, some widely produced blood pressure medications. Not to digress, but your payment method also could have a impact. Insurance paying, government paying(and government hospital), or you a farang paying cash. I know for a fact certain brand name drugs are not dispensed to those on Government insurance plans. Generic for one type of patient, brand for another. Lastly, when someone turns 50, she starts to wonder and worry about such things and the safety of same. Which brings me to "Obamacare" and the question what drugs are covered under same, if any?

Not sure how Obamacare got into this discussion. But I always ask for the generic drug to save money. Many insurance plans requires the use of generics if available.

[MTH]

Anyone know what is considered a script from a Doctor and if you have one, where you can get things filled such as sleeping pills and high level(meaning they relieve pain) pain medicines? Also there is a lack of availability of certain blood pressure medications at the various pharmacies who will in many cases reccomend another they have in stock which as informed people know may not be the best choice etc..

Had a doc write a prescription, easy enough to get it filled at Fascino.

[KittenKong]

I was very careful to compare identical products and identical payment methods (cash).

I fully expected a mark-up of perhaps 30% or even 50% at the hospital, but not 639%. To me this seems just plain dishonest and it will probably cost my hospital one long-term customer.

Please tell us what the medication was. Without that information, "something wrong" with your example as Dr. Lee would say.

Is that necessary? Both were very common medicines (anti high blood pressure and anti-cholesterol) used by millions of old farts people daily. Indeed when I went into Fascino the chap in front of me bought exactly the same medicines.

To also repeat, there is often a "Thai" price and a "Farang" price at even the top hospitals aka most expensive ones.

Well, there shouldn't be and as far as I'm concerned that is also a valid reason to use another hospital.

[Naam]

Bangkok Hospital in Pattaya is guilty of this. The orthopaedic surgeon I see there told me that he can give me a prescription for the (very common) medicine I needed and I could get it from the hospital pharmacy, but he said that they charge far too much and it was better for me if I went to an outside pharmacy as it would save money. Refreshingly honest.

same experience!

[gamini]

Fascino is still a lot more expensive than wholesale Chinese pharmacies in Bangkok. We go to Bangkok once every three months and buy 3 months supply of medicine. Some medicine can only be bought from a Hospital so the answer is get it from a Government Hospital whose price is very reasonable also cheaper than Fascino.

[Sheryl]

Not only is the mark-up huge as compared to the exact same thing at an outside pharmacy, but doctors at private hospitals tend to prescribe expensive import rather than locally made generic equivalents of the same thing. Always check to see if you can get a different brand of the same generic.

[KittenKong]

Fascino is still a lot more expensive than wholesale Chinese pharmacies in Bangkok. We go to Bangkok once every three months and buy 3 months supply of medicine.

3 months' supply of my two medicines would be about 450B at Fascino. Hardly worth trekking off to Bangkok to save a percentage of that. Of course if your medicine is much more expensive it may be more worthwhile.

[ray35ty]

What people have to realise is these hospitals are run like businesses there is care but the main objective is to just fill in their back pockets. Senior management much be pushing doctors to make profits and ensure all visits are given medications with 100% to 300% markup of the price of a retail pharmacy. You only have to look at the thai stock market and look at the publicly listed hospitals they have all gone up by 50% to 70% in the last year......

I needed a checkup from a skin specialist at a hospital in Pattaya. I just want a routine check of a skin condition. I have no problem in paying for the 1500 check up fee but I was given a 300baht nurses fee. No nurse even saw me and also an administration fee plus the doctor. The doctor requested I go on a special vitamin a drug for a skin condition the hospital sell the box for 2100 baht I got the same pills for 900baht at the pharmacy and I told him a prescription wasn't necessary however he insisted I have some dermatological soap at 380baht where I can buy from big c for 80 baht I declined. And left paying 1900 baht.

[SantiSuk]

My very limited sample of such divergence in Isaan is less marked. My relevant sample is three different respiratory drugs; relatively expensive, so not widely available except in hospitals and better-stocked retail pharmacies. 25 to 30% cheaper in a Bangkok retail pharmacy than the prescribing Ubon Ratchatani private hospital's pharmacy and 10 to 15% cheaper in an Ubon retail pharmacy.

I have found that the drugs are however usually a bit fresher in the hospital pharmacy. Don't buy low volume drugs from a retail pharmacy without asking to see the packaging for manufactured/expiry date.

[yermanee]

My very limited sample of such divergence in Isaan is less marked. My relevant sample is three different respiratory drugs; relatively expensive, so not widely available except in hospitals and better-stocked retail pharmacies. 25 to 30% cheaper in a Bangkok retail pharmacy than the prescribing Ubon Ratchatani private hospital's pharmacy and 10 to 15% cheaper in an Ubon retail pharmacy.

I have found that the drugs are however usually a bit fresher in the hospital pharmacy. Don't buy low volume drugs from a retail pharmacy without asking to see the packaging for manufactured/expiry date.

Good advice.

Yermanee

[DMC1]

I'll just throw this one out there but have any of you seen 'Avamys' nasal spray on your travels in any of these pharmacies? I had real trouble getting the last one. It cost me 1800 Baht from Phyathai last time (120 squirts). Cheers

[balo]

This is nothing new.

The few times I had to visit the hospitals I always informed them that I will buy the tablets outside in a local pharmacy. They don't like it but I save maybe 2000 baht .

Sent from my GT-I9300 using Thaivisa Connect Thailand mobile app

[Bpuumike]

In all fairness to the hard working staff at the hospitals, they often either have instructions or simply do it, fill the order from the Doctor with name brand drugs, not generics we may often compare prices to. As an example, Cipro and as I mentioned elsewhere, some widely produced blood pressure medications. Not to digress, but your payment method also could have a impact. Insurance paying, government paying(and government hospital), or you a farang paying cash.

I was very careful to compare identical products and identical payment methods (cash).

I fully expected a mark-up of perhaps 30% or even 50% at the hospital, but not 639%. To me this seems just plain dishonest and it will probably cost my hospital one long-term customer.

At no point did I blame the counter staff or nurses or physicians who evidently are not responsible for setting the prices and are just doing their job.The management is entirely to blame.

I don't buy from the pharmacies at major hospitals in BKK, it's a big earner for them. I even stay clear of pharmacies in the tourist areas, much cheaper to buy in 'local' Thai areas. I'm talking brand names, not generics, but am usually offered the option of either at very different prices.

[chakatee]

I usually don't drink coke from the minibar in my hotel but I go and buy it outside ... quite a saver.

In lower tier hotels the mark up will not be too high, in higher tier hotels it will be very high; whether I pay for the convenience ,and also as of course the cost for this hotel to get me the coke in my minibar, or not is up to me: where do I find the same coke, at what expense, with the same storage conditions, nicely cold in a clean glass).

On a business trip my employer pays and I may be tempted to go for the minibar. I will even be honest, not just tempted, I just do it for God sakes, I will not walk the extra 200 meter to save some of not-my-money. Jee it does taste good then haha.

Change coke by medication, minibar by pharmacy / poppa momma shor or 7Eleven, hotel by hospital and employer by insurance = exactly the same apart from the fewer rants on forums about coke prices in minibars.

[KittenKong]

I usually don't drink coke from the minibar in my hotel but I go and buy it outside ... quite a saver.

In lower tier hotels the mark up will not be too high, in higher tier hotels it will be very high; whether I pay for the convenience ,and also as of course the cost for this hotel to get me the coke in my minibar, or not is up to me: where do I find the same coke, at what expense, with the same storage conditions, nicely cold in a clean glass).

Change coke by medication, minibar by pharmacy / poppa momma shor or 7Eleven, hotel by hospital and employer by insurance = exactly the same apart from the fewer rants on forums about coke prices in minibars.

Actually it's not the same thing at all. No matter where you buy the medicine from it is exactly the same and comes in the same plastic wrapper created by the manufacturer. A hospital has no more costs selling it to you than a pharmacy in the street outside does. There is no nicely chilled clean glass: just the same cheap plastic bag. Therefore a large extra markup seems entirely unreasonable.

As I said, 30% or even 50% could be considered acceptable but not 639%.

[jacko45k]

Bangkok Hospital in Pattaya is guilty of this. The orthopaedic surgeon I see there told me that he can give me a prescription for the (very common) medicine I needed and I could get it from the hospital pharmacy, but he said that they charge far too much and it was better for me if I went to an outside pharmacy as it would save money. Refreshingly honest.

Especially since there are two private pharmacies next to BPH on the same side of Sukumvit, to the South is a branch of Fascino and to the North is another private pharmacy

One of the best I've found is just past the flyover as you are headed south on Suk. Left side. A few hundred meters down from the flyover. I've found some items there are as much as 1/3rd less than Fascino.

I am trying to figure out where you mean.

Could you position it relative to Soi Siam CC Rd (lights) and Klang Junction?

It's just that it sounds like the place opposite Tesco there, turn left before Numchai at Bangkok Bank, which is a Fascino.

Edited November 23, 2013 by jacko45k

[ThaiBob]

I usually don't drink coke from the minibar in my hotel but I go and buy it outside ... quite a saver.

In lower tier hotels the mark up will not be too high, in higher tier hotels it will be very high; whether I pay for the convenience ,and also as of course the cost for this hotel to get me the coke in my minibar, or not is up to me: where do I find the same coke, at what expense, with the same storage conditions, nicely cold in a clean glass).

Change coke by medication, minibar by pharmacy / poppa momma shor or 7Eleven, hotel by hospital and employer by insurance = exactly the same apart from the fewer rants on forums about coke prices in minibars.

Actually it's not the same thing at all. No matter where you buy the medicine from it is exactly the same and comes in the same plastic wrapper created by the manufacturer. A hospital has no more costs selling it to you than a pharmacy in the street outside does. There is no nicely chilled clean glass: just the same cheap plastic bag. Therefore a large extra markup seems entirely unreasonable.

As I said, 30% or even 50% could be considered acceptable but not 639%.

His analogy was a good one, he meant the hotel room minibar. I stayed at the Dusit Thani and the mark-up on canned sodas was greater than 639%.

[jacko45k]

I usually don't drink coke from the minibar in my hotel but I go and buy it outside ... quite a saver.

In lower tier hotels the mark up will not be too high, in higher tier hotels it will be very high; whether I pay for the convenience ,and also as of course the cost for this hotel to get me the coke in my minibar, or not is up to me: where do I find the same coke, at what expense, with the same storage conditions, nicely cold in a clean glass).

Change coke by medication, minibar by pharmacy / poppa momma shor or 7Eleven, hotel by hospital and employer by insurance = exactly the same apart from the fewer rants on forums about coke prices in minibars.

Actually it's not the same thing at all. No matter where you buy the medicine from it is exactly the same and comes in the same plastic wrapper created by the manufacturer. A hospital has no more costs selling it to you than a pharmacy in the street outside does. There is no nicely chilled clean glass: just the same cheap plastic bag. Therefore a large extra markup seems entirely unreasonable.

As I said, 30% or even 50% could be considered acceptable but not 639%.

His analogy was a good one, he meant the hotel room minibar. I stayed at the Dusit Thani and the mark-up on canned sodas was greater than 639%.

I think the analogy is quite good.

At the hospital the medications have been prescribed by one of their doctors and is enclosed in the package including the doctors services.

(And in some instances likely being picked up by insurance).

Some medications may not be available outside.

I queried some medication last time, saying it was not necessary,and had it removed.

Saved 600 baht and a glass of milk would cover what I missed.....(calcium supplement).

Edited November 23, 2013 by jacko45k