Locally Manufactured Drugs

[guyham]

I have to take a number of heart medications which were prescribed for me when I lived in America. For the past 4 years living in Thailand I have been obtaining them from a large internationally owned hospital in Udon Thani, where European versions of these drugs are provided at surprisingly high prices. However, I have recently obtained a quantity of one particular drug (the most expensive at 2,000 baht per month) from a pharmacist in Udon Thani. The drug is manufactured in Bangkok and costs 10% of what I have been paying the hospital pharmacy. Can anyone tell me how I can find out if the company manufacturing this drug is bone fide in terms of the quality of the drug (particularly potency) – I am less concerned about the issue of patent violations etc. I am certainly not interested in having the medicine analyzed – just want to determine if the drug company is producing genuine medications. Does the Thailand FDA provide any meaningful info on its drug companies? Guess that’s a stupid question. This ought to be a concern for all of us who are taking medications manufactured in Thailand or imported from Asia.

[lopburi3]

If it was accepted most likely the hospital would also stock it. Have you asked them? Often times they will put a foreigner on imported drugs, where they would ask a Thai first. I would not risk my life on pharmacy drugs that are of local manufacture unless the same drugs are being prescribed by hospitals. You really should ask your doctor, as he should know. Many drugs are made locally, even for major producers, that are cheaper than other places. Feel free to mention the drug name as there may be others who will have specific information. I take Tenormin and Amlodipine myself.

I would be very cautious of a Udorn pharmacy myself, even if the drugs are real and made with proper quality control; have they been stored correctly.

But by the same token Nong Khai is a large export base for drugs so they may have fresh stock and proper storage. So it really goes back to asking those that should have the best information and that would be your doctor.

[guyham]

If it was accepted most likely the hospital would also stock it. Have you asked them? Often times they will put a foreigner on imported drugs, where they would ask a Thai first. I would not risk my life on pharmacy drugs that are of local manufacture unless the same drugs are being prescribed by hospitals. You really should ask your doctor, as he should know. Many drugs are made locally, even for major producers, that are cheaper than other places. Feel free to mention the drug name as there may be others who will have specific information. I take Tenormin and Amlodipine myself.

I would be very cautious of a Udorn pharmacy myself, even if the drugs are real and made with proper quality control; have they been stored correctly.

But by the same token Nong Khai is a large export base for drugs so they may have fresh stock and proper storage. So it really goes back to asking those that should have the best information and that would be your doctor.

Thanks lopburi3. The three medicines I take are Simvastatin (the one I got from the Udorn pharmacy), Ramipril & Metoprolol. The manufactured date on the Simvastatin package is 22/2/06 so presumably has not had enough time to be affected by poor storage assuming the date is correct. By the way, I am glad you mentioned that point as I am at fault as well since I store my meds in a drawer in the kitchen which must, at times, get way beyond the 30 C marked on the package. Now they are all in the fridge.

[lopburi3]

Simvastatin under the brand name Bestatin is sold in hospitals here and is considered first class. I and wife take and lipid levels are way, way down. This was also available under another name that was made here sold in hospitals (believe began with "G") and was considered good. These are much cheaper than the imported version and should be real. Doctors at Chula took wife off the imported even though we had no problem paying for it as they did not believe it was any better. So believe you have found a good product. And I would be very upset with hospital trying to sell you imported product - we changed to local made several years ago. And I get the Bestatin at a large hospital here in Bangkok.

//Edit: Believe the other local simvastatin had the brand name Zimmex or something like that//

[katana]

I've often wondered that about the antibiotics in Thailand as well. There's often a much cheaper local alternative available.

For example, Norfloxacin made by the Siam Chemical chemical company, is available much cheaper than the imported Norfloxacin from Astra (Brit company I think). Both seem to work OK, although maybe the locally made drug is less pure since when making pharmaceuticals, the hardest step is often the purification process.

Same with Ciprofloxacin. The locally produced stuff is much cheaper the the same drug from Bayer. The hospitals only seem to dispense the Bayer version, the pharmacies both versions.

[Gary A]

When I came over here I was on three different drugs from the US. Two were for blood pressure and one was a blood thinner. I had insurance and the doctor's writing the prescription was $10. The co-payment on each drug was $20. The doctor over here told me to throw them all away and put me on a ACE inhibitor blood pressure drug called Enaril. I buy a box of one hundred foil wrapped tablets for 325 baht. He also wanted me to take one coated 60 mg aspirin a day. For the first time ever my blood pressure is under control and I feel great.

I think drugs in the US are a big rip off.

[Sheryl]

The Thai FDA does have quality control mechanisms in place and to the best of my knowledge Thai manufactured drugs are of reliable quality. I'm a health professional and I personally always buy a Thai made generic drug for myself, friends and family when one is available. In fact I buy them in bulk & bring them to Cambodia for friends & acquaintances on chronic medication. Never had any problems & saves a good deal of money.

I know that during the refugee camps years the UN set up a quality testing mechanism for Thai manufactured drugs purchased with UN funds for the camps and while I don't know if there were any they found not acceptable I do know that virtually all of the drugs purchased and used were manufactured in Thailand.

[Sheryl]

P.S. forgot to add -- for those of you on chronic meds for which there is no Thai generic available, imported drugs are much cheaper in Cambodia (no customs duty) enough so to more than pay for a trip there & back esp now that Air Asia has such cheap flights. Just be sure to confine yourself to a reputable pharmacy that imports directly from the pharmaceutical companies (assures no counterfeits and also corrwect handling & storage...most of the small pharmacies buy on the market where real & fake are hard to distinguish & drugs exposed to sunlight & heat). . Best one is Pharmacie La Gare, near the train station. Also quite OK but smaller range is Naga.

[lopburi3]

I agree with Sheryl that real drugs are FDA approved and should meet QC standards but that there has been press reports of a very high incidence of sub standard/fake drugs being sold in border regions so I would be very carful to buy only from large pharmacy/hospital sources with fresh stock rather than the country store pharmacy with a visiting pharmacist who is not involved in the day to day operations. I believe anti malaria medications, in general, are a very suspect group.

[Sheryl]

There was indeed a recent influx of counterfeit Malarine (the Cambodian brand name for commercially sold of malaria tx) along the border and a number of deaths as a result. There is a web site with detailed instructions on how to tell the real from the fake. Aside from that, within Cambodia there are tons of counterfeits and presumably some of these could make their way to the Thai border. But as far as I know, none of the counerfeits are of Thai brands. Mostly it is of French pharamceuticals, with very convincing looking fakes made in Viet Nam. There would not be much profit margin in countefeiting Thai generic drugs as they are cheap to begin with.

But of course, regardless always stick with a reliable pharmacy. Aside from the counterfeit issue there is the mater of proper drug storage, very few drugs can retain their potency after prolonger exposure to more than 35 C or so. So buy from places that are air con and preferrably have a "real"pharmacist on site (so that they know what they're selling you!) There is usually at least one such pharmacy in every provincial capital town.

[catmac]

I've used the generic Simvastatin "Bestatin" from a major pharmacy in Chiang Mai and found it worked perfectly O.K., as always, use your common sense on where you purchase any product.

Does anyone have any experience of local generic versions of Amlodopine or Perindopril (the medications for blood pressure I'm on in the U.K.?

[Sheryl]

As I've said before you should have no problem in terms of quality of Thai made generics as long as you purchase from a reliable source with proper drug storage facilities (and check the expiration date). The question is, does Thailand produce a generic of what you need? There is a book called MIMs which comes out annually and lists all the pharmaceuticals licensed for sae in Thailand (both Thai made and imported), I am not in Thailand right now but perhaps someone who is could take the time to look these drugs up for you. Every pharmacy worthy of the name has MIMs, usually right on te counter.

[libya 115]

I am sceptical:

I was taking omeprazole for GERD and used to buy a pack of 14 for 150 baht, then my wife discovered the (same?) drug for 100 baht for 14 tablets.

The cheap ones did not work; they were well packaged and looked O.K. but did not work at all.

It is possible that some pharmacy owners 'obtain' some drugs 'cheaply' for sale? Anything is possible in the L.O.S.

[Sheryl]

Were these Thai made generic or foreign import? Counterfeits are most likely to be encountered with the latter, the former has too little profit margin to be worth faking.

Aside from counterfeiting another issue is storage. Very few drugs retain their potency with any prolonged exposure to heat beying about 35 C. So if drugs are transported in the back of hot trucks, stored in non a/c arehouses or shops, they can inactivate. I had this happen with completely new batch of a foreign drug purchases straight from the manufacturer, no possibility of any quality issue. Bought a years supply for a friend in Cambodia coz drug not available there. 3 months later, afer storage in her un aircon home in PP the entire batch deactivated. And these were just off the assembly line....

Always buy from a large air con pharmacy with a real pharmacist which buys directly from the suppliers.