Truvada (generic name=Tenvir EM) available in Thailand?

[wolfcreek]

My cousin buys this in the US and will be retiring from Dallas to Thailand/Cambodia later this month. He asked me if it is available here in SE Asia . I asked my pharmacist in Phnom Penh (Pharmacy de la Gare) and he says they have it from time to time (but not at present). Does anyone know if it is readily available in Thailand? If so, would he need to bring a doctors prescription from the US, or could he get a local doctor to write it for him once he arrives?

[metisdead]

Moving to the Health forum for knowledgeable answers.

[Sheryl]

Truvada is a combination of two drugs: Tenofovir and emtricitabine

There is a locally made generic equivalent in Thailand called Teno-Em.

It requires a prescription and is generally available only from hospitals and special clinics.

The easiest and least expensive way to get it is in Thailand is from the Thai Red Cross Anonymous Clinic in Bangkok. He will need to see a Thai doctor first to get a script and then can buy the meds there regularly. He will need a physician in any event to monitor his treatment periodically.

He can also get his lab work (CD4, Viral load, liver enzymes etc) done there at much lower cost than at a private hospital. See this thread http://www.thaivisa.com /forum/topic/285198-hiv-testing-and-treatment-in-los-doctors-meds-costs/ for information on location of the Red Cross clinic as well as suggested doctors. I particularly recommend Dr. Asda at Bumrungrad, but only for consultation, getting all tests and meds at the Red Cross clinic as these are very expensive at Bumrungrad. The doctor consultation alone is not bad, should be under 2000 baht (US $70) and probably only need to see him once every 6 months or so unless there is a special problem. I can't tell you the current costs of the meds but perhaps someone else can.

Of more worry is how your cousin will finance other medical costs especially should he need hospitalization, which as a retiree sooner or later he will. Quite likely his US insurance won't cover him in Thailand and with HIV he will probably not be able to get a local policy. US Medicare/medicaid does not cover treatment abroad.

Might - not sure - be able to get an international expat policy issued out of Europe with the HIV excluded as a pre-existing condition. Should research this - google "expat insurance" and the like, or work with a broker. A broker would be wise as even if he has a policy with only HIV as exclusion, some companies take rather draconian views of what health problems can be attributed to HIV or HIV meds, he needs one that will be reasonable in that regard so that if for example years down the line he develops coronary artery disease or has a stroke they don't try to claim that it is due to elevated blood lipids that in turn were due to his HIV meds, even though this sort of thing occurs in a large number of older people without HIV as well...

[wolfcreek]

Thanks for that detailed answer, Sheryl. I will pass the info along to him. By the way, he isn't HIV positive, but uses the medicine as a HIV preventative ("just in case the condom breaks" as he told me....).

[FritsSikkink]

Thanks for that detailed answer, Sheryl. I will pass the info along to him. By the way, he isn't HIV positive, but uses the medicine as a HIV preventative ("just in case the condom breaks" as he told me....).

isn't that quite expensive

[wolfcreek]

about a dollar per day looks like (according to the prices on the Red Cross Bangkok website..... he is a retired commercial airline pilot so he can afford it I guess....

[FritsSikkink]

about a dollar per day looks like (according to the prices on the Red Cross Bangkok website..... he is a retired commercial airline pilot so he can afford it I guess....

ok, googled US prices were 50 times higher

[wolfcreek]

Yes, the Thai and Indian generic ones seem to range from $1-$3 per day, whereas the name brand one (Truvada) is much, much higher.....

[fugu]

I registered specifically to reply to this question. I am a HIV negative male living in Bangkok using Truvada for PrEP (pre-exposure prophylaxis), the reason cited by the OP.

I get mine from Bumrungrad hospital. The (relevant) doctors are knowledgeable about PrEP and willing to prescribe if they agree that your behaviour is high risk. Until the most recent prescription I was using brand-name Truvada which costs more or less 12,000 baht for a 3 month prescription.

At the most recent prescription (three weeks ago), on the doctor's recommendation, I switched to Ricovir-EM, which is a generic Truvada containing emtricitabine 200mg and tenofovir disoproxil fumarate 300mg. The precise cost for the medication was 6,030 baht for a three month course. You can find information by just googling Ricovir-EM.

You will need to go to the infectious diseases clinic on the 20th floor as general practitioners are unaware of Truvada for the most part. The prescribing doctor will likely require you to have an HIV screening and a kidney function test before prescribing.

At risk of diverging somewhat, I wish that doctors in Thailand were more knowledgeable about PrEP and more willing to disseminate this knowledge to the at-risk population, but I think that cultural factors might be inhibiting this. I've informed some friends of mine who are in high-risk groups and to-a-person, they were surprised they didn't know about it already.

Hope this helps

[Hammock]

You can try Bangkok Saint Louis Hospital for this medicine. Register at the reception and ask for infectionist doctor. Explain your situation, normally they should prescribe you Ricovir-EM. Keep in mind that after 72 hrs after possible exposure this medicine might not be helpful. Stay healthy and good luck!

Edited January 19, 2016 by Hammock

[Jingthing]

Yes, this prevention therapy is quite popular and well accepted in the U.S. now.

But Sheryl has a point, if an insurance company here knew you were on Prep that might confuse them as to your HIV status and even though taking it makes it lower risk to be infected if doing high risk sex acts, I assume they would likely (irrationally) see you as high risk.

[wolfcreek]

Thanks to all of you for the helpful responses......

[filipfrog]

try Dr Donna, the Brit doctor  in sukhumvit 49/9 . She can help on pep and prep

 

See link

http://www.medconsultasia.com/sexual-health-check-ups