Statin - rosuvastatin

[iancnx]

Would be grateful for some advice if possible.  I am a Statin newbie.  I have just been prescribed Crestor 10mg for the first time.  30 tablets cost me Baht 2160 at Ram Hospital Phrae.  With my other medications this cost is going to damage my wealth if I have to take them for a prolonged period.  I have a follow up appointment in 4 weeks time.

 

I read somewhere that there is a generic version of rosuvastatin available in Thailand (some reference to Govt Hospital Pharmacy).  Can anyone give me any guidance on where to buy rosuvastatin at a cheaper cost than 72 baht per 10mg tablet?  Is there any on-line options for purchase as Iive right out in the sticks.  Thanks in Anticipation.

[KittenKong]

Rule 1: never buy medicines in a hospital or clinic.

 

Rule 2: see rule 1.

 

Why? Because hospitals/clinics apply mark-ups of anything up to 7 or 8 times the true price. So get your written prescription from the hospital doctor, politely refuse the medicines and find a local pharmacy. Ask the pharmacy for a local generic or equivalent (if available). Be aware also that prices in pharmacies are not regulated and can vary wildly from one to another. So ask around.

 

The only exceptions would be strong medicines that are restricted and not available in pharmacies but I doubt that statins would fall into that category.

 

I take statins and BP pills and the total cost for both tablets is under 3B per day. I wonder what is so special about your brand that makes it cost so much more?

[thaitero]

OP: Medicin is expensive if the patent is still valid and only original brand is allowed. I eat rosusvastatin also but my medicin is from europe and generic version is available there. What rosuvastatin i have now is made by sandoz. Patents do not expire everywhere in the world same time but most likely generic version are also available in Thailand for rosuvastatin.

 

Just do ask around..

 

Rosusvastatin is not same like old statins so it might be possible that they have here only this orginal brand, i hope not also since my stock will end also before my next trip to Europe.

Edited August 24, 2016 by thaitero

[chiang mai]

Rosusvastatin (Crestor) is out of patent so there are generic products out there which are cheaper. I buy a product made by Sandoz, I only need to take 10mg but I buy the 20mg tablets and use a pill cutter to split them, a box of 28, 20mg tablets when spilt will last two months and costs 900 baht (or 450 a month/16 baht each).

Edited August 24, 2016 by chiang mai

[Oxx]

"I read somewhere that there is a generic version of rosuvastatin available in Thailand (some reference to Govt Hospital Pharmacy). "

 

There used to be Rosuvastat GPO, but it appears currently to be off market.  The only available brands here are Crestor and Rosuvastatin Sandoz.

[d2g]

There are good substitutes for over priced statin meds in Thailand.

Bestatin is a Thai made generic version of Simvastatin.

Box of 100pills(40mg) cost me 350 Baht at Fascino's pharmacy in Pattaya.

There are other options.

I would suggest you see another Dr. and ask for a less expensice medication.

[chiang mai]

34 minutes ago, Oxx said:

"I read somewhere that there is a generic version of rosuvastatin available in Thailand (some reference to Govt Hospital Pharmacy). "

 

There used to be Rosuvastat GPO, but it appears currently to be off market.  The only available brands here are Crestor and Rosuvastatin Sandoz.

 

34 minutes ago, Oxx said:

"I read somewhere that there is a generic version of rosuvastatin available in Thailand (some reference to Govt Hospital Pharmacy). "

 

There used to be Rosuvastat GPO, but it appears currently to be off market.  The only available brands here are Crestor and Rosuvastatin Sandoz.

 

Did you not read the preceding post to yours! Crestor generic are widely available, I buy them every month and have done for at least a year.

[Scotwight]

5 minutes ago, d2g said:

There are good substitutes for over priced statin meds in Thailand.

Bestatin is a Thai made generic version of Simvastatin.

Box of 100pills(40mg) cost me 350 Baht at Fascino's pharmacy in Pattaya.

There are other options.

I would suggest you see another Dr. and ask for a less expensice medication.

I talked to my doctor at the expensive hospital and we agreed to try Bestatin.  Seems to work fine for me.  It is really cheap.  I buy it at the Pharmacy in the Lotus mall.  Or really any Thai pharmacy. 

Edited August 25, 2016 by Scotwight

[chiang mai]

Simvastatin and Rosusvastatin are two very different products, the OP is looking for Rosusvastatin!!!

[Scotwight]

6 minutes ago, chiang mai said:

Simvastatin and Rosusvastatin are two very different products, the OP is looking for Rosusvastatin!!!

GENERIC NAME: rosuvastatin

BRAND NAME: Crestor

Edited August 25, 2016 by Scotwight

[chiang mai]

That's good, but since you clearly didn't understand what I wrote I'll say it a again, Simvastatin and Rosusvastatin are two very different products, the OP is looking for Rosusvastatin.  If a doctor prescribes a patient vancomycin, would you recommend they buy cyprofloxin instead, just because it's cheaper!!!

 

Your post and comparison are irresponsible.

 

 

[Oxx]

8 minutes ago, chiang mai said:

Simvastatin and Rosusvastatin are two very different products

 

No, they are not. Both are statins, and both are competitive inhibitors of HMG-CoA reductase.

[chiang mai]

5 minutes ago, Oxx said:

 

No, they are not. Both are statins, and both are competitive inhibitors of HMG-CoA reductase.

 

Post a copy of your medical practitioners license if you want people to believe your pharmaceutical recommendations and before you go contradicting another doctors advice. You have no idea about the OP's medical history, his current intake of drugs that may not be compatible with your recommendation or any of the other associated medical data needed to make that decision.

Edited August 25, 2016 by chiang mai

[thaitero]

Both Simvastatin and Rosusvastatin belong the group of statins and they are totally two very different products. 

[Scotwight]

31 minutes ago, chiang mai said:

That's good, but since you clearly didn't understand what I wrote I'll say it a again, Simvastatin and Rosusvastatin are two very different products, the OP is looking for Rosusvastatin.  If a doctor prescribes a patient vancomycin, would you recommend they buy cyprofloxin instead, just because it's cheaper!!!

 

Your post and comparison are irresponsible.

 

 

Rosusvastatin is the generic name of Crestor. 

[chiang mai]

5 minutes ago, Scotwight said:

Rosusvastatin is the generic name of Crestor. 

 

I'm very well aware of that fact. Are you aware that Rosusvastatin is NOT the same as Simvastatin and it's NOT the same as bestatin, neither of which were prescribed by the OP's doctor and neither of which were enquired about in the OP!

[Scotwight]

1 minute ago, chiang mai said:

 

I'm very well aware of that fact. Are you aware that Rosusvastatin is NOT the same as Simvastatin and it's NOT the same as bestatin, neither of which were prescribed by the OP's doctor and neither of which were enquired about in the OP!

I think I said it before but if not I'll say it again.  I talked to my doctor at the high priced hospital about Statins and we agreed to try Bestatin and it worked fine.  I am monitored once a quarter and all my meds checked.  I posted the difference between two Statins I would suggest anyone with questions consult with their doctor as to the best one for them. 

[Sheryl]

1.  Crestor brand will cost much less at any pharmacy than it does at the hospital. Statins do not require a prescription in Thailand. Private hospital pharmacy mark-ups are huge, soemtimes as much as 5-fold or even more.

 

2.  There are currently just 2 brands of Rosuvastatin on the market in Thailand: Crestor and Rosuvastatin Sandoz (previous GPO brand is off market) . Both are imports so will be expensive, but if bought at an outside pharmacy, certainly much less expensive than what you paid at the hospital.

 

3. Simvastatin ansd Rosuvastatin are both stains and have the same mode of action and are used for the same conditions.  They are chemically quite similiar but not identical. Simvastatin has been around much longer and there are innumerable locally made generic equivalents to it, Bestatin being one, and these are extremely inexpensive. 

 

Pharm companies tend to come out with slightly tweaked versions of older drugs once the older ones  go off patent and rosuvastatin is an  example of this. The newer versions are usually  were justified by initial studies that suggest they work a little better; not infrequently these studies are funded by the pharm company. In the case of rosuvastatin,  subsequent studies failed to show this difference. The side effect profile is also similar to that of simvastatin.  http://www.ncbi.nlm.nih.gov/pubmed/21995692

 

If I were you I would ask your doctor if there is any reason you cannot switch to simvastatin and explain that it is a financial issue. Then buy local brands, at a local pharmacy. You will save an enormous amount by doing this.

 

And, stop buying medications at hospital pharmacies. It is a little bit of a hassle because the system is set up to try to force you to do so, but you do not have to. Simply find out what drug and dose has been ordered - -either from the doctor or later at the pharmacy window - then tell them you already have the drug, or that you prefer to buy it outside (the "already have" seems to go over a little better in my experience).  If you can manage to do this at the point of initially paying the bill, good, but that is possible only if you know already from the doctor what drug was ordered as the bill cashier won't know (or will say she doesn't know) what the meds are and say you have to find out at the pharmacy window, which will deal with you only after you have already paid the bill inclusive of the medications.You can, however, then get the drug taken off the bill and the difference refunded to you after refusing it at the pharmacy window, I've done this countless times in multiple hospitals. Just takes a little longer.

 

Alternately if the doctor is willing you can ask him or her not to order any meds from the hospital pharmacy to begin with, explaining that you will buy them yourself. Some doctors will go along with this and some will not; they are all asked by hospital administration not to and some are more inclined to follow this request than others. (I consider a doctor's willingness not to go along with such practices to be a good sign in terms of character -- though to be fair, it may also reflect how secure s/he feels regarding their privileges at that hospital and a younger/newer doctor or one in less demand may have more reason to worry about doing anything the hospital admin may not like).

[iancnx]

12 hours ago, chiang mai said:

Rosusvastatin (Crestor) is out of patent so there are generic products out there which are cheaper. I buy a product made by Sandoz, I only need to take 10mg but I buy the 20mg tablets and use a pill cutter to split them, a box of 28, 20mg tablets when spilt will last two months and costs 900 baht (or 450 a month/16 baht each).

 

I am Indebted to all who have responded, especially Chiang Mai, with the info on Rosuvastatin Sandoz.  Also to Sheryl for confirming the position.  I found an image on Mims and have a screen shot of the box so I can now go around the few pharmacies local to me (I live way out in the sticks).  As this was the first time with this particular doctor (kidney specialist for my gout), I expensively decided to play the game, I will certainly not pay RAM prices again.  Once my lipids are in check I will look to change to the simvastatin as recommended here..... I think a step by step process is needed and I will certainly employ the 'already have' explanation in the fullness of time.  Once again many thanks to all.

 

One final thing, I have never heard of a pill cutter before?  Where might I buy one?  Pharmacy?  Is there a term in Thai?

 

On a bright note I feel better already after only 2 days.  Is that possible or more likely psychological..... 

[chiang mai]

28 minutes ago, iancnx said:

 

I am Indebted to all who have responded, especially Chiang Mai, with the info on Rosuvastatin Sandoz.  Also to Sheryl for confirming the position.  I found an image on Mims and have a screen shot of the box so I can now go around the few pharmacies local to me (I live way out in the sticks).  As this was the first time with this particular doctor (kidney specialist for my gout), I expensively decided to play the game, I will certainly not pay RAM prices again.  Once my lipids are in check I will look to change to the simvastatin as recommended here..... I think a step by step process is needed and I will certainly employ the 'already have' explanation in the fullness of time.  Once again many thanks to all.

 

One final thing, I have never heard of a pill cutter before?  Where might I buy one?  Pharmacy?  Is there a term in Thai?

 

On a bright note I feel better already after only 2 days.  Is that possible or more likely psychological..... 

It's a small plastic box about two inches by one with a hinged lid and a small blade inside, pop the pill into it and close the lid and presto, two pills. Available at most pharmacies.

 

[iancnx]

Chiang Mai, many thanks.

[lopburi3]

Most any drug store will have pill cutters for sale - most are clear plastic and rather flimsy.  Have had one like this and still working good after 30 years.

[chiang mai]

3 minutes ago, lopburi3 said:

Most any drug store will have pill cutters for sale - most are clear plastic and rather flimsy.  Have had one like this and still working good after 30 years.

 

ditto, ten years for mine, about 125 baht or so when first purchased.

[iancnx]

Just to update all who tried to help.  I had a crippling gout attack which by great fortune enabled me to sneak my toe in the door of the local military hospital.  The Military Doc reviewed my Meds and lipids checked a couple of weeks ago, and again yesterday.

 

20 August.  Phrae RAM

Cholesterol 301

Trig 220

HDL 38

LDL  247

 

31 August. Mil Hospital 

Cholesterol 236

Trig 151

HDL 39

LDL 181

 

16 September. Mil Hospital.    Visit specifically for Uric Acid blood test.

Cholesterol not tested

Trig not tested

HDL not tested

LDL -Cholesterol 109

 

Above is a result of being on Crestor 10 mg for 26 days.  Meds about to run out so military doc has prescribed readily available Bestatin 20 mg once a day (simvastatin) which is cheap as chips. He says they are weaker than Crestor, and I am booked for more bloods in a months time.

 

He said the lowering of my LDL - Cholesterol in such a short space of time was remarkable and wondered if the 'other' laboratory perhaps had [quality] issues.......... Ho hum! 

[iancnx]

Afternote. I will not be keeping my appointment at Phrae Ram! 

[rainwater]

New study by Cleveland Clinic Center , included more than 1,000 patients, average age 57, with coronary artery disease. Participants were randomly assigned to take high doses of either Lipitor (80 mg) or Crestor (40 mg) daily for two years.
Patients taking Crestor did better than those on Lipitor: LDL levels in the Crestor group dropped to an average 62.6 mg/dL, compared with 70.2 mg/dL for patients on Lipitor. Also, more patients taking Crestor (72%) than Lipitor (56%) saw their LDL levels fall below the 70 mg/dL target set for high-risk heart patients. Patients taking Crestor also had higher levels of good HDL.

http://healthland.time.com/2011/11/16/lipitor-vs-crestor-cholesterol-drugs-are-on-a-par/

 

Edited November 1, 2017 by rainwater

[Jingthing]

Is there a local generic that would be similar and cheaper than branded imported Mevalotin? Chemical is Pravastatin. I know there is a generic in the west but last I checked not sold in Thailand.

Edited November 1, 2017 by Jingthing

[Oxx]

39 minutes ago, Jingthing said:

Is there a local generic that would be similar and cheaper than branded imported Mevalotin? Chemical is Pravastatin. I know there is a generic in the west but last I checked not sold in Thailand.

 

No.  Mevalotin Protect is still the only available brand in Thailand.

 

I believe an Indian generic maker (Aurobindo) started making a generic version earlier this year.  It may well make it over to Thailand soon.