khunbillmex Posted October 2, 2016 Share Posted October 2, 2016 In my experience this year a Khon Kaen Ram Hospital pharmacy itemizations are not given unless specifically asked for - the pharmacy charge is just bundled together as a single line item. Once I started asking for an itemized list of whatever meds were being prescribed and then comparing the hospital price with my local pharmacy price the hospital was generally 3x over the local shop. Is the hospital pharmacy paying some commission to the Dr or just flat out overcharging? Link to comment Share on other sites More sharing options...
Pib Posted October 2, 2016 Share Posted October 2, 2016 Hospitals, especially private hospitals, almost always charge 2 to 3 times more for medications that what your local pharmacy charge. Link to comment Share on other sites More sharing options...
chiang mai Posted October 2, 2016 Share Posted October 2, 2016 AND.... doctors in many hospitals receive a percentage of all charges made for tests, MRI's etc. Link to comment Share on other sites More sharing options...
lopburi3 Posted October 2, 2016 Share Posted October 2, 2016 If you want itemized list you ask for detail receipt. The normal hospital bill would not have such information. But they can easily print out the detailed receipt and sign for you (as is used for insurance coverage). Link to comment Share on other sites More sharing options...
KittenKong Posted October 2, 2016 Share Posted October 2, 2016 1 hour ago, Pib said: Hospitals, especially private hospitals, almost always charge 2 to 3 times more for medications that what your local pharmacy charge. 2 or 3 if you are lucky. I've known 7 times. Link to comment Share on other sites More sharing options...
KittenKong Posted October 2, 2016 Share Posted October 2, 2016 1 hour ago, chiang mai said: AND.... doctors in many hospitals receive a percentage of all charges made for tests, MRI's etc. I dont know about that but one hospital doctor told me in so many words that the hospital would not be happy with him if I bought my medicines from an outside pharmacy. That didnt stop me though. Link to comment Share on other sites More sharing options...
Pib Posted October 2, 2016 Share Posted October 2, 2016 Don't worry, per this 16 May 2015 Nation newspaper article the govt going to fix the high medications cost. Full article at the weblink. http://www.nationmultimedia.com/national/Govt-to-control-medicine-prices-in-coming-months-t-30260224.html Partial quote below. Remember, it will just take time. Quote "The cost and profit from selling medicines will be regulated. There will be a price ceiling for different categories of drugs that hospitals can charge their patients. It will take some time to implement this measure," Rajata said. Link to comment Share on other sites More sharing options...
JHolmesJr Posted October 2, 2016 Share Posted October 2, 2016 The medical industry is crooked as hell….but they do it under a cloak of respectability. Doctore get backhanders for prescribing one medicine over the other….they also get kickbacks for recommending certain specialists and higher costing treatments…you cant trust any of them….thank god for the internet. Link to comment Share on other sites More sharing options...
al007 Posted October 2, 2016 Share Posted October 2, 2016 I go to a couple of private clinics, and need to remember the Doctor often only charges 250 to 300 batt per consultation, and then if he has a dispensary I will buy my first prescription there Hospitals ,where possible I try not to buy at their pharmacies, I also use a Canadian online pharmacy that can be cheaper than the Chinese in town pharmacy on some drugs I also buy my frontline flea treatment for our dogs online from Singapore, made in Thailand cheaper than I can buy here Link to comment Share on other sites More sharing options...
Sheryl Posted October 2, 2016 Share Posted October 2, 2016 In private hospitals in Thailand, doctors receive 100% of the consultation fee, the price of which they set themselves. They do not AFAIK receive any commission on the pharmaceuticals, but the hospitals make a bundle on them and indeed it is a major source of revenue. It is well known that mark-ups are enormous, 3-10 fold. One should never buy medications at a hospital pharmacy unless they are controlled substances you can't buy at an outside pharmacy. While hospitals don't give doctors a "commission" on them eds prescribed, they do encourage them to prescribe as many drugs as possible and actively discourage them from making it easy for patients to buy their meds elsewhere. Doctors vary in how they respond to this. Some ignore it altogether and will openly advise patients to get meds at an outside pharmacy to save money. Some will provide the info to patients quietly ehn requested. Others won't at all. I have had doctors frankly say that to avoid trouble with the hosp admin if they'd prescribe for just a few days and let me (or the patient) buy the rest outside. regardless, even if the doctor wouldn't tell you the meds and would only prescribe them through the hospital pharmacy, you can wait until you are at the pharmacy counter, see what they are and take note of name and dosage and then hand them right back and say you don't want them (easiest I find to just stay you already have them) and they will take them off the bill. The above refers to hospitals. Doctors with their own private clinics here typically charge very little in consultation fee and make up for it by adding a surcharge onto the medications they dispense. Vets ditto. Link to comment Share on other sites More sharing options...
1FinickyOne Posted October 2, 2016 Share Posted October 2, 2016 It seems to be a mixed bag and maybe a poor system... I understand that these are "for profit" hospitals and the doctors fees and many of the charges sound very cheap to me... And yet, the huge mark-ups on the meds, sound very high and annoying so as you can easily price these items out at your local pharmacy... though you cannot get an x-ray at your pharmacy for 300 baht... I think they need to have a little better understanding of their patients and the world around them... Charge a person 200 baht for meds that they normally buy for 40 baht and they are going to be annoyed... charge 500 baht for the x-ray and they shrug their shoulders... but, I guess we will be paying one way or the other and they are doing this for profit. Link to comment Share on other sites More sharing options...
Deepinthailand Posted October 2, 2016 Share Posted October 2, 2016 You can get just a prescription from khon kaen ram then take it to a local pharmacy have done this on many occasions. They charge 50 bht for prescription but I saved at least a 1000 on buying medication. Link to comment Share on other sites More sharing options...
oldhippy Posted October 2, 2016 Share Posted October 2, 2016 Doctors are HISO (not only in Thailand). More questions? Link to comment Share on other sites More sharing options...
Scotwight Posted October 2, 2016 Share Posted October 2, 2016 3 minutes ago, oldhippy said: Doctors are HISO (not only in Thailand). More questions? In exchange for the state paying their tuition fees, young Thai doctors are obliged to spend their first three years as qualified doctors working wherever the government feels they are needed. More questions? Link to comment Share on other sites More sharing options...
oldhippy Posted October 2, 2016 Share Posted October 2, 2016 Just now, Scotwight said: In exchange for the state paying their tuition fees, young Thai doctors are obliged to spend their first three years as qualified doctors working wherever the government feels they are needed. More questions? For peanuts? Link to comment Share on other sites More sharing options...
aussiandrew Posted October 3, 2016 Share Posted October 3, 2016 Do you mean just like any were else in the world. I THINK SO. Link to comment Share on other sites More sharing options...
lgking Posted October 3, 2016 Share Posted October 3, 2016 (edited) "It's illegal to give kickbacks to a doctor to prescribe drugs, but it is legal to give money to doctors to help promote your drug. Some doctors make tens of thousands or hundreds of thousands of dollars a year beyond their normal practice just for working with the industry." So why should patients be concerned? http://www.cbsnews.com/news/does-your-doc-have-ties-to-big-pharma-how-youll-be-able-to-find-out/ Edited October 3, 2016 by lgking Link to comment Share on other sites More sharing options...
pauleddy Posted October 3, 2016 Share Posted October 3, 2016 Doctors get incentives and discounts from Pharma reps all over the world. This used to be quite substantial things, e.g. vouchers for a holiday, cases of wine, etc but everything has got much tighter now. Bribery is not as common as it was, but it still goes on. In the US, Doctors who have been received benefits for trialling new drugs must declare such, and that they have an interest in the drug company. Thailand is very "crooked". When I taught student doctors at Thailand's Number One university, I did a snap poll (raise your hand if you are becoming a doctor for money rather than healing the sick). About 20% of the class raised hands. When I see my "foot doctor" he charges me 2000b. When I last saw my Urinary specialist, he wanted 1000. Yet when my bad ear plays up, the doctor (ENT) in the same hospital asks only 400b. Yes, always try to get the drugs from a pharmacy if you know what they are. Bumrungrad and BNH charge about 3-4 times more. Don't forget that the famous Tylenol (about 200baht for 20) is exactly the same as Paracetamol (40 tablets for 40 baht in your soi). Eddy Link to comment Share on other sites More sharing options...
Kwasaki Posted October 3, 2016 Share Posted October 3, 2016 l don't understand many of the posts l can only guess it's down to where you live. l get meds from the local Gov hospital where l am registered and their cheaper than any pharmacy. l would expect Doctors surgeries and private hospitals to be more expensive . Went to our local village clinic today with bad cut saw Doctor who prescribed 3 day antibiotics, nurse cleaned and bandaged. Thais free, falangies 30 baht. Link to comment Share on other sites More sharing options...
little mary sunshine Posted October 3, 2016 Share Posted October 3, 2016 Of course they do...The "Business of Medicine". Link to comment Share on other sites More sharing options...
akentryan Posted October 3, 2016 Share Posted October 3, 2016 The age of miracles. My 90-day supply of Atorvastatin just dropped ftom 4,500 baht to 2,385 baht. I do meds by EMS from Fascino in Bangkok. They charge 100 baht and the stuff arrives next day or the day after. Phone it in and pay by phone. Never a problem and I save about 30% vs buying from local Fascino pharmacies. Nor only do the hospitals charge more but they give you packaging on ointments that is not sealable. Lonagel (triamcinolone acetonide) in a 1 gram foil pack cannot be resealed.and cost 66 baht at the big Pattaya Hospital. Trinolone in tube form with a cap can be purchased for 42 baht (5 grams) at many pharmacies in Pattaya. That's 330 baht for 5 grams from the hospital vs 42 baht for 5 grams at the local pharmacy. Some one mentioned 7 times as much which is about the example cited. Never mind that the expensive stuff can't be resealed. Link to comment Share on other sites More sharing options...
lopburi3 Posted October 3, 2016 Share Posted October 3, 2016 30 minutes ago, pauleddy said: ((edit)) Don't forget that the famous Tylenol (about 200baht for 20) is exactly the same as Paracetamol (40 tablets for 40 baht in your soi). Eddy Not sure where you buy Tylenol but I use the drug stores on my local soi and never pay more than about 130 baht for 100 Tylenol 500mg caplets. I bought 60 Lipitor 40mg (1/2 per day) for 2250 from local pharmacy last month which I believe is a much reduced price (at long last). Link to comment Share on other sites More sharing options...
impulse Posted October 3, 2016 Share Posted October 3, 2016 49 minutes ago, Kwasaki said: l don't understand many of the posts l can only guess it's down to where you live. l get meds from the local Gov hospital where l am registered and their cheaper than any pharmacy. l would expect Doctors surgeries and private hospitals to be more expensive . Went to our local village clinic today with bad cut saw Doctor who prescribed 3 day antibiotics, nurse cleaned and bandaged. Thais free, falangies 30 baht. I thought the 30 baht plan was no longer available to western foreigners? Link to comment Share on other sites More sharing options...
lopburi3 Posted October 3, 2016 Share Posted October 3, 2016 2 minutes ago, impulse said: I thought the 30 baht plan was no longer available to western foreigners? You do not require 30 baht plan to use a government hospital - they are available on a pay for service basis. Link to comment Share on other sites More sharing options...
elgordo38 Posted October 3, 2016 Share Posted October 3, 2016 I also has an attempt to ram it up my wazoo. I was presented with a bill for 3 medicines for 9,900 bahts including my generous 10% discount. I said hold the phone here give me the list of drugs. I took it my pharmacist he filled it and charged me 1140 Link to comment Share on other sites More sharing options...
impulse Posted October 3, 2016 Share Posted October 3, 2016 (edited) 19 minutes ago, lopburi3 said: You do not require 30 baht plan to use a government hospital - they are available on a pay for service basis. Don't get me wrong I'm asking because I don't know. Like a lot of people, I come to this forum to get information to make my life in Thailand better/easier/more affordable. I guess what I'm asking is whether Kwasaki got in under the 30 baht plan, or whether it was a coincidence that his bill was 30 baht. If so, which government hospital, and how long ago? I'm not doubting that it happened. I'm just wondering if it's repeatable. I have this vision of showing up at a government hospital expecting a bill for 30 baht for services similar to what Kwasaki had done, and getting presented with quite a higher bill. For some folks tuned in here, it would be a minor irritation. To others, it could be a real financial problem. Edited October 3, 2016 by impulse Link to comment Share on other sites More sharing options...
Grubster Posted October 3, 2016 Share Posted October 3, 2016 On October 2, 2016 at 2:46 PM, KittenKong said: 2 or 3 if you are lucky. I've known 7 times. Yes and the PM ordered all the hospitals to charge same as pharmacy's last year. I guess that was just talk huh. Link to comment Share on other sites More sharing options...
Grubster Posted October 3, 2016 Share Posted October 3, 2016 On October 2, 2016 at 3:22 PM, JHolmesJr said: The medical industry is crooked as hell….but they do it under a cloak of respectability. Doctore get backhanders for prescribing one medicine over the other….they also get kickbacks for recommending certain specialists and higher costing treatments…you cant trust any of them….thank god for the internet. Yes and its ten times worse in the USA. If your not from the US you can't imagine the medical fraud there. If you are in the hospital there and they give you an aspirin they will charge you over $10 for it and $40 more for giving it to you. Q-tip at least $5. I am not making this up its unreal there. The doctors there also get kickbacks for drugs, and referrals. Sorry off topic, I am delighted that drugs are so cheap here though, just wish they had some good pain meds. Link to comment Share on other sites More sharing options...
chiang mai Posted October 3, 2016 Share Posted October 3, 2016 18 minutes ago, Grubster said: Yes and the PM ordered all the hospitals to charge same as pharmacy's last year. I guess that was just talk huh. Government hospitals perhaps, he's not able to order private hospitals to do the same. Link to comment Share on other sites More sharing options...
Sheryl Posted October 3, 2016 Share Posted October 3, 2016 Actually I do not think the PM "ordered" this nor can he, AFAIK. What was said was the legislation needed to be enacted and presumably would be, details yet to be worked out. Not sure the status of this now, though.... Link to comment Share on other sites More sharing options...
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