Diabetes Cost etc?

[moonseeker]

Good day all:

 

Anybody could advise me about cost and best affordable insulin "pens' etc. in Thailand. Need to help out a friend who is now at the point where oral treatment does not get him below

A1C (6-7) anymore and he has reached max. doses. He is not in good shape financially. Any hints what products and approx. monthly cost very much appreciated. Also possibly any other details very welcome. Location BKK & Pattaya.

Thank you all.  MS>

[Oxx]

Not answering your question, but HbA1c in the 6-7 range is within target for people with type 2 diabetes.  It would be premature to start injecting insulin when the drugs are still doing an OK job.

[tutsiwarrior]

I've been using  Mixtard 30 Penfill cartridges with a Novopen apparatus for years now and it's not more expensive in Thailand than what I've found in the Middle East where there are a lot of obese, diabetic arabs...

 

there is a reason for why they wear them white 'robes' ('dresses', in impolite western language)...there ain't no other attire that fits them...

[ThaiBob]

I tried Lantus pens but came back to buying vials of insulin and using syringes . Less convenient but 50-65% cheaper depending on the type of insulin. 

[Lefty]

I pay B3,750 for a box of 5 Lantus Solo Star pens.

Lefty

[ignis]

I have a NovoPen 4, the refill vials are NovoMix 30 penfill.... cost 1,050 baht for box of 5.... buy 1x vial = 220 baht.

 

Red Cross Hospital Bangkok,  they do a good job as they know I live well over 2 hours away, so pack them well in dry Ice..  get 3 boxes every 3 months, last time + 2 extra vials [ = why I have the price of box and of single vials]

 

Edit:

Related but just out of interest have a Accu-Chek Performa blood testing meter... Red Cross change 300 baht for box of strips..... Boots Pharmacy at Westgate same box cost 675 baht.. 

Edited October 28, 2016 by ignis

[moonseeker]

Thank you all so much. What would the average use/amount of insulin/cartridge/pen  be or just a rough average estimate of cost total per month?  Thank you all so much.

MS>

[ignis]

1 hour ago, moonseeker said:

Thank you all so much. What would the average use/amount of insulin/cartridge/pen  be or just a rough average estimate of cost total per month?  Thank you all so much.

MS>

Almost impossible to answer..

 

1st would suggest see a Dr at a Hospital.  [ Government Hospital would be cheaper] they will run tests, blood and urine if Insulin is needed they will suggest the dose..  NOTE the Test is 'fasting'  Eat and drink nothing for 12 hours before test.

 

Believe  you need a prescription to buy insulin in Thailand and it is not available in most pharmacies as it must be stored at a set temperature in a Fridge + packed in dry ice to travel home to store in your own fridge..

 

Myself take 30 units in Mornings and 26 evenings = 1 x  insulin cartridge last about 6 days = the brand + Hospital I buy from = 220 baht every 6 days..

 

You will need a blood testing machine + strips.. you will need every visit blood and urine tests.. when test are done see the Doctor which will read the report and the maybe adjust the dose of Insulin.    For me starting Insulin was visit ever 6 weeks, then 8 weeks, and so on, now visit every 17 weeks, believe by next year will be 2x year visits.

 

Just another note out of interest a Government Hospital or the Red Cross, you must do everything yourself, etc get bill go to another place and pay, go to another place and get test, go pay for next bit and so on until you leave.....My bills for the day, all added up to a total of 5,203 baht for everything for next 17 weeks...  for me leave home at 04:30 arrive at Hospital just before 06:00, if lucky have been done by 15:30, my last visit done at 17:45 then just over 2 hours to get home...  

 

Depends on money or how much you want to spend, Private Hospital everything would be done for you but at a high price.

 

 

Edited October 29, 2016 by ignis

[moonseeker]

Super-info to start informing my friend. Thank you Ignis & all others. Great help!  Have a nice Sunday.  MS>

[NancyL]

Moonseeker, if your friend isn't in Thailand now and is contemplating a move here, he should be aware that there is no "free" medical care for foreigners and he since he is a diabetic, his medical needs are likely to cost more than the monthly cost of maintenance of his diabetic care supplies.  As he ages, he will probably suffer complications from a lifetime of diabetes and need treatment for those problems.  

 

This paragraph from Ignis, while accurate, doesn't really paint a truly accurate picture of what it's like trying to obtain budget medical care at a Thai gov't hospital:

"Just another note out of interest a Government Hospital or the Red Cross, you must do everything yourself, etc get bill go to another place and pay, go to another place and get test, go pay for next bit and so on until you leave.....My bills for the day, all added up to a total of 5,203 baht for everything for next 17 weeks...  for me leave home at 04:30 arrive at Hospital just before 06:00, if lucky have been done by 15:30, my last visit done at 17:45 then just over 2 hours to get home... "

 

Here in Chiang Mai, the gov't hospitals are heaving masses at humanity when you arrive early in the morning for their outpatient clinics, you get queue numbers for everything from blood draw, submission of urine,  waiting to see the doctor, pay the bill, get your medications.  No signs in English, few staff people speak English, but the doctors do.   There are blaring loudspeakers with nurses calling the patients names (in Thai) and you wonder when they'll call yours, because they don't call actual queue numbers.  Not enough seats for everyone to sit and wait. The toilets are filthy.   It's hot, hot, hot. And when you finally get to see the doctors, it's a brief consultation and it's not uncommon for another doctor to be seeing a second patient in the same "examining" room because they're so crowded they're doubling up.  Needless to say, they rarely do proper full-on exams of your body.  It really stops the "assembly line" if a patient has to disrobe to show something.   The amazing up-side is that everyone seems to be fairly cheerful, or at least resigned to the situation.  No pushing, complaining, shoving like there would be if a much of westerners were in this situation.

 

Even for a simple check-up with no lab work, you're rarely done by lunch and if there is lab work involved, you can write-off the full day.  

 

 

 

 

[ThaiBob]

On 10/29/2016 at 10:31 AM, ignis said:

Almost impossible to answer..

 

1st would suggest see a Dr at a Hospital.  [ Government Hospital would be cheaper] they will run tests, blood and urine if Insulin is needed they will suggest the dose..  NOTE the Test is 'fasting'  Eat and drink nothing for 12 hours before test.

 

Believe  you need a prescription to buy insulin in Thailand and it is not available in most pharmacies as it must be stored at a set temperature in a Fridge + packed in dry ice to travel home to store in your own fridge..

 

Myself take 30 units in Mornings and 26 evenings = 1 x  insulin cartridge last about 6 days = the brand + Hospital I buy from = 220 baht every 6 days..

 

You will need a blood testing machine + strips.. you will need every visit blood and urine tests.. when test are done see the Doctor which will read the report and the maybe adjust the dose of Insulin.    For me starting Insulin was visit ever 6 weeks, then 8 weeks, and so on, now visit every 17 weeks, believe by next year will be 2x year visits.

 

Just another note out of interest a Government Hospital or the Red Cross, you must do everything yourself, etc get bill go to another place and pay, go to another place and get test, go pay for next bit and so on until you leave.....My bills for the day, all added up to a total of 5,203 baht for everything for next 17 weeks...  for me leave home at 04:30 arrive at Hospital just before 06:00, if lucky have been done by 15:30, my last visit done at 17:45 then just over 2 hours to get home...  

 

Depends on money or how much you want to spend, Private Hospital everything would be done for you but at a high price.

 

 

Being your own doctor and self medicating is obviously not recommended but I do know farangs(type 2) that do just that. I am type 1(45 years) and see my endocrinologist every 3 months here.) Insulin, syringes , meters , test strips, etc. are available in many pharmacies with no prescription at substantial savings from a hospital. My friends Lantis Solostar usage was 2250 per month (3 pens x 750) which was not affordable for him so he's using syringes. If he bought the Lantis at a private hospital the costs would have been easily over 4000 baht. 

[mesquite]

According to diabetes expert Dr. Richard K Bernstein, in his book "Diabetes Solution," an A1c of about 4.6 is desired.  The higher values are recommended by the ADA which views amputation, stroke, heart disease as "normal" complications of diabetes.  If you want to avoid these, Bernstein recommends a low carb diet and exercise, oral meds and incretin mimetics, and insulin, in that order.  Blood sugar should be 83 mg/dl. 

Edited October 30, 2016 by mesquite

[ignis]

11 hours ago, mesquite said:

According to diabetes expert Dr. Richard K Bernstein, in his book "Diabetes Solution," an A1c of about 4.6 is desired.  The higher values are recommended by the ADA which views amputation, stroke, heart disease as "normal" complications of diabetes.  If you want to avoid these, Bernstein recommends a low carb diet and exercise, oral meds and incretin mimetics, and insulin, in that order.  Blood sugar should be 83 mg/dl. 

 

That is the American way.. sadly many of the things listed in  "Diabetes Solution"  and advised by other American  diabetes experts are not sold here,  I have no idea what some are or mean / do...   Thai way appear you eat 4 slices of sweet bread with every meal, eat potatoes, or Rice. full of oil chicken, pork or fish = hated it [was in Hospital here with Diabetic meals for 6 days so know + was told by my Diabetic Dr to eat this way at home!!]

 

So say Target is BG reading of 200 or less.......... did not listen to that and mine for many months is 110 - 135. my main diet is fresh fruit. and use fresh Mulberries and make 3+ lts of tea every day to drink, if short on the berries than mix with the leaves, if no berries ready to pick then the leaves only.  No Sugar or Salt in or added to anything. well works for me.....  Friend has been on the Atkins diet for year passed 12 years does not take any meds at all anymore..  me just could not face all that grease and fat.

 

As for oral meds being 1st, many reports show that the most used diabetic med 'Metformin', does not work after a long period of use + messes up the Kidneys [I know was 17 years on Metformin, and in May in Hospital with stage 5 kidney failure] + helped alone with Diet Soda [Pepsi Max]  now drink only home made fruit drink

 

 

Edited October 31, 2016 by ignis

[ignis]

On 10/30/2016 at 8:48 AM, NancyL said:

Moonseeker, if your friend isn't in Thailand now and is contemplating a move here, he should be aware that there is no "free" medical care for foreigners and he since he is a diabetic, his medical needs are likely to cost more than the monthly cost of maintenance of his diabetic care supplies.  As he ages, he will probably suffer complications from a lifetime of diabetes and need treatment for those problems.  

 

This paragraph from Ignis, while accurate, doesn't really paint a truly accurate picture of what it's like trying to obtain budget medical care at a Thai gov't hospital:

"Just another note out of interest a Government Hospital or the Red Cross, you must do everything yourself, etc get bill go to another place and pay, go to another place and get test, go pay for next bit and so on until you leave.....My bills for the day, all added up to a total of 5,203 baht for everything for next 17 weeks...  for me leave home at 04:30 arrive at Hospital just before 06:00, if lucky have been done by 15:30, my last visit done at 17:45 then just over 2 hours to get home... "

 

Here in Chiang Mai, the gov't hospitals are heaving masses at humanity when you arrive early in the morning for their outpatient clinics, you get queue numbers for everything from blood draw, submission of urine,  waiting to see the doctor, pay the bill, get your medications.  No signs in English, few staff people speak English, but the doctors do.   There are blaring loudspeakers with nurses calling the patients names (in Thai) and you wonder when they'll call yours, because they don't call actual queue numbers.  Not enough seats for everyone to sit and wait. The toilets are filthy.   It's hot, hot, hot. And when you finally get to see the doctors, it's a brief consultation and it's not uncommon for another doctor to be seeing a second patient in the same "examining" room because they're so crowded they're doubling up.  Needless to say, they rarely do proper full-on exams of your body.  It really stops the "assembly line" if a patient has to disrobe to show something.   The amazing up-side is that everyone seems to be fairly cheerful, or at least resigned to the situation.  No pushing, complaining, shoving like there would be if a much of westerners were in this situation.

 

Even for a simple check-up with no lab work, you're rarely done by lunch and if there is lab work involved, you can write-off the full day.  

 

 

 

 

Sound about the same as Red Cross in Bangkok... "examining" room has been up to 3 Drs in same room, can just about get in and difficult to hear the Dr... Not hot but the other way around very cold, hate the cold, problem if seated getting up to go outside to get warm = get in line for a seat again..  Noise every floor the same, every waiting room on all floors set out the same.. 2 people shouting on loud speakers name to see Drs, loads of different people with loud speakers calling your number to get meds priced another 4 windows calling names to pay, then 4 to 6 other windows with loudspeakers calling name to pick up your meds. can be up to 8+ people shouting in loudspeakers at the same time in the same room = same on all floors + a nurse calling name with new Appointment cars for next visit...  me start = floor 3 then floor 13, then floor 5 and the final see Dr on floor 1..   Take 2 head ache  tablets to take after blood test and 2 more around lunch time.. 

Edited October 31, 2016 by ignis

[Sheryl]

Sounds like every government hospital I have ever been in. Basically need to plan on a full day, come very early in the morning,. dress for heat & humidity and bring plenty to read.

 

It is also a mistake to assume costs at government hospitals will always be easy to afford. For outpatient care, and even for short inpatient hospitalizations not requiring ICU, and simple surgical procedures, true unless one is really on a shoestring budget.

 

But as soon as ICU care is involved, and/or highly specialized surgeries, costs go way up and 1 million baht can easily be reached or surpassed.

 

Also, for surgeries that involve insertion of an imported devise (stents, joint replacements, and many other orthopedic surgeries requiring insertion of rods, plates etc) the full cost of the device is charged on top of the costs of the surgery, and these can be substantial. For example, a friend of mine recently had back surgery at a government hospital. Total came to about 200,000 baht, of which about 175,000 was just for the hardware --  ttitanium screws, plates, rods  etc.

[tutsiwarrior]

14 hours ago, mesquite said:

According to diabetes expert Dr. Richard K Bernstein, in his book "Diabetes Solution," an A1c of about 4.6 is desired.  The higher values are recommended by the ADA which views amputation, stroke, heart disease as "normal" complications of diabetes.  If you want to avoid these, Bernstein recommends a low carb diet and exercise, oral meds and incretin mimetics, and insulin, in that order.  Blood sugar should be 83 mg/dl. 

 

a normal fasting BG reading is achieveable by controlling diet alone...minimise (but not eliminate) the carbs, eat lotsa fresh veg and lean meat and cut out the booze...I would do 1 x 500 mg metformin after breakfast and 20 units of insulin before bed...but ye got to play around a bit to see what works for you...

 

ye gotta check out what's available and plan yer diet and stick to it...

 

 

[ThaiBob]

On 10/31/2016 at 1:13 PM, tutsiwarrior said:

 

a normal fasting BG reading is achieveable by controlling diet alone...minimise (but not eliminate) the carbs, eat lotsa fresh veg and lean meat and cut out the booze...I would do 1 x 500 mg metformin after breakfast and 20 units of insulin before bed...but ye got to play around a bit to see what works for you...

 

ye gotta check out what's available and plan yer diet and stick to it...

 

 

As a type 1 diabetic of 45years with few complications so far, am well aware of the importance of diet and exercise. My body produces no insulin. As far as Dr Bernstein, well he has a book to sell. Many diabetics require insulin not by choice but by necessity. Glucose management in a diabetic body is a battle between insulin and glucagon. I will begin a trial drug in a month which inhibits the production of glucagon which in turn should reduce the need of insulin (oral or injected ). 

[mesquite]

As a type 1 diabetic of 45years with few complications so far, am well aware of the importance of diet and exercise. My body produces no insulin. As far as Dr Bernstein, well he has a book to sell. Many diabetics require insulin not by choice but by necessity. Glucose management in a diabetic body is a battle between insulin and glucagon. I will begin a trial drug in a month which inhibits the production of glucagon which in turn should reduce the need of insulin (oral or injected ). 

Best of luck. BTW, Bernstein is a type 1 diabetic of 70 years, diagnosed at age 12. He went to med school at age 42 because medical publications refused to publish his work without MD behind his name. He has been complication free for over 45 years due to maintaining normal blood sugars.

Sent from my iPhone using Thaivisa Connect

[moonseeker]

Thank you all fore the interesting info.  MS>

[ThaiBob]

On 11/3/2016 at 1:09 PM, mesquite said:

Best of luck. BTW, Bernstein is a type 1 diabetic of 70 years, diagnosed at age 12. He went to med school at age 42 because medical publications refused to publish his work without MD behind his name. He has been complication free for over 45 years due to maintaining normal blood sugars.

Sent from my iPhone using Thaivisa Connect

Thank you, like most diabetics I wish I had the dedication of Dr Bernstein in managing my diabetes using his method. In the real world, management such as his is realistically attainable by only a small percentage of people. I have been hospitalized 5 times due low blood sugar and his method wouldn't work for me . Diabetic complications are a result of uncontrolled blood sugars over long periods of time . When my a1c levels dropped below 6 I had hypoglycemia reactions and was instructed by physicians to have a number between 6-7.

[Thanyaburi Mac]

I was down to the local P&F Pharmacy, Lotus Klong 7, this morning, noticed that they had a bunch  of items from www.accu-chek.com on the shelf.  I'm not diabetic so didn't check out the details, but the availability might be handy for some folks.

 

Mac

[ignis]

16 hours ago, Thanyaburi Mac said:

I was down to the local P&F Pharmacy, Lotus Klong 7, this morning, noticed that they had a bunch  of items from www.accu-chek.com on the shelf.  I'm not diabetic so didn't check out the details, but the availability might be handy for some folks.

 

Mac

 

Most Pharmacies have Accu-Chek items, it is just the price here..   

 

Size of my test strips [Performa] are in 10 or max size 25 strip tubs...  here 650 - 728 baht for 25 depending on Pharmacy..   that in UK money is over £16..... in UK they cost £16.70 for 50 strips ! or buy online from Amazon 100 strip tubs cost £18.35

 

I get mine at the Red Cross Hospital, but there is a catch, max Dr will write a note for, is 3 x 25 tubs every 90 days cost is 300 baht per tub.. test 6 days a week ?  some of us are used to testing 3+ times a day = would need a very large Pension.

[ThaiBob]

On 11/8/2016 at 7:40 AM, ignis said:

 

Most Pharmacies have Accu-Chek items, it is just the price here..   

 

Size of my test strips [Performa] are in 10 or max size 25 strip tubs...  here 650 - 728 baht for 25 depending on Pharmacy..   that in UK money is over £16..... in UK they cost £16.70 for 50 strips ! or buy online from Amazon 100 strip tubs cost £18.35

 

I get mine at the Red Cross Hospital, but there is a catch, max Dr will write a note for, is 3 x 25 tubs every 90 days cost is 300 baht per tub.. test 6 days a week ?  some of us are used to testing 3+ times a day = would need a very large Pension.

I use the OneTouch system and buy generic strips from Ebay, about $10 for a box/vial of 50. That is about 700 baht or 1/4 the costs here in Thailand. A friend in California brings them to me and have never tried international shipping. 

[THAIPHUKET]

I did Aktins 3x in the last 20 years, always easy and successful . Only constipation problems. Will do it again now. Using Magnesium Milk M against constipation. Much better than anything else. Cheap! No awkward urge to control when to look for a toilet, no cramps, no stink. Only searching for a solution against the typical bad breath.