Private Hospitals Must Post Drug Prices from Next Week

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fountainhall
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Private Hospitals Must Post Drug Prices from Next Week

Post by fountainhall » Thu May 16, 2019 10:30 am

Private hospitals have been advised they must not only post the price they sell drugs at their in-hospital pharmacies, they must also give the patient a prescription to purchase from elsewhere if so desired. The mandate commences next week. I am not sure if this covers all drugs, but it should certainly be a substantial saving for those who require most drugs on a regular basis.

In my own case, I only require one prescribed drug. Here at Bumrungrad, even though i do not see a doctor and only email for a repeat prescription, I have to pay around Bt. 3,000 for 60 tablets plus a doctor's fee of Bt. 600 just for a minute of his time scribbling something on his computer. The tablets are not the originals from Europe. They are a Thai generic.

Occasionally if in Hong Kong where I am still on a doctor's list, I will obtain the same medication there instead. That charge is HK$300 (Bt. 1,200) also for 60 tablets but these are the originals. There is no doctor's fee for repeat prescriptions. So Bumrungrad is charging for a generic three times more than that for an original drug in a much more expensive city like Hong Kong. I admire the facilities which Bangkok's top hospitals offer (although I have never been an in-patient - yet), but making such massive profits from drugs is surely a ridiculous rip-off.

https://www.bangkokpost.com/news/genera ... -hospitals

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Gaybutton
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Re: Private Hospitals Must Post Drug Prices from Next Week

Post by Gaybutton » Thu May 16, 2019 11:15 am

fountainhall wrote:
Thu May 16, 2019 10:30 am
Bumrungrad is charging for a generic three times more than that for an original drug in a much more expensive city like Hong Kong.
I would imagine most, if not all, private hospitals in Thailand are acting similarly. I see a doctor at Bumrungrad too. Most of what he prescribes is readily available at my favorite pharmacy, Fascino. However, there are 1 or 2 that are not available outside the hospital at any pharmacy, so I have to either buy it via Bumrungrad or live without it. Fortunately for me, neither is very expensive anyhow.

Actually, considering the quality of the facilities, the competence of the doctors, and the quality of care, I don't mind their prices at all. That's why Bumrungrad is my first choice hospital and I pay out-of-pocket for outpatient care without the help of some ridiculous 40,000 baht outpatient insurance rule.

I can understand much more expensive than, say, Banglamung Hospital, but I would definitely object if prices go beyond expensive and get into rip-off.

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Re: Private Hospitals Must Post Drug Prices from Next Week

Post by fountainhall » Thu May 16, 2019 12:20 pm

Gaybutton wrote:
Thu May 16, 2019 11:15 am
I can understand much more expensive than, say, Banglamung Hospital, but I would definitely object if prices go beyond expensive and get into rip-off.
I suppose the question really boils down to - how do we define rip off? I compared Hong Kong and Bangkok - admittedly comparing just one item. Comparing the cost of living indices in the two cities on the Expatistan website, Hong Kong is 159% more expensive a city in which to live than Bangkok. So, in theory, my one drug (the original, not a Thai generic) purchased at my doctor's pharmacy in Hong Kong ought to be Bt. 9,300 when in fact it is Bt. 1,200. In my view - again in theory, when the price of an article works out at between 7 and 8 times more expensive here, that surely constitutes some form of rip-off.

https://www.expatistan.com/cost-of-livi ... /hong-kong?

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Re: Private Hospitals Must Post Drug Prices from Next Week

Post by Trongpai » Thu May 16, 2019 12:39 pm

fountainhall wrote:
Thu May 16, 2019 10:30 am
So Bumrungrad is charging for a generic three times more than that for an original drug in a much more expensive city like Hong Kong. I admire the facilities which Bangkok's top hospitals offer (although I have never been an in-patient - yet), but making such massive profits from drugs is surely a ridiculous rip-off.
https://www.bangkokpost.com/news/genera ... -hospitals
I found that Bumrungrad charges 2,500B for Co-Diovan valsartan HCTZ by Novartis 80mg 40pill box. Same product at Chula MD Pharmacy on Rama 4, 450B. You don't need a prescription. It's a common blood pressure drug. I do visit doctors at Bumrungrad regularly and get lab tests but I decline the in-house prescriptions. They don't seem to mind.

Boots sells Co-Doivan for 750B.

I do get an in house prescription when I am being prescribed something new but ask for only a weeks supply. Then I can take the box to Chula MD Pharmacy and be sure I am getting the same drug. If you don't have the box Bumrungrad will give you a nice color print out of the drug, packaging and the exact name of the drug.

I've found that I do have to be careful when buying drugs at a local pharmacy. I pass them a list but some of the staff really don't know English and most of the packaging is all in English.

Almost all of the drugs that I've been prescribed at Bumrungrad I've been able to obtain at Clula MD.

The doctors used to tell me to comeback in 6 months but now I get a lot of return in 3 or 4 months. Perhaps it's me getting older and needing more checks ups? Also, they seem to be doing more and expensive lab tests like vit D levels. I've priced the same lab tests at the Pulse Clinic on Silom and they're about 1/3 of Bumrungrad's prices.

Another thing to check is the costs of the same drug at a higher dose then prescribed. Crestor 20mg Q30 is only a few hundred more than a package of Q30 10mg. You can cut the pill in half and save a lot in the price. It's the same with other drugs like Jardance and Cadura.

USA has similar price inconsistencies but it get more complicated. Walmart Pharmacy would move into a community ( a red state to be safe) and under price the independents actually taking a loss. The independents one by one would close and then Walmart would slowly increase the product retail price and exceed what the independents were originally charging. Then along came HMO's, Health Management, and they contracted with the big box stores, consumers have no choice. HMO's usually charge a drug co-payment and they get you with a limited quantity per refill as well as not covering some of the more expensive drugs. Often the co-payment equals the actual cost of the drug.

Pharmaceuticals in USA is in need of some serious federal regulations but the republicans will have none of that!

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Re: Private Hospitals Must Post Drug Prices from Next Week

Post by fountainhall » Thu May 16, 2019 1:34 pm

Trongpai wrote:
Thu May 16, 2019 12:39 pm
I found that Bumrungrad charges 2,500B for Co-Diovan valsartan HCTZ by Novartis 80mg 40pill box. Same product at Chula MD Pharmacy on Rama 4, 450B.
If that's not a rip-off by Bumrungrad, then I clearly don't understand the meaning of the word! Obviously Bumrungrad is classier. It's a comfortable place to sit whilst the cost is being worked out and the medicine prepared. And their overheads are obviously a lot higher than Chula MD Pharmacy. But that doesn't justify charging 5 times more.

The major hospitals will always have a large overseas clientele for over-expensive drugs as these people will not want the hassle of finding an outside pharmacy.

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Re: Private Hospitals Must Post Drug Prices from Next Week

Post by Gaybutton » Thu May 16, 2019 2:13 pm

fountainhall wrote:
Thu May 16, 2019 12:20 pm
I suppose the question really boils down to - how do we define rip off?
I really have no definition for it. For me it's an "I know it when I see it."

If I find myself paying for something, whether it's pharmaceuticals or anything else, if I'm being charged 1000 baht and elsewhere the same thing costs 200 baht, then I'd say rip-off.

At Bumrungrad my doctor always tells me which medications can be bought at pharmacies. The ones he says can only be bought at the hospital - he's telling the truth. I've checked and indeed outside pharmacies don't carry them or a generic for them, even if you have a prescription. Of course, if pharmacies don't carry those medications, I don't know whether I'm being ripped off or not. So, I don't know what good posting prices does if the hospital is the only place they are available. As I said, in that circumstance the choice is either pay the hospital or do without.

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