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Thread: Need medication - bit of advice if possible....

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    Need medication - bit of advice if possible....

    Hi All

    ll, I'm moving to Bangkok to look for a teaching job and in general all the necessary organising for doing that is going well. The only thing I do have to look into is how I will sort out my pescriptions.

    So, I have to take a drug called Methotrexate every month for a joint problem I have. It would be a good if i have a blood test every every month as well. I can get 3 months worth of the drug before I come but after that I need to get it from somewhere else. Does anyone know how I would start doing this? Really, any information/advice would be useful and appreciated.

    Cheers now. Becks x

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    Möbius Strip Tease Array Anna Key's Avatar
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    Becks, if you get all your ducks in a row I doubt very much that you'll have any problems out here. I'm British - and the private Thai hospitals put my own to shame. Yes, you pay - but it's peanuts really.

    (Not knocking the NHS. Lions led by donkeys and all that.)
    "Take this, brother; may it serve you well."

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    dis member Array zeusbheld's Avatar
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    also worth noting that a lot of stuff that's prescription elsewhere you can just waltz into a pharmacy and buy. (alternatively you could walk in but there's something charming about 3/4 time imo).

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    Möbius Strip Tease Array Anna Key's Avatar
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    ^ +1, Zeus. Yes.

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    Quote Originally Posted by zeusbheld View Post
    (alternatively you could walk in but there's something charming about 3/4 time imo).
    Nice, there's something charming in your reply; well done squire.
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    Exiled Liberal Array Killing Me Softly 101's Avatar
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    It is available in Thailand both as an import (Leucovorin) and in several local generic brands (very inexpensive).

    Due to its toxicity methotrexate is a "Category S"drug, not legal for sale over the counter.

    I take a similar resticted drug (dapsone). Note that the most important factor is not going to be the drug cost but hospital markup.

    Generic Dapsone is cheap wholesale in Thailand. At a government hospital a bottle of 100 retail is 150 baht.

    At most thai oriented private hospitals I pay 350 baht.

    One of the expensive large private hospitals catering to international patients wants 500 to 800 baht .

    An in one exclusive expat hospital in a beach city the bill was a whopping 2500 baht. When I queried the pharmacist, he got it reduced to 850 baht after calling the director.

    Same for the liver function tests, AST/ALT around 500baht each in expat private hospital, at the local lab I go to part of a 500 baht all in one package blood check. I just bring the results to my Dr at the OP clinic of the local 'B' level hospital pharmacy.

    Last refill was 850 baht including the Dr. and the meds.

    Hospitals I recommend for reasonably cheap care in Bangkok would be St Louis and Bangkok Christian. In Pattaya, Memorial.

    Don't get me wrong, If I was having a heart attack straight to a Bangkok Hospital or Bumrungrad but for a chronic problem that is ongoing and on a retirees budget...... plan B.

    ---Update---

    P.S. Bring the pill bottle to the Pharmacy of the Hospital and ask first if they have the medicine and how much it costs. Then head for the hospital OP desk and make an appointment. Show the Doctor the bottle and tell him you want a 3 month prescription or a full bottle.

    He can then decide if he wants to test you for liver function if so off to the lab for 10 min then a 30 minute results wait. Back to the Dr for result of lab and then off to pharmacy.

    Every time you want a refill, go to the pharmacy repeat procedure.
    Last edited by Killing Me Softly 101; 28th August 2011 at 10:52.
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    Great post, KMS. for Bangkok, I can also recommend Lad Prao and Rama 9 (Praram 9) hospitals if the OP is living in either of these areas.

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    dis member Array zeusbheld's Avatar
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    i'd highly suggest the OP go to a government hospital rather than private one if it's a chronic problem, wait times are longer, the lobbies are far less impressive, but many of the same doctors work shifts at both private and gov't hospitals, so the care can be quite acceptable. since the problem's already diagnosed to your satisfaction, the quality of the doc matters less, and the ongoing expense matters more. BNH, Bumrungrad etc are quite nice and i've gotten good care at 'em, and not having to wait long is nice, but you pay a lot, comparatively, for that spiffy lobby.

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    Quote Originally Posted by Anna Key View Post
    Thai hospitals put my own to shame. Yes, you pay - but it's peanuts really.
    And if peanuts are too expensive - I just went to see my doctor and got a diagnosis, left with antibiotics/cough remedy/fever pills, and paid 230 baht.
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    Ladprao are a bunch of assholes... Ram is okay though
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    dis member Array zeusbheld's Avatar
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    Lad Prao are a private hospital, and their doctoring is shit compared to gov't hosptitals at 1/3 the price. that said, in the lad prao area (that soi between surawongse and ramkamhaeng, the one close to big c) there's a clinic near the bridge over the klong and the doc is fucking fantastic. he knows his shit, doesn't overmedicate (a rarity in these parts) and doesn't charge you if he doesn't have to give you medicine. i've been there and walked out paying ONLY FOR THE TAXI. and he's cool as hell, although he doesn't have much downtime to chat as it's a busy clinic...

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    Wow, this is fantastic. Thanks so much for all your advice - it really helps I as really do have to take that drug. I'm in the middle of sorting out loads of stuff for the trip at the moment (travel insurance is expensive huh!) so will refer back to this thread when I'm walking the streets of Bangkok and might get back in touch.
    Once again, cheers guys, your great. I've never done 'forums' before so am slightly overwhelmed by how useful they are...!
    Beck

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    Take
    your three month supply then just walz into a paharmacy and by a genentic equivalant over the counter.

    No problems. No need to sweat it.

    Pretty well everything is available over the counter. Not withstanding narcotics. If you need anything opium based you'll have a problem.

    Good luck.
    When being run out of town, get in front of the crowd and make it appear like a parade.

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    Exiled Liberal Array Killing Me Softly 101's Avatar
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    Quote Originally Posted by russellsimpson View Post
    just walz into a paharmacy and by a genentic equivalant over the counter
    Though generally true. There are exceptions. Like the Dapsone, hiv anti-retrovirals, chemo-therapy drugs to name a few. I believe the OP's med is in that category. But hey go on in to a pharmacy and find this particular drug R and prove me wrong in this specific case.

    ---Update---

    As for the government hospitals, for me the increased cost of a private focused on Thai middle class clients vs the local district or regional hospital. My time is valuable. I save time. Also I have visited several Thai Friends in government hospital wards and seeing 15 other recent amputees in ward beds, with various family members around in addition to visit my own friend and watching the gruel they were serving for 'dinner' convinced me that other choices would be preferable if I had a choice.

    In my friends case, I believe the ward room was priced at 100 baht a day for care. By comparison, Pattaya Memorial has semi-private rooms at 800 baht.

    As for insurance the Group policy here on Ajarn for inpatient hospital care is good value for money, Tony has and email and can arrange the cover to start when you get here. It of course will not cover pre-existing problems. But generally the costs of outpatient medication and office visits in not a real concern for most expats and probably less than an insurance copay in America.

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    as Killing Me Softly 101 mentioned, this drug is not available in the drug store.....and even if it illegally is available for sell without prescription, you will be given this drug mostly by shop assistant who doesn't have any medication knowledge. i guess it's ok to go straight to drug store for non-serious acute illnesses or some shortage in your chronic disease drugs before your next doctor visit. most antibiotics and some other chronic drugs are available in drug stores here but definitely not this drug. and in your case, since you'll need a periodic blood test as well as doctor's evaluation, it's best to go to the hospital.

    as for which hospital should be the choice, it depends where you'll be living/working? any insurance coverage offered? i'm local Thai so i don't know much about your benefit offers. But in general, just go to an affordable private one if you don't have AT LEAST a few hours to wait/waste at the public hospital. the private hospitals would be MUCH MUCH more friendly to foreigners as well. but yes, they will charge you higher prices. good news is methotrexate is not a new drug, so it shouldn't be too expensive. and yes, medical fee here is quite affordable....sorry i don't know much about pricing in details though.

    btw, although i'm not working in the hospital or drug store, i'm a pharmacist and i'm pretty amazed how well Killing Me Softly 101 knows all about this. i guess the one who's using the service knows the best, hmm?

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