Private hospital patients ‘free to buy medicines outside’

[webfact]

Private hospital patients ‘free to buy medicines outside’

By The Nation

 

File photo

 

PATIENTS at private hospitals have the right to buy medicines elsewhere after getting a prescription from their doctors, according to the Health Service Support Department (HSSD).

 

The department, however, has no plans to force private hospitals to inform their patients of this right through announcements in their facilities. 

“Patients have long had the right to buy medicines outside hospitals,” HSSD director-general Dr Nattawuth Prasertsiripong said yesterday. 

 

He was speaking publicly in order to downplay speculation that the latest resolution from the Medical Facilities Committee (MFC) could make it impossible for patients to produce a prescription and get their needed medicine from drug stores. 

 

Last Thursday, MFC ruled that medicines be treated as among the medical services that doctors must take responsibility for. 

 

While MFC has recognised that patients have the right to buy medicines from outside hospitals, it has also absolved private hospitals of having to put up on-site announcements informing their patients of this right.

 

Nattawuth said his department would forward the resolution to a subcommittee established under the Committee on Product and Service Prices with the mission to prepare measures related to price control over medicines and medical-services. 

 

 

Overcharging

 

The committee has assigned relevant organisations to gather opinions on price-control measures. Among these organisations are the HSSD, the National Institute for Emergency Medicine and Thai General Insurance Association.

 

“Between 60 and 70 per cent of patients at private hospitals are health-insurance policyholders,” Nattawuth said.

 

According to him, just two per cent of complaints about private hospitals that the HSSD had received last year were about high prices. 

 

Many non-governmental organisations have long complained about perceived overcharging by private hospitals. In one extreme case, a medical bill exceeded Bt23 million. 

 

“There are many complaints about medical-service fees. In one extreme case, the bill exceeded Bt23 million. A surgeon, for example, charges about Bt170,000 per operation,” Foundation for Consumers secretary-general Saree Ongsomwang said recently. 

 

Nattawuth said the HSSD, for its part, was responsible for ensuring that medical facilities provided a good standard of services. 

 

Source: http://www.nationmultimedia.com/detail/national/30364347

 

 -- © Copyright The Nation 2019-02-19

[YetAnother]

2 hours ago, webfact said:

downplay speculation that the latest resolution from the Medical Facilities Committee (MFC) could make it impossible for patients to produce a prescription and get their needed medicine from drug stores. 

hospitals don't work that way; prescriptions are not given to patients, prescriptions are routed internally to the onsite pharmacies; then medicines are dispensed there and the prescriptions kept internally; in many cases patients are not told what the medicines are specifically for

[marcusarelus]

18 minutes ago, YetAnother said:

hospitals don't work that way; prescriptions are not given to patients, prescriptions are routed internally to the onsite pharmacies; then medicines are dispensed there and the prescriptions kept internally; in many cases patients are not told what the medicines are specifically for

I am always told and asked if pharmacy or I'll buy.  I buy viagra at the hospital because I don't want fakes.  Some times if a doctor forgets to discuss a prescription I refuse it at the cashier when paying the total bill for physician and drugs - no problem.  You must not have experience with all hospitals.  Probably only post about what you know for sure.  I deal with BDMS. 

[sungod]

51 minutes ago, YetAnother said:

hospitals don't work that way; prescriptions are not given to patients, prescriptions are routed internally to the onsite pharmacies; then medicines are dispensed there and the prescriptions kept internally; in many cases patients are not told what the medicines are specifically for

You should ask your Doctor for a prescription, I never had a problem either with BDMS.

[kingstonkid]

The challenge is that Thai doctors do not have prescription sheets and when asked to refuse as it is hospital policy that you have to buy the drugs from them.  The system is kind of wack but it seems that high priced prescriptions i\s the way they make the money for the hospital.  

BNH is not bad it is the lower tier private hospitals that cause the issue.

 

I went into one hospital and asked for viagra and got told they do not stock it in the hospital and that the doctor could not give e a prescription as he had no means of writing them.

[Rawairat]

I always give back the over priced panadol but loath to refuse others unless it is a refill from a second visit and I know of cheaper alternatives. 

[marcusarelus]

1 hour ago, kingstonkid said:

The challenge is that Thai doctors do not have prescription sheets and when asked to refuse as it is hospital policy that you have to buy the drugs from them.  The system is kind of wack but it seems that high priced prescriptions i\s the way they make the money for the hospital.  

BNH is not bad it is the lower tier private hospitals that cause the issue.

 

I went into one hospital and asked for viagra and got told they do not stock it in the hospital and that the doctor could not give e a prescription as he had no means of writing them.

I never had a problem.  The hospital doctors write prescriptions all the time.  Maybe try a better hospital.

[Deli]

Used Bangkok Phuket Int. yesterday for the 1st and for the last time. Got fleeced as I paid for talking to the Doc for 2 minutes and getting some eye drops and pills THB 2600.-

Never again.

 

[Bob12345]

11 minutes ago, Deli said:

Used Bangkok Phuket Int. yesterday for the 1st and for the last time. Got fleeced as I paid for talking to the Doc for 2 minutes and getting some eye drops and pills THB 2600.-

Never again.

 

What has this to do with the topic?

 

Every topic about hospitals, no matter the context the topic is in, get filled with comments of people wanting to mention how much they paid for what, how a doctor misdiagnosed them, and or other stuff.

 

Now its about getting prescriptions for drugs and the option to buy those drugs at an outside pharmacy. Please stick to the topic or i will arrest you as deputy topic officer.

[KittenKong]

2 hours ago, marcusarelus said:

I am always told and asked if pharmacy or I'll buy. 

I have never been asked this in any private hospital or clinic here. The assumption is always that the hospital/clinic will dispense medicines and charge accordingly. However, I always refuse their kind offer and have the items removed from my bill, and then I buy them elsewhere. The saving is often several hundred percent.

The only exceptions are some medicines which can only be dispensed by a hospital pharmacy and are not available elsewhere, and there one has no choice.

[spidermike007]

Bangkok Hospital adamantly refuses to honor this policy. They will not give a prescription, to purchase medicine outside. This policy is a travesty, and they should be brought to task for this, immediately. The profits they charge in their pharmacy are astounding. 

[marcusarelus]

15 minutes ago, spidermike007 said:

Bangkok Hospital adamantly refuses to honor this policy. They will not give a prescription, to purchase medicine outside. This policy is a travesty, and they should be brought to task for this, immediately. The profits they charge in their pharmacy are astounding. 

If by Bangkok Hospital you mean BDMS you are wrong as I've never had a problem getting a prescription.

[Dumbastheycome]

5 minutes ago, spidermike007 said:

Bangkok Hospital adamantly refuses to honor this policy. They will not give a prescription, to purchase medicine outside. This policy is a travesty, and they should be brought to task for this, immediately. The profits they charge in their pharmacy are astounding. 

I agree. The system used in most private Hospitals is to send charges for consults and prescription via internal server. The Patient victim is then required to pay all up costs before ever even seeing what is prescribed. Invariably the Pharmacist will give  information  as to the purpose of the prescription/s as well as asking about any known allergies  to such. As  stated the cost is assumed to be reclaimed  under  Medical Insurance in the  majority of  cases.

My experience in Government hospitals is that the patient is given the bill and expected to present it  at the in house Pharmacy. But again it is pay on presentation of  bill,  not after sighting prescriptions. An option  could be to over write the prescriptions before paying only the  service fees. Refusing presented prescriptions another  choice  but would  mean going back in a queue for a refund.( Or doing a runner to become a mark ! )

Given that the  vast majority of patients  would  have no real/ any knowledge of pharmaceuticals it is assumed there would be no rejection by the  patient  in either system.

I have seen it said that the private Hospitals  prescribe "better" medicines but I have found they issue  generics same as  Government Hospitals if there is one.

Street Pharmacies in general do not stock anything "special" and are not so willing to order in either.

But at Private Clinics they will offer best/recent/ new  generation medicines although at  high price. At least  you have  more opportunity  to discuss the cost versus merits or decline.

 

[ChipButty]

The amount of money they charge for drugs in the hospital, Cocaine is cheaper

[ignis]

I've never had a problem getting a prescription. as they type it out they also add the price.. if I say that is expensive, they tell me the cheaper Pharmacy to get the same med's... and will write the name of Med's and dosage for me to go there myself.  Not all med's are more expensive at the Hospital infect some are cheaper at the Hospital.

 

I get some at the Hospital and some outside....... The downside is that 'outside Pharmacy' med's are not on your file, so if you see another Dr they have no idea = I take a list of all the med's I take +  dosage 

[300sd]

Yes patients are "free to buy medicines outside". But a patient in a hospital is a captive audience and hospitals have been in business for a long time. It's a scam that works very well.

 

If they were trying to help the patient monetarily then the doctor would give a separate prescription and then a separate invoice for the visit. (get it filled wherever you want). It's kind of uncomfortable to ask the Doctor for this, but I'll do it next time....I usually give them back half the stuff that is prescribed after asking the pharmacist what everything is!

[Thaidream]

If one goes to a large outside Pharmacy most every drug is available unless on the restricted list- you have to ask the doctor. the cost at an outside Pharmacy is  much less.

 

Unfortunately, Thailand follows the American  Medical way of doing business-  and see healthcare as solely a for profit business opportunity. As long as insurance companies are left to become dominate- costs will rise and insurance will go up and both are in business with the Pharmaceutical industry.

 

Thailand has one advantage over the US Medical system in that it can obtain life saving medicines Worldwide; has the 30 Baht scheme for the disadvantaged and costs are still much less than the West.  This trend will not continue as Thailand is allowing Western Medical Insurance companies to enter Thailand and they will certainly drive costs upward.

 

The only way to stop the rising cost of Healthcare is to get control of the process; highly regulate or eliminate insurance companies and force life saving drug prices down by eliminating all tax on them and  regulate prices. Healthcare is a human right not an industry which should have profit as its motive.

[marcusarelus]

33 minutes ago, Dumbastheycome said:

I agree. The system used in most private Hospitals is to send charges for consults and prescription via internal server. The Patient victim is then required to pay all up costs before ever even seeing what is prescribed. Invariably the Pharmacist will give  information  as to the purpose of the prescription/s as well as asking about any known allergies  to such. As  stated the cost is assumed to be reclaimed  under  Medical Insurance in the  majority of  cases.

My experience in Government hospitals is that the patient is given the bill and expected to present it  at the in house Pharmacy. But again it is pay on presentation of  bill,  not after sighting prescriptions. An option  could be to over write the prescriptions before paying only the  service fees. Refusing presented prescriptions another  choice  but would  mean going back in a queue for a refund.( Or doing a runner to become a mark ! )

Given that the  vast majority of patients  would  have no real/ any knowledge of pharmaceuticals it is assumed there would be no rejection by the  patient  in either system.

I have seen it said that the private Hospitals  prescribe "better" medicines but I have found they issue  generics same as  Government Hospitals if there is one.

Street Pharmacies in general do not stock anything "special" and are not so willing to order in either.

But at Private Clinics they will offer best/recent/ new  generation medicines although at  high price. At least  you have  more opportunity  to discuss the cost versus merits or decline.

 

I disagree with you for a number of reasons.  1.  BDMS the largest chain of hospitals in Thailand does not do this.  2.  Who isn't bright enough to check a med on a smart phone?  3.  I get tell the doctor I have enough meds and never a problem.  4.  At the cashier they ask me to check the bill for meds and I tell them I have them the doctor made a mistake - no problem. 

[shackleton]

the doctor I have used for a lot of years in the hospital always gives me a weeks course of tablets  if a new prescription 

as I take quite a few others as well he is aware of the cost to me 

I have the list and get the tablets at a outside Pharmacy  

[Old Croc]

I see 5 doctors at BPH on a regular basis and take 8 different drugs for my various conditions. 

I buy all, but one, at supercheap, and several times a doctor has given me a prescription to use there. As an example, the doctor gave me a script to buy Warfarin.  

(The drug I have to get from the hospital is unfortunately, very expensive, and their markup hurts, but it's just not available in regular pharmacies. I even started a thread about it on this forum and also tried unsuccessfully to source it from India)

The hospital obviously prefers you buy drugs from them, as they are a business and not a free government hospital, but it's up to you to find the alternatives. 

You should ask the doctor for a script to buy outside, and tell them not to put drugs on the hospital bill. These days the doctors ask me how I want to source it.

[HAKAPALITA]

Best to find No1 Hospital No1 Specialist, do as yer told, pay the bill n go home.  Jeez what a fuss.!

[Surasak]

I've never had to produce a prescription at any pharmacy up to now, fortunately. Meds supplied at the hospital I use, are very expensive. The pharmacy I use is a wholesale supplier which I found quite by accident. Hospital price, ฿1200 for 14 tabs. Pharmacy ฿750. No contest, no scrip.

[Dumbastheycome]

57 minutes ago, marcusarelus said:

I disagree with you for a number of reasons.  1.  BDMS the largest chain of hospitals in Thailand does not do this.  2.  Who isn't bright enough to check a med on a smart phone?  3.  I get tell the doctor I have enough meds and never a problem.  4.  At the cashier they ask me to check the bill for meds and I tell them I have them the doctor made a mistake - no problem. 

Samitivej does.  Checking a med online does not provide comparative information. Using Doctor Google could be considered  dangerous practice. A new patient or with a new health issue may not know what meds  to question. Either to the Doctor or the cashier. If  you tell the Doctor you have enough meds it  appears he prescribes them anyway so you have to decline them  at the cashier?

 

[dcnx]

5 hours ago, YetAnother said:

hospitals don't work that way; prescriptions are not given to patients, prescriptions are routed internally to the onsite pharmacies; then medicines are dispensed there and the prescriptions kept internally; in many cases patients are not told what the medicines are specifically for

You have to take control of the situation. Tell them what you’ll take or won’t take, and that’s the end of that. Make them tell you what each one is for if you don’t know. Use your phone to photo the papers they give you with the med names on them if you’re not familiar with the names.

 

I have been to several hospitals who have flat out lied and said it’s illegal to buy the medicine at a pharmacy. RAM in Chiang Mai is really bad about this. I know it’s not so I call them on it. They get pissy as Thais do when they are caught lying but it ends there and I buy outside for much, much less.

 

[spidermike007]

2 hours ago, marcusarelus said:

If by Bangkok Hospital you mean BDMS you are wrong as I've never had a problem getting a prescription.

Bangkok Hospital in both Samui and Hua Hin refuse to hand out prescriptions. I have taken it all the way to management level, and they refuse to give in. Buy our medicine, or do not get any. I have been able to coerce a doctor into telling me what he recommends, rather than prescribing it at the hospital. 

[TallGuyJohninBKK]

5 hours ago, kingstonkid said:

The challenge is that Thai doctors do not have prescription sheets and when asked to refuse as it is hospital policy that you have to buy the drugs from them.  The system is kind of wack but it seems that high priced prescriptions i\s the way they make the money for the hospital.  

BNH is not bad it is the lower tier private hospitals that cause the issue.

 

I went into one hospital and asked for viagra and got told they do not stock it in the hospital and that the doctor could not give e a prescription as he had no means of writing them.

 

I think the OP article is missing the point, not surprisingly.

 

Here in TH, AFAIK, there is NO formal prescription system like in other countries, where you need a doctor's written note (prescription) in order to obtain drugs from a pharmacy. No prescription, no drugs.

 

Instead, here, AFAIK, it breaks down into two categories:

--drugs that anyone can buy from any pharmacy regardless of having any written "prescription" from a doctor.

or

--drugs that only hospitals are allowed to dispense, and private pharmacies are NOT allowed to dispense, regardless of having any "prescription" note from a doctor.

 

I've never heard of any drug here in Thailand that a private pharmacy could dispense, but would only do so with a written prescription from a doctor. If the private pharmacy has a drug and is allowed to sell it, they'll sell it to you upon request, doctor's "prescription" or not.

 

And that is why, AFAIK, that doctors here will often say they can't write a "prescription" for you to take away, because there's no system and no established paperwork to allow for that. Because it's not part of their system.

 

If the private pharmacies are allowed to sell a drug and they have it in stock, they'll sell it to you, doctor's paperwork or not, AFAIK. The only thing a written "prescription" here would accomplish would be to tell you the quantity and dosing instructions from the doctor, assuming you were obtaining the drug from somewhere other than the hospital.

 

 

[hansnl]

4 hours ago, Deli said:

Used Bangkok Phuket Int. yesterday for the 1st and for the last time. Got fleeced as I paid for talking to the Doc for 2 minutes and getting some eye drops and pills THB 2600.-

Never again.

 

Welcome to private healthcare(?)

[Maestro]

12 hours ago, marcusarelus said:

...I deal with BDMS

What does BDMS stand for?

[natway09]

Sorry Spidermike you are wrong.

My Doctor actually writes down what I need & suggests to me I buy outside

[Emmess]

11 minutes ago, Maestro said:

What does BDMS stand for?

Bangkok Dusit Medical Services, which own the majority of the big private hospitals in Thailand.