Postonly_2005 2015-12-08 16:47:04
History: First time glaucoma medication user, professional whiner.
I saw an M.D. in the opthomology department of Bangkok-Pattaya
Hospital (Pattaya, Thailand). This is Pattaya’s second best hospital
(Pattaya Inter is supposedly higher standard and also more expensive
so it attracts the better doctors). Since this post is about
medication I won’t go into much detail about the doctor visit except
to say that it was largely a positive experience.
The only complaint I have is more of the medical system in Thailand in
general. Doctor visits are undervalued and prescription medication
overvalued (that’s where Thai hospitals make their money). Until when
has paid one isn’t told the name or much detail about what medication
will be prescribed and service can be affected if one insist on buying
elsewhere than the hospital’s own pharmacy. Plus since profit is from
sale of medication more than doctor’s profesional services the
tendency is to ‘push’ drugs. It’s hard to avoid, even the best doctors
do it here.
I was told that since my pressure was 21-23 that I was borderline
whther I would need drops right now but to check it every month or so.
When I mentioned that I would be going into the third world for an
indefinite period he recommended I begin straight away since normal is
Anyway, I was sold Rescula (5 ml B900, that’s about US$23). My bottle
read that it was made in Switzerland. Thailand has high import duties
on some things. I don’t know if medication is among them. I also have
no idea how that price compares to US drugstore price. I was told by
the pharmacy staff to refrigerate. Immediately alarms went off in my
head. I travel upcountry in hot S.E. Asia. Thus for days and often
weeks I have no refrigeration. And what does this say about the health
situation of the vast majority of persons in the third world who also
don’t have ice or money?
I would have been happy to pay extra if a small gel pack and
waterproof insulated bag was offered for sale – something that would
fit in a packsack pocket or better yet my shirt pocket. I expect
Japan has this (in fact I saw compromise articles that would do in a
pinch, both in Isetan department store in Bangkok, top floor imported
goods section) but I was looking for something smaller and intended
I pointed out to the staff that I don’t have refridgeration. After
some talk among themselves it was decided that I shouldn’t worry, that
the dropper could be left unsealed for one month after opening. It
sounded like they were winging it.
So what is the truth, which products need to be refridgerated and what
is the questionable temperature anyway? I presume that the tropics are
legitimate cause for concern.
I bought a sealable plastic kitchen container and filled it with ice
to use as a temporary medicine fridge. I promptly lost it.
of the biggest chain optometrist (the reputable Top Charoen which has
high standards of training)in order to get my first pair of
prescription eyeglasses. My prescription had changed so much that the
details of the mockup the opthomologist made were now not suitable.
Uneasy about spending US$80 (OK so I’m cheap)on a pair of glasses that
would be wrong I decided to wait until I came back in the country for
a checkback with the MD. I have no idea if there is any connection
between the drops and changed (better vision)in two days.
I should add here that a year previous when I make my first abortive
(frameless can break easily)attempt at getting eyeglasses my
prescription was different in five minutes, from shop to shop. This
time I had visited a professional eye doctor instead expecting more
accurate results. There was no way I was going to trust an
opthomologist’s machine and interpretation over my own discomfort with
his assigned numbers. They were perfect a few days before – now
wearing them, made me almost ill. I decided to wait until I would come
back from Malaysia in a few weeks after using drops some more.]
So here I am in another city about to leave the country with no
glasses and no drops. Neither an emergency situation I should add
since I can get along without glasses and there was no huirry for
I went into Bangkok’s Bumrungrad, the only internationally accredited
hospital in Thailand (btw, I am a little cynical of the value of that,
how many excellent busineses do you know which aren’t members of the
Better Business Bureau?) They were unable to refill my prescription
since I don’t have one and have never seen one of their doctors.
Telling them I wanted to change to another medication that did not
require refridgeration (Lumigan according to avclinic.com) I decided
to wait and see what was available in Malaysia, both cost of drug and
medical care. But I did ask selling price…
Most expensive: Lumigan (Bimatoprost) would be B925 for 3 ml. That’s
US$8 per ml.
Medium: Xalatan (latanoprost) was B1000-1300 for 5 ml at two other non
hospital pharmacies. That’s US$6 per ml.
Cheaper still: Rescula (unoprostone) would be B675 for 5 ml. That’s
US$3 per ml.
Note: I have no idea how this pricing compares to the west, and how
much of it is affected by state controls, shipping etc.
The price of glaucoma drops sounds rather dear. My mother in Canada
has a 30 ml bottle (courtesy of her tax dollars.) BTW don’t believe
the stories about how good the Canadian socialized medicine system is.
Not only has the standard of care gone down hill considerably in a
decade but as well a non-resident would have to wait two months to see
a specialist and pay C$250 for the consultation, not counting any
procedures or medication.
Thus anyone without medical insurance who has more than a single or
cheap medical problem would be wise to fly to Bangkok. Even after
paying for hotels and meals he would save considerably.
Frankly I don’t know why medical tourism isn’t promoted more. I am
seriously considering travelling to Bombay to get the very inexpensive
chemically identical drugs available in India. Don’t know is glaucoma
drops are available by the barrel for fifty cents. 😉 From the
initial purchases I made with Sildenfil citrate costs are a fraction
of those in Thailand or the west. Others have suggested mail-order.
But then you don’t get to enjoy the food and Temples!
Tnartlady 2015-12-08 16:47:17
Hi Marion, I hope you get an answer about the refrigeration problem as I
am curious –I do not refrigerate my Rescula or Xalatan . I live in
Tennessee and have air condition . ? – I pay $47.00 US for Rescula and
$50.87 for Xalatan . I use antibiotics regularly for my lung condition ,
COPD , and every rx I get lately is $100. –+ NO Doubt we are being
grossely overcharged —
Tnartlady 2015-12-08 16:47:21
I hope this helps
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from Mayo Clinic