My experience in placing my mother on generic medication in Thailand

Thai people who visit government hospitals in Thailand would be required to pay only 30 baht per consultation which covers medication and even hospitalization (in a common ward and not single room). There are however certain medications which they would need to pay out of pocket but the charges is usually cheaper than buying the same medication in the pharmacy.

Government hospitals would usually prescribe generic equivalent of the original medication. The generic medication is usually manufactured in Thailand itself to keep the cost low.

If you are consulting with a private hospital, you can also request for generic medication if the cost of the original medication is high. Private hospitals usually would have the generic equivalent of the medication which would be at a lower cost.

My mom’s experience with generic medication in Thailand

First, I would like to share about my initial experience with generic medication when I was still back in Malaysia….

My mom has liver cirrhosis due to hepatitis B which I believe she contracted due to blood transfusion in an operation performed 21 years ago.  The specialist in Malaysia had placed her on Entecavir under the Baraclude brand. My mom had initially developed jaundice and ascites- and with the medication we saw improvement in her condition.  Initially in Malaysia, the hospital was supplying Baraclude (at a subsized price) when they decided to switch to generic brand.

Within 2 weeks of switching to a generic brand, my mother started becoming lethargic and wanted to sleep all the time, showing similar symptoms prior to her hospitalization due to acute hepatitis B. I quickly went to a pharmacy and brought Baraclude. It cost RM530 per box of 30 tablets (30 day supply). After taking the medication, my mom’s condition improved.

I took the generic medication back to the pharmacy in the hospital to return it and feedback to them that the medication was not effective. Perhaps it was effective for others but not suited for my mom. Nevertheless, I started purchasing the medication separately from pharmacy.

Treatment in Thailand

Originally when we came to Thailand, I took with me few months supply of my mom’s Entecavir Baraclude medication. We started to consult with a specialist in Mahachai Hospital and he taught me that my mom needs to be given the medication at a fix time each day to prevent mutation of the virus. In Thailand, the Baraclude medication is very expensive- it cost more than 8000 baht for a box of 30 tablets.

Initially, pre pandemic, we had friends and family coming over from time to time. I would ask their help to purchase for me about 6 months supply and bring it over to Thailand. However when the pandemic hits, there was no one that could visit and bring the medication.

I spoke to the specialist and he asked if we would want to try a generic medication. It cost about 2100 baht for 21 day supply which is much cheaper than the original medication.

The medication is in liquid form. Each day I give my mom 10ml of the medication. The specialist monitored the effectiveness of the medication and run blood test within a month of starting the medication. My mom’s liver condition was under control and hence we continue with the medication.

My faith in generic medication is restored. Not only that, the specialists are caring and compassionate, and especially kind to older folks. The healthcare is one of the reason that made me continue to stay in Thailand with my mom.

Then as my mom’s Alzheimer’s condition progresses, there were a lot of additional medical costs involved as my mom has been placed on nasogastric tube feeding. We moved her over to a government hospital which also supplies her tube feeding food and we could get a nurse come in for free to change her nasogastric tube.

She is also placed on generic medication for her liver cirrhosis. This time, the medication is in tablet form and cost about 1100 baht for 30 day supply:

Her medication is in tablet form and I would crush it into powder, mix with warm water before administering it via her feeding tube using a glass syringe. She is also on Seroquel (25mg) and Lorazepam (0.5mg), 1 tablet each daily to help with her rest and sleep. Due to her advanced stage of Alzheimer’s, and the fact she has low heart rate, the specialist did not prescribe Alzheimer’s medication. Seroquel and Lorazepam are not Alzheimer’s medication but the function is to help to relax her brain and allow her for deep sleep. My mom actually had insomnia for about 20 years so for the first time in a long long time, she was able to sleep well.

The Seroquel comes in the generic form:

My mom is also on cholesterol medication, a generic version that cost 1 baht per tablet. As statin in cholesterol medication may interfere with the liver medication, the specialist did a blood test to check her liver function. The rest result showed my mom’s liver function is under control.

Conclusion

My mom is on mostly generic medication. Only exception is Fluimucil, which is an original medication taken to dilute her phlegm, the rest are all generic medication. Fluimucil cost 12 baht per tablet if prescribed by the doctor but cost about 15 baht per tablet if purchased from the pharmacy.

As foreigners, we pay for consultation and medication but as generic medication is being prescribed, we would keep the cost at an affordable range of about 2000 baht per month. Out of 2000 baht, about 1100 baht is due to the liver medication.

My mom’s tube feeding food costs 100 baht per day for 4 enteral bags which is supplied from the same hospital. Some people did not opt for enteral bags but in normal plastic bag- the cost would be 60 baht for 4 bags. The food is prepared fresh daily using ingredients such as eggs, vegetables, pumpkins, bananas, chicken meat/liver, etc. The food is dietician approved and contain most of the nutrients required. The cost is much lower compared to milk formulas and these are freshly cooked and prepared food.

Hence, I am thankful that my mother is receiving good medical care at an affordable cost. Usually at end stage Alzheimer’s when the person could no longer swallow, other countries would leave it up to the patient’s family but would discourage tube feeding. This means the person would slowly starve to death from organ failure due to severe dehydration and malnourishment.

Whereas in Thailand, specialists from both the private and government hospitals all advocated nasogastric tube feeding. Tonnes of videos in Thai languages are available for the caregiver in mind- anything from tube feeding food preparation to making DIY hand mittens (to prevent them from pulling out the tube). The Thai healthcare system also have a strong support system to make tube feeding affordable as some hospitals actually allocate a separate section just to prepare and cater for these food. When my mom goes to hospital for checkup, there are attendants that help carry her from the car to a stretcher bed and she is wheeled by an attendant.

I am grateful for the Thai healthcare system and the affordable pricing of consultation, medication and care.

 

 

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