Obtaining Meds in Thailand [Long Read]

[detect]

Hi boys and girls,

I spent two weeks of December 2016 in Thailand - for a mini vacation and to explore the possibility of continuing HIV treatment there. Below is a diary-style account of how things worked out for me. I’ve included a lot of unnecessary detail, so please skip this post if you are in a rush and check out more to-the-point documentation such as that given by pozboysg on tumblr. Anyway, considering the implications of medical coverage under Trump in the US and my continuing inability to source meds in Europe, I hope this account helps someone out there

Best,
Detect

P.S. Exchange rates may have changed since writing this a few months ago.

Day 1: Arrived in Bangkok and checked into my hotel in the Silom area. I found a cheap place located a few steps from the BTS station Sala Daeng, which is a very convenient (and very gay) area. My first destination after check-in was the Thai Red Cross Anonymous Clinic (located a short 7 minute walk from the Sala Daeng BTS and Silom MRT stations), next to Lumpini Park. Unfortunately, it turned out that the clinic was observing a national holiday and would be closed for three days.

Day 2 & 3: Enjoying great food, re-visiting temples and spending some time at the municipal gym [around 1 EUR / USD for a one year membership, which is beyond awesome].

Day 4: With the clinic open again, I decided to head over there after breakfast. The place was really packed (as it had been closed for an extended period of time), but processing went pretty quickly. Upon entering the clinic one has to obtain a ticket from a machine, where you can choose the service you require. I wasn’t sure which option to select, so I went for ‘HIV testing’ and figured I could explain my situation in more detail when speaking to a nurse or doctor.

After waiting in the lobby area for a few minutes, my ticket number appeared on a monitor facing the waiting area and I was directed to a computer terminal, where I entered my details [initials, passport number, address in Thailand, phone number and some medical background info – which included HIV status]. Upon completing the electronic form, a small printer next to the computer churned out a piece of paper that I was to give to one of the ladies at another counter to produce my patient card. First, I had to wait in the (thankfully air-conditioned) seating area of the lobby, for about 20mins, until my ticket number showed up on the TV screen again.

When my number was called, I proceeded to the desk number indicated on the screen and gave the friendly lady the paper printout that I had received at the computer terminal as well as the ticket / service number I had obtained at the entrance. I was given a patient card which cost 20 Baht [EUR / USD 0.5]. I explained to the lady at the counter that I did not need an HIV test, but would like to see a nurse or doctor in order to obtain a prescription for HIV medication (I had read somewhere that the clinic has doctors that can issue prescriptions). After being directed to the first floor of the building a nurse explained to me, however, that no doctor at the clinic could provide me with a prescription and I should visit a hospital first and then return to the clinic with a prescription.

After receiving this info I left the clinic, hopped onto the BTS / Skytrain and went to Bumrungrad International Hospital. At the hospital, I informed a receptionist that I am a new patient and would like to see a doctor at the Center for Infectious Diseases (not entirely sure what the exact name of the center / department is). She told me to go to the clinic building and complete my registration on the 10th floor. Upon exiting the elevator on the 10th floor one enters a hotel-like lobby area (that includes a Starbucks), where you can register your details (passport required) and the process takes about 5-10 minutes. I was given a paper wrist band with my patient details, a laminated patient card and was told to proceed to the 15th floor, to register at the desk of the infectious diseases department (I just walked in without an appointment).

Having checked in at the reception desk on the 15th floor I relaxed in the comfortable waiting area, was briefly whisked away by a nurse for height / weight / blood pressure / body temp. measurements and after a further 10-15 minutes of waiting I was taken to a consultation room to be seen by a doctor. I explained to the doc that I was HIV+ and taking Complera, but was running low on supplies and could not afford to buy the medication back home. Recognising my financial constraints, the doc advised me to head back to the Thai Red Cross to have my CD4 count, viral load, kidney function, etc. tested (much cheaper there than at a private hospital) and he wrote down the exact details of the tests on a piece of paper to give to the Anonymous Clinic staff. Furthermore, he suggested that I come back to the hospital in a week’s time to discuss the test results. He also gave me a prescription for three months of medication, with which I could buy the generic meds that constitute the single pill Complera regimen at the Anonymous Clinic (two tablets instead of one, but same active ingredients). The Bumrungrad Hospital excursion cost me 1645 Baht [EUR 43 / USD 46] and took less than an hour - excluding the time spent on public transport.

After some delicious Thai street food [approx. EUR / USD 1.5] close to the hospital, I jumped back on the BTS / Skytrain and visited the Anonymous Clinic once more. This time I selected the option ‘other blood tests (existing patient)’ at the ticket machine in the lobby (other options at the terminal include buying medication and having blood tests taken as a new patient). After a 10 minute wait I was called to a desk to have the test details logged into their computer system, was asked whether I wanted to collect the results in person or preferred to receive an email and I received a printout with the submitted details.

After a further 15 minutes of waiting in the lobby my ticket number appeared on the monitor again and I was directed to another desk to pay for my blood and urine test. In total, I was charged 2,390 Baht [EUR 63 / USD 67] and was told to go to the first floor to do the tests. On the first floor my number showed up on a monitor after less than 5mins of waiting (way too soon, as there was a really hot guy in the waiting area, with whom I would have loved to have struck up a conversation*) and I had my blood taken / given instructions on how and where to give the urine sample. I did not want to use the hospital prescription / buy the meds at the clinic on this day, as I was about to head to the south of Thailand for five days and did not want to expose the meds to excessive heat and / or water.

* I know - perhaps not the right place to chat up a guy, but we made eye contact and he smiled…

Day 5: Travelling to the south of Thailand and my bag of toiletries goes missing (all meds in carry-on, so no major damage)… Day 6: Island hopping… Day 7: Had 8,000 Baht [EUR 213 / USD 223] stolen from my hotel room. More importantly though, I got my test results from the Anonymous clinic sent to me via email - way quicker than the 1 week time estimate given during my visit at the clinic and, on a side-note, the results were all good … Day 8-9: Dealing with police and hotel management, because of the theft (not expecting money back - just wanted to report it out of principle). Also, I spent some quality time at various beaches.

Day 10: Back in Bangkok, doing some X-mas shopping and sweating at the gym (no A/C).

Day 12: Business meetings, followed by a very much non-business meeting in the evening

Day 13: Visited Bumrungrad Hospital to discuss my test results. All good – just need to quit smoking and drinking. Decided to get another 3 month prescription, to have 6 months in total. Consultation fee at the hospital was 1645 Baht [EUR 43 / USD 46] again.

Revisited the anonymous clinic, pressing the option ‘Buying medicine […] (old patient)’ at the ticket machine in the lobby area. Waited about a minute until my number showed up on the screen, went to the appropriate counter, handed over my patient card along with my two 3-month prescriptions and held my breath as the lady at the desk tallied up the numbers. The total bill amounted to 5,895 Baht [EUR 157 / USD 164], which works out as EUR 26 / USD 27 per month of meds. After paying, I got a receipt and was directed upstairs to the dispensary. One has to place the prescriptions (and probably the proof of payment) into a plastic basket next to the counter of the dispensary, before sitting down to wait until one’s number is called up. I didn’t know about that step and just sat down straight away, which the pharmacy guy later informed me was wrong. Got a big plastic bag with well-packaged containers and headed out for a late lunch.

Day 14: More x-mas shopping and packing (placing two months’ worth of meds in my carry on and distributed the rest into two pieces of check-in luggage. Flight back home with 2 hour stop-over in the Middle East). Arrived back home, without incidents during transfer and all luggage /meds arrived safe and sound at my final destination



Addendum: I flew out to Asia again in February 2017 to go backpacking for a few months. In December I flew via Doha in Qatar with a direct connection. This time around I flew via Dubai / UAE with a change of airports. Was carrying four months’ worth of meds in carry-on luggage and did not encounter any problems whatsoever.

[MitchMiller]

Thanks for that story.  I found it interesting.  Do you know if an HIV infected US citizen can relocate there for an extended period of time (4 years)?

Now I wish someone would post a similar story describing a visit to Mexico from the US (by car or on foot), to purchase meds.  It's a lot cheaper to travel to Mexico from the southwestern US than to fly to Thailand.

[daveR]

Thailand does not discriminate against HIV positive people. There are no tests required to enter so you can relocate without a problem.

[hungdv]

I'm Vietnamese. I can go to Thailand to buy Stribild ? But I don't speak Thailand language

[Expat1]

Yes, Hung.  Have you current doctor in Vietnam write a prescription for 180 pills.  And take that script to the Thai Red Cross clinic.  It is about 6000 baht for 30 pills.  You do not need to speak Thai.  English is fine.  But the Thai Red Cross will probably have translators if needed.  They did a lot of training in SEA for the mother/child hiv prevention programs for neighboring countries especially Lao and Cambodia.  Cheaper   

[mecch]

Great thread. Q:
Does anyone know if they sell Triumeq yet?  Last year they did not.

[Expat1]

The web board says that tivicay is likely next month and (june) and Triumeq in September. 

[Expat1]

Hungdv,
I noticed my last post got cut.  I wanted to point out that if Stribild is too expensive, the local version of generic Atripla (Teevir) is about 1100 baht per month and the generic Recovir EM plus Edurant is about 1000per month.  Even cheaper is the generic GPO VIR drugs at around 600 bath per month. : So if the Stribild is too pricey  You may have other options.