Tips : Buying medicine in Bangkok.
You may be taking some rather expensive medication (if you have to pay for it yourself, and not your insurance). It is worthwhile to check out what is available in local pharmacies in Bangkok. A lot of currently used popular drugs are imported and on sale for a price (we think prices of most drugs are somewhat cheaper than in the Western world). Of more interest are those drugs that have proven efficacy and have been around for a while. Some of those are produced locally (patent expired already) and are really cheap.
As an example we can quote simvastatin (well known under the name Zocor). While the imported (original) version costs up to 50 baht a tablet, it is also possible to buy the locally produced version at 42 baht for 10 tablets of 10 mg, under de brandname Zimmex, produced by Silom Medical Co. Ltd.) So you can get this medication at about 10% of the price of the original!!!
Now if the pharmacist sees you coming, he or she will certainly want to sell you the expensive medication first, so you have to be prepared and ask for the brandname mentioned above. The same applies for other drugs, just ask for the locally made product, and ask in different pharmacies!
Drugs Safety and Efficacy
In July 2007 a study conducted by the Hospital Association of Thailand was mentioned in both English-language newspapers in Thailand.
According to this study about 5 per cent of all drugs prescribed in Thailand are below standard. 7 out of 137 selected drugs covered in the study had less active ingredients than the amount stated. Only drugs used for treatment of heart and coronary ailments were tested, apparently in state hospitals, which account for 40 % of drugs dispensed in Thailand (20 % are distributed by private hospitals, and the rest by pharmacies). The below standard drugs were not named, nor was it disclosed whether they were brand name drugs or generic drugs.
From our understanding the problem seems to be related to improper storage and logistical problems. Exposure to heat, sunlight and humidity are involved.
In our opinion, these results are not surprising, and we would like to have data to compare these results with the results of tests in other, even more developed, countries.
What it does stress, is the need to properly store any medicine purchased. Any advice mentioned on the packaging (the problem is that you often do not get any written information with your drugs, even in hospitals) should be followed. Indeed, some medications and topical drugs like creams and ointments are better kept in the refrigerator. We noticed also that even some brand name drug tablets, can become brittle when kept at room temperature.
In conclusion, due to the excessive heat and often humidity in Thailand, it is more important to pay attention to proper storage instructions, and to check expiration dates more carefully. Indeed, if drugs have a tendency to deteriorate in quality, it may be wiser to acquire only recently manufactured products. In the case of creams and ointments, we would be even more careful. As a rule of thumb we only buy this type of medicine, when it has been manufactured within the last year. After all, often cream and ointments are supposed to be kept at room temperature (less than 25 degrees). You can imagine how high the temperatures soar in open air, and in non-airconditioned rooms.
What is unresolved is what the recommended storage temperature for drugs actually means (it is never mentioned on the packages, actually). If drugs have to be stored at a temperature of 25 degrees (Celsius, that is) or kept in the refrigerator, we assume that this recommendation only applies after the drug container has been opened. If this is not so (that is, even on display in pharmacies) then a lot of medication in Thailand is kept in suboptimal conditions.
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