HealthCare: what you should know about the pharmaceutical drug ‘business’
Medicine and Pharmacies are difficult to control as virtually everything is permitted: advertising, selling, traditional medicines, non-prescription, home storage. Prices can vary from 1-to-10 for the same medicines.
Prescription and over-the-counter drugs are a volume and repeat business
Expats are mostly surprised by the volume of medical health advertising on prime time TV, even some foreign milk powder promise your child will have an IQ over 100 and grow tall as it contains 3xDHA.
- Advertising on TV promises to cure anything: “if you don’t see results for 1-to-3 month, you can return the medicine to us” the ad says.
- Doctors can prescribe and sell when consultations are around VND150,000, the selling of medicines averages x2.3 the consultation cost.
- Traditional medicine concocting packs of plants to cure you is still common.
- Regularly fake imports, copies or home made medicines are uncovered after more or less victims complains.
The below modern pharmacy brands account for only 1% of the distribution market: Way to go for investors, whilst trying to be profitable.
Patient healthcare cultural habits in Vietnam: blind trust of the educated
A 2020 study shows 73% medicines are taken straight from the hospital or doctor’s practice. On the 27% remaining, 26% is purchased out of street pharmacy and less than 1% of modern pharmacies using international standards purchasing, traceability and storage.
- Doctors’ words are final: they represent knowledge. Whatever medicine is prescribed and how often the ‘refill’ patients obey willingly. To the point medicines are prescribed and supplied in colored pills in separate transparent plastic bags, without any box and user guide.
- Then comes Pharmacist attitude and sales skills that can ‘prescribe’ virtually anything over-the -counter based on the symptoms Vietnamese ‘client/patient’ will describe to them. Note that the Pharmacist with the degree/knowledge that authorizes the pharmacy to open shop is usually absent from the sales counter.
- Traditional medicines ‘official’ and hear-say.
Pharmacy low level of compliance to best medical practice worldwide
To open a pharmacy all you need is to have or ‘borrow’ a pharmacist degree. With medicines sales of US$4.6Bn with 27% by street pharmacy, we have US$1.2Bn market.
- Over the counter or prescribed is not clearly defined.
- Imported brands, generics and fakes are very difficult to track by enforcement officials from the Ministry of Trade or the customs with hand carried carton boxes.
- Traditional medicines and enhancers bears the same value in the mind of the consumers.
- Some kind of regulations exist but not enforced.
The price for medicine in Vietnam can vary from 1 to 10
One common mistake expats make is to think medicine as a vital commodity. In a poor country like Vietnam however the variation is huge depending on the following factors:
- the medicine is imported via the official channel that includes registration
- going through the big pharma expatriate run office, the local distributor
- follow the logistics rules: transportation, cold storage and expiry dates
- paying the intermediaries to sell your brand
- the competition of generics that look alike
- some pure fakes illegal and dangerous are on the market
- the competition of demos or free hand carried over run stock
- etc…
All reasons above supposedly explains the much higher costs by international clinics -who must play by the rules- and still be profitable.
So what to do?
Based on our experience with medical consultations and bills, with the maze of various offers for medicine, here are a few tips to help you navigate clinic and pharmacy practices:
- For most medicine over the counter, you can purchase blind folded even if prices seem very low as the competition and the big pharma are having special prices for countries like Vietnam.
- If your treating doctor -usually Vietnamese– prescribes medicine without giving you the actual name, box, expected treatment duration and appoints you to come back for a refill. Beware!
- International clinics charge the highest prices, they offer you a certain guarantee. If you are insured or money is not an issue: go for it. For refills order in advance with them.
- For specialty medicine, get enough months of supplies in advance or friends/family from western countries to hand carry as they come based on your prescription they will need to buy at their trusted/regulated pharmacy.
Not planning in advance exposes you to have no choice but to buy generic or fall short of supplies. In Vietnam, as you may know after a while you can purchase anything, it is ‘just’ a matter of time, money or relationship. Especially when it comes to healthcare and medicine.
To receive the list of international standards clinics email us to medical@insuranceinAsia.com.
You can also read more on Healthcare in Vietnam.
