Chile Forum

Just went to the doctor as am having problems with my asthma (all very efficient, appointment on the spot, electronic bono even though my ISAPRE membership is a little regular - I am proper RUT-less).

The real shocker, though, was I just went to Cruz Verde to get my prescriptions.. and my Flixotide inhaler came to $32,000. I thought I'd heard the pharmacist wrong or that the decimal point was in the wrong place, but no. The nasal spray came to $12,000. And the anti-allergy thing the doctor prescribed, which I couldn't afford because who takes that much money to the pharmacy.. came to $53,000. And these weren't big prescriptions, just for a month's supply of each one.

The question is, am I missing something really obvious that's making my prescriptions pretty unaffordable? I know that the pharmacies here are notorious for price-fixing. And I could have gone elsewhere and got a small discount with my ISAPRE card (and will do next time, just didn't have the energy), and I guess I'll search online for cheaper alternatives that the doctor could prescribe next time, but is this really the deal? Is it going to cost me $100,000 per month (plus my ISAPRE, which is probably half again) to have asthma in Chile? I guess I've been too used to the NHS's generous flat-rate prescription and pre-payment certificate systems.

It's a shocker isn't it and I used to moan about paying the flat rate NHS fee, lol. My son and husband had respiratory infections last year and their combined antibiotics came to 120 pounds plus the cost of the x-rays. I had heard something about the supermarkets wanting to sell certain medicines to offer them at a cheaper price and stop the price fixing by the chemists and there was something about the big chemists being fined last year for price fixing, but not heard anything since.

Unfortunately, prescriptions in Chile are a total abuse of the monopoly that the pharmacy chains have here. We do read from time to time that some non prescription items should be allowed to be sold by supermarkets but the law never gets changed , no doubt because of the usual coimas that go back and forth in most businesses and are notorious in the pharmaceutical area here. The NHS can be criticized for a lot of things but the prescription charges are an example of where it does beat other countries as does the wonderful feeling of knowing that if by some chance I need to hospitalised there, I´ll be able to walk out of the hospìtal without having someone asking about how the bill will be settled. We can´t have it always; at least we do have sun for 9 months or more a year in Santiago at least.
Just out of interest did you ask in the pharmacy if there was a generic subsitute available? This can often save you a fortune. Also it´s not unheard of that doctors prescribe the most expensive medicine available because of the kick backs, so you should ask the doc if there is an alternative is available. A good example is having the doc prescribe Nexium ( for reflux problems ) which is around $11000 whereas you can use any generic omeprazol for less than $1000, and your doc will confirm that if you ask him. There are many examples of these differences, so next time just ask the doc before you leave his office

Those prices are still very low compared to what you'd pay in the US. Not sure about Chile, but here in the US the markup on brand name drugs is not huge;
it is instead the manufacturers who charge the pharmacies the high prices. The pharmacies' profit margin brand name drugs is markedly less than the markup on cost of goods in altogther different lines of business. (posted by a pharmacist)

Yeah, just check out the price of aspirin or common painkillers in Cruz Verde, etc., pretty amazing cost per pill for someone used to paying a few dollars for hundreds of the same. Ditto what dfjordan said in re asking MD for generic, and I agree that I'd research it first and then ask MD. UK et al can keep their NHS, the price tag in pounds and freedom is much too high and the service lousy, though I suppose it is a great short-term deal for those who are looking to take plenty while contributing little. It definitely pays to research and use connections/trips elsewehere to arbitrage best of each system. For example, evil places like Walmart in the US sell a lot of very cheap generics, while many treatments are much cheaper in Chile. I have not explored ordering drugs from Canada, etc, I do not doubt that opportunities for greater arbitrage exist....along with risk of mail fraud, etc.

John Hyre,

JHyre wrote:Yeah, just check out the price of aspirin or common painkillers in Cruz Verde, etc., pretty amazing cost per pill for someone used to paying a few dollars for hundreds of the same. Ditto what dfjordan said in re asking MD for generic, and I agree that I'd research it first and then ask MD. UK et al can keep their NHS, the price tag in pounds and freedom is much too high and the service lousy, though I suppose it is a great short-term deal for those who are looking to take plenty while contributing little. It definitely pays to research and use connections/trips elsewehere to arbitrage best of each system. For example, evil places like Walmart in the US sell a lot of very cheap generics, while many treatments are much cheaper in Chile. I have not explored ordering drugs from Canada, etc, I do not doubt that opportunities for greater arbitrage exist....along with risk of mail fraud, etc.<br style="text-shadow: none;"><br style="text-shadow: none;">John Hyre,

The price tag is low overall for the NHS and you still have freedom, private health insurance in the UK costs a fraction of what you pay in the US. Incidentally the NHS service is good, since they will treat you for anything unlike US insurers who will kick you're arse out the door if you have a expensive problem, granted you have to wait a while for non life threatening problems but that's a small price to pay. If it's so bad why does the UK have a longer life expectancy than the US, we eat the same shitty food as you do.

You're right that the best way to get cheap medicine here is take advantage of trips out of Chile or use people who will be visiting to bring you medicine, I always get friends to bring me a vast supply of aspirin when they come, it saves a fortune.

Healthcare in Chile, provided you can afford it, should be seen as a consumer market. Do your due diligence, ask around, do the comparison shopping you'd do for every other significant purchase. If you want to apply here the logic you're used to from semi-nationalized systems in richer countries on the fast track to bankruptcy, I don't think you'll like what you get here.

Well, medicines would be 19% cheaper if the government didn't tax them.

I have read comments on chilean sites about small pharmacies, instead of pharmacy chains.
The name 'marsil' appeared several times, a lot of people said it is the cheapest in Santiago.
Here I C&P a few comments (in spanish) from chileans

"Aqui les voy a dejar un dato, yo hace mucho tiempo que me aburri de seguirle el juego a estas grandes cadenas farmaceuticas. Voy al centro de Santiago en la calle Artesanos en la primera cuadra del rio Mapocho hacia Recoleta, hay una farmacia que se llama "Marsil" esta casi llegando al mercado de la vega por la vereda norte. Alli se encuentran remedios casi a la mitad de lo que los venden en estas infames farmacias.
Es inmoral que se este lucrando con algo tan sensible como la salud de las personas, de ustedes depende de hacerle un boicot a estas farmacias y a sus ejecutivos. "

"Yo compro en una farmacia pequeña que está en Club Hípico con Av. Lazo, dos cuadras antes de Departamental. Y he salido ganando, pues siempre encuentro las cosas más baratas que en las cadenas. "


And of course, always ask for the generic

Thanks for all your insights... very interesting. rocksana, I shall definitely try the smaller pharmacies. And next time I'm with the doctor, I'll be more inisistent about generics, although the pharmacist didn't have one and I've never seen one in the UK (and the NHS always goes generic where possible). It's a shame I can't get anyone to bring inhalers over without some seriously rule breaking at home.

Two questions:
Any opinions about whether medicines are generally cheaper in Argentina - should I be trying to see a doctor and stocking up next time I go?
And anyone know of an ISAPRE or similar that has something like a part-pay prescription system? For example, when I lived in France, I only paid 10% of my prescription cost because my carte vitale paid most, and my mutual, to whom I paid a monthly subscription covered the rest. Not that the inhaler was at all expensive there, under €10.

Interesting how the thread became quite political Don't get me wrong, I'm not trying foist the NHS on Chile. It's hardly perfect. And I do rather like lots of elements of the private system here. But making prescriptions affordable is something the NHS does that is sensible and seems to work pretty well. For me, it seems incredibly unjust that managing an relatively easy to control illness like asthma is probably out of reach for so many - if I, a middle-income spoiled gringa has to think twice about drugs because my prescriptions plus ISAPRE are as expensive, if not more so, than my rent, how are others managing? I guess many don't. In the UK, it's in the NHS's interest for prescription medicines to be accessible as they have to pick up the pieces if, for example, a patient ends up in A&E every week with a massive asthma attack. Here, who cares?

try this, this is what we found after we contacted the insurance, under GES or something, no idea what it is, this is the translation i got from my gf who called Consalud... the insurance company has to provide you with certain things for free, asthma inhalers being one of them... if you have chronic asthma (i.e from a kid pre 18), doesnt matter if you only use your inhaler once a year), go to your insurance provider, they will send you to their SPECIALIST, not just normal doctor SPECIALIST, it will cost you abound $2 luca ($CLP2000) $US 4, if all is in check, the specialist will hand you a FREE yes FREE asthma Inhaler.....

also, use the Pharmacy associated with your insurance provider, it will be cheaper, up to 60% cheaper... this can all be found by reading your insurance providers website.... or in the case of consalud, login and there isa sacobrand tab where it does all types of cool discount stuff....

cafecreme wrote:Thanks for all your insights... very interesting. rocksana, I shall definitely try the smaller pharmacies. And next time I'm with the doctor, I'll be more inisistent about generics, although the pharmacist didn't have one and I've never seen one in the UK (and the NHS always goes generic where possible). It's a shame I can't get anyone to bring inhalers over without some seriously rule breaking at home.

Two questions:
Any opinions about whether medicines are generally cheaper in Argentina - should I be trying to see a doctor and stocking up next time I go?
And anyone know of an ISAPRE or similar that has something like a part-pay prescription system? For example, when I lived in France, I only paid 10% of my prescription cost because my carte vitale paid most, and my mutual, to whom I paid a monthly subscription covered the rest. Not that the inhaler was at all expensive there, under €10.

Interesting how the thread became quite political Don't get me wrong, I'm not trying foist the NHS on Chile. It's hardly perfect. And I do rather like lots of elements of the private system here. But making prescriptions affordable is something the NHS does that is sensible and seems to work pretty well. For me, it seems incredibly unjust that managing an relatively easy to control illness like asthma is probably out of reach for so many - if I, a middle-income spoiled gringa has to think twice about drugs because my prescriptions plus ISAPRE are as expensive, if not more so, than my rent, how are others managing? I guess many don't. In the UK, it's in the NHS's interest for prescription medicines to be accessible as they have to pick up the pieces if, for example, a patient ends up in A&E every week with a massive asthma attack. Here, who cares?

cafecreme wrote:when I lived in France, I only paid 10% of my prescription cost because my carte vitale paid most

Out of public debt, i.e. your medication was funded by future French taxpayers. The Sécurité Sociale accounts are heavily and increasingly in the red, to the tune of 20 billion Euros last year (régime général). Not surprising with political midgets like Bachelot in charge. It's a profoundly immoral as well as entirely unsustainable system. Thank you-know-who that Chile is not mimicking such trainwreck policies. The French system is not "affordable", it's kicking the can down the road.