Project Doctor Shopping: Malaysian Edition

veritas in Malaysia.

Greetings from Malaysia! I am not dead yet, though I did have to
make another trip to the ER (drug related) before I came back. 🙂 I may
or may not be posting about that in the future since I’m still deciding
if doing that will reveal too much and break my anonymity. I will say
that it was the BEST service I ever had though, no triage nurses, it
was straight into a bed where I was hooked up with all sorts of
thingies and a doctor came immediately. Hypertensive crisis in
progress, heart failure probable. I would have enjoyed it if I wasn’t
really afraid for my well being. Heh. It was a bit too close for
comfort this time, please don’t take too much stimulants over a
prolonged period of time if you have an existing medical condition
which contraindicates stimulants (hypertension, heart problems etc).

I digress, that’s not what I’m talking about today. All turned out
good though, so fear not, veritas will not kick the bucket that easily.
😉 I hate it when people refer to themselves in the third person too,
so you’re not alone. Anyway, today I will be reporting about doctor
shopping in Malaysia. Yeah, you heard me right, doctor shopping, not
pharmacy runs. 🙁 Unfortunately, the days of freely available
benzodiazepines seems to be over…the pharmacies now display a startling
respect for prescribing procedures, and Xanax (alprazolam) and other
benzos seems to be getting the bad kind of attention due to unknown
instigating factors.

Front of the blister pack.

Pharmacy run attempts:

Pharmacy #1

This was the good one that I had no problems getting Xanax
(alprazolam) and Valium (diazepam) off of last time I was back home
(about six months ago). Unfortunately, they seem to have stopped all
restricted drug sales (or so they claim) and they don’t stock any
benzodiazepines anymore. Well, too bad, but I’ve had a nice haul from
this one last time I was back so it’s all good. Thanks anyway.

Pharmacy #2

I did not want to visit this one due to personal reasons. However, a
friend of mine gets her Xanax from here, so I know they stock the
stuff, but they’ve not displayed a willingness to hand over the goods
without a prescription the last time I was here, so I was not
optimistic about walking out with benzodiazepines. Nevertheless, it
won’t hurt to try, so in I walked and told them about my situation
(just got back from Australia, couldn’t bring my prescription back, can
I have some alprazolam please?). Well, they said they’ll be happy to
sell it to me, with a prescription, which I didn’t have. Oh well.

Pharmacy #3

They don’t carry restricted medications.

Pharmacy #4

They also don’t carry restricted stuff.

Pharmacy #5

This was attached to a medical center so I doubt they will sell it
w/o a prescription but again, it won’t hurt to try, so in I went. The
counter was staffed by only a single girl, who was friendly even though
I think she suspected I was attempting to acquire benzos for
recreational purposes. I asked for alprazolam and told her my situation
(see above) and she pulled out this deliciously large container full of
generic 0.5 mg Xanax. The packaging looked like that beta blocker that
pharmacies #3 and #4 was offering me as an alternative, so I said it’s
not a beta blocker but a benzodiazepine. She said, this is a
benzodiazepine. Oops, my mistake, it was alprazolam. 🙂 Unfortunately,
she says that company policy does not allow her to sell it without a
prescription, but she suggested that I visit the medical center beside
and get a prescription, come back and she’ll sort me out. Sounds like a
plan, until I walked into the medical center and saw rows upon rows (I
am not exaggerating) of waiting patients. I doubt it’ll be my turn come
evening, so I walked back and *cough* asked if bending the rules would
be possible. She smiled and said they have regular stock counts so she
would not be able to sell even a small amount to me even if she wanted
to. Thus, Project Doctor Shopping had to be revived in Malaysia.

Back of the blister pack.

Project Doctor Shopping:

Doctor #1

I walked into this clinic because it was empty, so I didn’t have to
wait. After registering as a new patient, I got to see the doctor and
explained my situation. I have to add that I wasn’t properly dressed
for the occasion and my current attire (which revealed my tattoos –
something I found to be a hindrance when doctor shopping) probably
contributed to the lack of helpfulness from this doctor. He said they
didn’t stock Xanax, and he was unwilling to write a prescription for it
and suggested that I visit a clinical psychologist instead as they are
more qualified to issue these medications. The doctor also commented
that I was a bit young to be taking Xanax, he said that “it’s what old
people take” (his words). I refrained from correcting his presumption,
and he refrained from charging me consultation fees. 😉 No harm, no
foul, walked out in a couple of minutes and visited another doctor.

Consultation fees: RM 0
Medication fees: What medication?

Interesting fact: Every single blister pack has a different tablet
arrangement. The first one had all the tablets with the front showing,
the second one had all backs except for the last three, which were
fronts, and the third was all fronts, except for the first two and last
two, which were backs.

Doctor #2

I ensured I looked presentable before dropping in on this one.

Doctor: Hello, what can I do for you?
Me: Hello, I have been diagnosed with anxiety disorder.
Doctor: Yes, what medication are you taking?
Me: I was prescribed with 0.5 mg alprazolam twice daily in
Australia. I just came back, but unfortunately I could not bring the
medication back.
Doctor: I see. How long have you been taking it?
Me: Oh, about one and half years. I just graduated (shows him my
Student ID card) and my health insurance (shows him my Medibank Private
card) does not allow me to bring back the medication, so I have to get
a new prescription here.
I showed him the cards and offered him additional information
because it seemed like this was a go, and if it was, I wanted to
establish a long term relationship with the doctor, considering the
stricter pharmacy guidelines which have fallen into place during the
time I was away.
Doctor: Okay, I’ll just show you the tablets that I have.
(talking to nurse) Bring me the Upjohn tablets. Is these the ones that
you’ve been taking?
He shows me a blister pack of 10 x 0.5 mg brand name Xanax tablets. I examined the pack for a while and replied:
Me: Yeah, the packaging is different but the ingredient is the same.
It never hurts to play the ignorant patient. 😉
Doctor: That’s expected, the packaging would be different as
this are the ones packaged for Malaysian sale, but if it’s the same
thing, it’ll work like your last prescription did. How many do you want?
Me: How much are the blister packs?
Doctor: It’s RM 1.50.
Me: RM 1.50 for the blister pack?!?!?
Doctor: Oh, it’s RM 1.50 per tablet, RM 12 for a blister pack.
Me: Okay, can I have two blister packs please?
RM 1.50 = A$ 0.75. RM 12 = A$ 6. The price per mg of alprazolam is
RM 2.40 or A$ 1.20, not cheap for someone who paid A$ 26.40 (RM 52.80)
for 200 mg of clonazepam. Clonazepam is equivalent on a mg to mg basis
with alprazolam so that works out to just RM 0.26 or A$ 0.13 per mg,
almost 10 times lower than the price I’m getting in Malaysia.
Doctor: Sure, just remember that this is a restricted drug, so
remember to carry the authorization letter with you (?) and don’t give
the tablets to anyone else.
Me: Yeah, I’m aware of that. Oh, can I have three blister packs? It would be easier to come back in 15 days instead.
Doctor: No problems, I’m happy to sell you as many as you need.
Hehehe!
Me: Thanks!

Consultation fees: RM 0
Medication fees: RM 36 (A$ 18) for 15 mg of alprazolam (Xanax).
These are the Pharmacia & Upjohn brand name tablets, so it would be
more expensive than generics.

Xanax 0.5 mg pink tablets. Mmm…

Success! 🙂 This also established a possible long term relationship
with the good doctor and a good medical history with the clinic, so I’m
happy with the way things turned out. The clinic did not charge me for
consultation, and that was good. I went back to Pharmacy #5 and asked
if they were willing to sell me the generics with my “unofficial
prescription” and the she said that company policy requires a signed
doctor’s prescription for filing purposes, so it’s a no go. However,
she told me that the generic alprazolam they carry is RM 0.50 (A$ 0.25)
per 0.5 mg so that works out to be cheaper than the brand name Xanax
tablets. I’ll probably get a prescription next time I drop in on the
good doctor to get the generics instead. It was a good project, nice
and easy. 🙂