Buying cheap insulin in Chumphon, Thailand

On a long-haul backpacking trip, a Type 1 diabetic will eventually have to buy diabetes supplies from a local place. I found myself in that situation while in Chumphon, Thailand, a small town in the south part of the country. I needed insulin – both basal and bolus, and some thyroid pills.

I have been using Lantus for my basal, and Humalog for my bolus, for a few years. They work well for me in tandem. And now, four months into this trip, the large supply I’d brought from Japan was running out. But how would I – traveling (foolishly) without insurance and with barely any money – be able to find and purchase more here in small-town Chumphon?

One possible answer is that I could go to the capital, Bangkok, where presumably supplies are easier to come by. But Masayo and I are enjoying Chumphon and the colorful characters at Kae’s Guesthouse; we want to stay.

So we rented bicycles from Kae and rode out to the provincial public hospital on the edge of town. They probably don’t see many foreigners here, but they bemusedly checked me in and told us to have a seat in the cavernous concrete waiting room. A large bird was flying in and out of the big open entrance, and why not: just part of the easy pace of life in Thailand.

Finally we went in to chat with the doctor. Surprisingly, the doctor was an attractive young woman, and she spoke pretty good English. I explained what I needed and she listened patiently.

This hospital couldn’t get Humalog, she told me. For that, I’d have to go to a private hospital over on the other edge of town where most foreigners tend to go for medical matters. However, the doctor’s consultation alone would probably be out of my price range; the Humalog would almost certainly be.

But her hospital could get me something called ActRapid. I’d never heard of it, but she said it ought to do the trick. I had to make a decision right then and there, and told her all right – go ahead and order me some.

We went back to the guesthouse and I was, as usual, grumpy. What if this insulin doesn’t work like I want? I can’t afford Humalog, even if the private place can get it. Could this mean the end of the trip? Why am I so poor anyway?

Whine whine whine!

I did some online research that night. As it turns out, ActRapid is similar to Lilly’s Regular insulin (“R”). I used that for many years before starting Humalog. Maybe this would work out all right. I wondered if I’d have to inject ActRapid half an hour before eating – that would be a tall order while I’m traveling and ordering unusual meals from roadside restaurants in rural Asia.

But what can a traveling diabetic do? I had to do my best and see what happened, while using my wits and instinct to guide my health decisions. And I don’t recommend starting a new kind of insulin without your regular doctor’s advice, but you have to be open-minded and realistic on the road.

A few days later I went back to the hospital and found the attached pharmacy. I had ordered several things, and wondered how expensive it would all be:

• Thyroxine pills, 100 micrograms (90 count) – I take Synthroid, a thyroid medication. The Thai doctor said this was the local version. I need 150 mcg a day, so I’ll take a pill and a half every morning.
• Lantus pens (3) – Unlike Humalog, I was able to get the basal insulin I wanted. Perhaps I should have ordered more than three.
• ActRapid (4 vials) – They didn’t have pens, so I had to get vials and syringes. That’ll be a pain in restaurants; I haven’t used actual syringes since they invented pens.

The great thing about this place was that they let me buy as much as I wanted of each thing. Four vials of insulin is a lot – 4,000 units! If it works out medically, this stuff will keep me going for months.

And the total price, including the doctor consultation? 4,300 baht, about $130. An excellent price; in the U.S. it would be several times that.

So I spent a relatively tiny amount of money for a large quantity of insulin that may or may not be okay for me. It’s a gamble. I can say that it all looks on the up-and-up; official, properly refrigerated, and far before the printed expiration dates. Let “most foreigners” go to the private hospital with their expensive doctors and indulgent selection of medicines – I’ll stick to the public places and shoot up insulin like the locals!

Further research has told me that finding Humalog is tough in general in Thailand, even in Bangkok. I think it was a good choice to take a chance with the ActRapid; I’ve used it a few times and it seems to work just like Humalog. I don’t even worry much about injecting thirty minutes before eating.

It’s nice that I was able to get by after running out of insulin in a small, hot, dusty town in Asia. At every turn, I am reminded that the diabetes travel gods are watching out for you. There’s always a way. You really can go anywhere with diabetes.

Have you ever bought insulin abroad?

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