23 April 2013

Affordable Medical Care in Russia 2013

Russian pharmacies haven’t changed much since 2000.  This pharmacy has two windows... no impulse items, stationery, candy, as you find in US drugstores.  You never have to wait for a prescription to be counted, packaged, and labeled.

SDC11581 

A full week of medical appointments

After a long rest from tests and doctors, this week Larissa had me busy.   First,  the phlebotomist, then an annual echocardiogram to check on my pacemaker, later the  cardiologist, and finally a visit with a psychologist who follows heart patients.

Much of medical care in Russia is delivered by neighborhood clinics, some of it free, some paid.  There is a crush of mainly old people every day, and naturally the care tends to be impersonal and hurried.  It’s my good fortune that the expanded federal heart complex was sited just a few miles  from our apartment.

The Almazov Heart, Blood, and Endocrinology Center for Northwest Russia

I knew this first as a simple heart hospital in an old building where I stayed three times for the mandated 10 days after arrhythmia or edema.  Now it is housed in a government funded complex that looks like any modern medical institution in the US or Germany.

How people view their doctors...

Doctors are viewed much more matter-of-factly than in the US.  There isn’t a reverential attitude. Perhaps that’s because medical education is more available and most doctors still do not become wealthy.

No GPs

Medical care is provided in a clinical setting.  I don’t know of any general practice doctors.  No one takes the time to follow your health year in and out.  It’s up to you to figure out how to proceed through the complicated medical system of clinics, technicians, and specialists.

I now view a family doctor as a luxury that a cautious, well-read, and sensible person may do without.  Here all medicine is provided by clinic doctors, specialists, and technicians.  The Russian system is more impersonal but a lot cheaper, and usually effective.

Clean, modern, but not plush medical care...

Many doctors in Russia are women, while men predominate as surgeons.  A cardiologist appointment lasts half an hour. 

My cardiologist is highly qualified, and a kind woman, whom I’ve seen intermittently for most of my time in Russia.  She has a small office in Almazov where patients wait in comfortable chairs in the hall, but - typical for Russia – with no magazines or music.  She does all computer entry and copying during the appointment, Twith no secretarial help. 

Much less expensive than in the States...

Prices are surprisingly affordable - to an American - if  you stay away from the clinics for foreigners.  Russians view as normal that you can call 03 and have a doctor come to your apartment, no charge.  Same for an ambulance ride.

My ledger for last week...

(1000 rubles recently exchanged for $31.71)

Clinical and Biochemical Blood Test 1200 rubles $ 32
Cardiologist   800 rubles $ 25
Echocardiogram 1500 rubles $ 50
Cardiac Psychologist 800 rubles $ 32
                             $139

I’ve never seen a pharmacist in Russia.

Doctors indicate what to buy, but rarely write prescriptions, which are only required for strongly additive drugs.   Pills are sold by women clerks in the same boxes they are shipped in (not counted out of large bottles to little plastic safety containers as in the States).

Are medicines more affordable in Russia? 

Almost always!  I take these heart medicines every morning.  I feel lucky to not pay American prices. 

Diuver (Torasemidum) US brand Torsemide, loop diuretic... 10 mg... 789 rubles = $24.88 . Pliva Co., Zagreb, Croatia.

Hebilet (Nebivolol) US brand Bystolic, beta blocker... 5 mg... 758 rubles = $23.90. Berlin-Chemie, German subsidiary of Menarini, Florence, Italy.

Verospiron (Spironolactone) US brand Aldactone, potassium sparing diuretic... 148 rubles = $4.67. Gedeon Richter, Budapest, Hungary.

American braggadocio...

It’s irritating that some Americans continue to spout that the US has the best medical care in the world.  This reflects ignorance.

Russian medical care is in reach of most of the population, but is what I call spotty.  If you are lucky, or smart enough, and have the initiative to find the best doctors, medical care in the USA or Russia can be very good. 

Ironic...

Russia is gradually shifting to more platna (paid for) services, and higher prices... Ironic, as finally the US is trending toward a more egalitarian system.

Let us know!

My medical care in Russia has been one of the bright spots  of living here the last 13 years.  How do you view your country’s system?  Let us know!

 

4 comments:

  1. Agree with most of your analysis, I have to take to you to task on generic drug pricing. Having purchased medicines in Moscow and the US. I haven't seen all that big of a difference between the two. Brands names is whole different story.

    Here are verifiable prices from Costco. Also you do not need to be a Costco member to use their pharmacy. Prices quoted are found on their website.

    Torasemidum $5.90
    $5.90 for 30 pills
    BISOPROLOL FUMARATE 5 MG (Beta Blocker)
    $11.65 for 30 pills
    Spironolactone 25 MG (you didn't list the amount)
    $5.90 for 30 pills

    As you see Costco is cheaper.

    Physician and lab fees are more here and hospital fees are way higher. Yes, Doctors in Russia seem fine. My only major concern in Russia was lab work and the apparent lack of quality protocols as seen in Western countries.

    Well written and overall I agree with your conclusion.

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  2. Thank you Tampa Pirate for an interesting detailed response. I'm going to continue the investigation and change that part of the post to reflect reality.

    Just before publishing this item I saw with surprise that Walmart has generic Fluvoxamine (Luvox), in Russia, Fevarin... 15 tablets, 100 mg, Abbot... for $10.17. We pay $20.78.

    The younger Russians buy without much discrimination these days. This negative imbalance in drug prices has slipped by me up to now. I need to investigate whether generics are available.

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  3. Hi Rob,
    i am currently in St Petersburg and have liked reading your comments, would it be possible to meet for a coffee and a chat somewhere?. I am an Australian who has very little Russian and would be really interested to get some comments and suggestions from you. I am here until the 4th of June so i would hope to meet in the next couple of weeks if that would suit you.

    Regards

    Ian

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  4. Ian,if you get to read this, I wasn't able to reply as the system doesn't supply your email address. If you use the Wibiya strip at the bottom of the post, and click Contact Us, then I would get the particulars to contact you right away.

    I hope you're having a great trip. Please write again.

    ReplyDelete

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