drug prices in NZ

November 19, 2008 3:12 PM

What will prescription medications cost an uninsured US resident who is buying them in New Zealand?

First of all, I won't be actually uninsured. I'm quitting my job and heading to New Zealand for four months to backpack and pick apples. I'd prefer not to keep my present insurance through Cal-COBRA, because it's really expensive, so I'm applying for high-deductible insurance that includes overseas coverage. It won't cover my meds, because they're for a pre-existing condition.

I take 100mg Wellbutrin (bupropion) SR, and 50mg Luvox (fluvoxamine), daily. Even buying generic, without insurance they'd cost me something like $300/mo here.

My present insurance will let me buy only 60 days' worth of each medication at a time, and my psychiatrist will not prescribe me twice what I actually take. He will, however, write me scrips to take with. So, I need to either do something dodgy involving Canada, or actually purchase the meds in NZ.

I'm guessing they're not as expensive there as they are in the US, even for an un-government-subsidized foreigner. If they are, though, I may as well keep my COBRA insurance.

So. Any ideas how much it'll run me, or where I can go to find out?

posted by moonlet to health & fitness (8 comments total)

Sorry don't know the answer but you might try calling a pharmacy. Here's one pretty much at random Miramar Unichem Pharmacy [phone] - I would imagine if you called before you could fax them a copy of your scripts and they would give you a quote. Unichem is a chain of pharmacies so if you use www.yellowpages.co.nz you could find one that's near to where you'll be.

Also although I've never used them there are a number of online pharmacies in NZ - here's one http://www.onlinepharmacy.co.nz/ - again you could get in touch and get a quote.
posted by southof40 at 3:32 PM on November 19, 2008

I just rang my local pharmacy, and they told me that they can only dispense medicine when given a prescription written by a doctor here in NZ. So you would need to visit a doctor here first - perhaps a referral letter from your doctor would help. An article from earlier this year, says that travellers are incorrectly being asked to pay only the subsidised rates for their medicine due to the prescription system. However, your mileage may vary - you can't rely on that happening!

Pharmac manages all the medicines that are available in NZ; whether they are subsidised; and whether the 'real' version or a generic is dispensed. You can search their "Pharmaceutical Schedule" for details on your medicines and their status - I had a quick look and couldn't find anything, but you may have better luck.
posted by slightlybewildered at 4:10 PM on November 19, 2008

Pharmac manages all the medicines that are available in NZ; whether they are subsidised; and whether the 'real' version or a generic is dispensed

I think that's bit broad brush my understanding is that a doctor can prescribe things that don't have the blessing of Pharmac but they need to jump through more hoops to do it (effectively the doctor has to personally import it). Sorry can't find a reference for this but I remember hearing something on the radio about one drug or another which someone wanted and this was the mechanism used to obtain. Of course that's bit off course for the original questioner but I just thought I would mention it.
posted by southof40 at 4:21 PM on November 19, 2008

I've been using the Pharmac schedule myself just recently so happen to have a copy of the pdf (long story, but I won the argument with my Dr). Neither of your specific drugs are listed. Here is (hopefully) a link to the relevant part of the schedule online: http://pharmac.co.nz/patients/Schedule?code=A2205. Psych meds aren't always able to be prescribed by a GP, so it's possible that yours are psychiatrist only which in turn may mean they aren't listed in the standard schedule. I don't know how that works, sorry.

Pharmac are definitely the people to contact about availability, they oversee everything. southof40 is correct in that you can make an application to get a drug off schedule but that application still goes via Pharmac, so you never leave them out of the loop. Also there has to be a very good reason why you need to take that specific drug and not one that's on the schedule, which can mean jumping through hoops and trying other meds and whatever and could be a huge pain for your only four month long trip. There's info about this on the Pharmac site.

How much the drugs cost will depend on which one it is and where you get it from. You definitely will not be getting it subsidised (and I'd prefer you to be honest about this frankly, there's only so much money to go around and I'm sick of my meds being taken off the schedule because the money has been used up). This means you need to pay both the full cost of the drug (set by the manufacturer) and whatever markup the pharmacy puts on (which can vary apparently). So it pays to shop around. The pharmacy is required to tell you the exact breakdown of costs though, so you should be able to see how much is the medicine and how much is markup, helping you decide how much shopping around is necessary. If you can find it in the schedule that will show how much Pharmac funds, which in turn gives you an idea of it's full price (generally that plus either $15 or $3 depending on which level they work it from, I'm not sure which). Again, info is on the Pharmac site.

Your doctors visit also won't be subsidised and can cost around $60 (maybe more or less, again shop around). This will be both more expensive and harder to arrange if you do need a specialist to prescribe what you need, so definitely should find that bit out before you come. Picking apples is going to pay you a pittance at best and there's no health insurance or whatever done via your job here, so you really won't get any help.

Go to Pharmac first and find out if they're even available then what you'll need to do to get hold of them, then follow up with a few pharmacies to find prices. It could well end up being much easier to get hold of them at home rather than try down here. Four months travelling isn't really time to be messing around with alternative 'equivalent' meds so in your shoes I'd be focussing on a steady supply of what I know already works.
posted by shelleycat at 6:03 PM on November 19, 2008

And you know, reading through the Pharmac site it's not totally clear to me that you can't be prescribed stuff that's not on the schedule. Just that it won't be funded at all (the special consideration thing for off schedule drugs may be about getting it funded not getting access, it's not clear). So it may be that your meds are as available as anything listed in there, and the funding makes no difference to you anyway. So definitely contact Pharmac to clarify.
posted by shelleycat at 6:13 PM on November 19, 2008

I've bought a year supply of meds for a backpacking trip. My doctor was able to give me 6 months of samples although it wasn't as serious a drug. She also wrote me a prescription that allowed me to buy the rest at once (although at full price). I also buy drugs over the counter in a lot of countries but they were non-western and didn't require a prescription like NZ would. That's great if you can fnd a policy that covers you out of the US (especially if you find one that doesn't have a rider excluding Welbutrin). I couldn't find one that covered me if I left the US more than 90 days and now I have a gap in coverage which I couldn't find a way around.
posted by Bunglegirl at 7:11 PM on November 19, 2008

It says something about me that it didn't even occur to me to call a NZ pharmacy. No, asking strangers on the internet is clearly much easier. :)

slightlybewildered, thank you so much for calling the pharmacy, and shelleycat, thank you so much for clarifying things on Pharmac.

It sounds like it will be much easier for me to a) try to sweet-talk my psychiatrist into double-prescribing my meds, or b) do something dodgy involving Canada.

Thanks, all!
posted by moonlet at 8:39 PM on November 19, 2008

This askme is a couple of years old but indicates that Welbutrin at least isn't available here, which matches the idea of you only get what's on the schedule. It's probably going to be a lot easier to convince your Dr if you can point out that you literally can't get your meds here, so if he won't give them to you you'll have to go without.

If you do bring the whole four months worth (actually, even if you only bring some) make sure you have a note from your Dr etc. NZ customs website gives a brief outline over here.
posted by shelleycat at 10:07 PM on November 19, 2008