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Psoriasis Medical Tourism in Mexico: My Story

Psoriasis Medical Tourism in Mexico: My Story

If you started following me, my Instagram and my blog recently you probably thought that I’m just like any other woman, carefreely traveling the world in pretty outfits. It’s hard to imagine that less than 2 years ago, however, I was sharing with you my photos and stories about my psoriasis. This is a story of my medical tourism in Mexico.

I was a contributor to a psoriasis column for two health publications, and while learning more self-confidence to ignore my flares by doing what I planned on doing and dressing how I planned on dressing or undressing, psoriasis has been a big part of my life. At some point, however, my psoriasis stopped being a problem and so I paused writing about it.

Did my psoriasis get cured? I’m sorry to disappoint, but psoriasis isn’t something that can be ‘cured’ forever as there’s no forever fix to an overactive immune system.

Did I learn to accept my condition? While I have realized that there’s no cure and I must live with it, I actually didn’t even think about it.

What changed then?

I stopped traveling full-time.

Since I left the Netherlands back in 2014 I’ve been bouncing between the US and London for a while, but without a proper base. By the time I moved to Playa del Carmen in Mexico my psoriasis was a complete mess, as you could see in some of my photos.

When you’re working remotely while traveling, this can sometimes lead to an unhealthy lifestyle. Working long hours or during awkward times without a routine or schedule can make one stressed or tired, especially if you have clients in different time zones.

In my case, I’ve left my skin without any treatment or care, and as a result, I was almost completely covered in psoriasis spots. I thought that my will to live just like any other human without a chronic disease was strong enough, and while mentally it was, physically my body didn’t really get the memo.

Over the years, various doctors in different countries have been testing multiple forms of treatment on me and every time I was moving they liked to start the entire psoriasis therapy from the beginning: topical creams, UV lights, steroid creams, charcoal products and other things that never really worked for me.

Knowing what I know about my illness and by researching a lot I decided to treat myself. One might say that we need doctors to tell us what to do and what medicines to take, and while it’s true you also know your body best.

plaque psoriasis
Before starting any type of treatment…

Becoming My Own Doctor in Mexico

By visiting different doctors in public and private sectors in Poland, United Kingdom, United States, Netherlands or Mexico I saw that dermatologists simply aren’t always able to follow up with every single new drug for psoriasis that comes out.

They treat many different conditions and with many drugs being available in some countries but not all, so many times it came down to them telling me that I need to tell them what kind of prescription do I need from them and whether they can provide it or not.

If you’ve been dealing with psoriasis for some years now you might know exactly what I’m talking about. We, those who deal with this condition have to research everything, see what works for us and basically treat ourselves with doctor’s supervision.

Once I settled in Mexico I researched all my options. As a digital nomad with no health insurance (no travel insurance covers chronic conditions) my options were limited to self-funded drugs.

In Mexico, most drugs are available over the counter. Quite often tourists and locals go to Mexico just to buy medicines, as they’re available over the country and are much cheaper. Not surprisingly I was able to get Methotrexate, an oral medicine, over the counter for psoriasis that I was prescribed back in the Netherlands.

With one small difference. In the Netherlands, despite my health insurance and prescription I had to pay 55 Euros a month for these pills and required weekly visits at the hospital for a check-up. It was expensive and required me to work from home for a day.

In Mexico, I could simply go to a pharmacy and ask for the box of Methotrexate, no questions asked. It was the same exact drug in the same exact box I was receiving it in the Netherlands, but I had to pay 80 Pesos for a monthly supply, which is around 3.50 Euros.

medical tourism in Mexico

Methotrexate Treatment

As I’ve had experience with this drug before I knew what to expect, double-checked the right dosage and controlled my blood tests, which can also be cheaply done in Mexico. By saying that I knew what to expect I knew that I’d feel bad after it, as it’s a strong dangerous drug and it’s often used to treat cancer, in bigger doses naturally.

Being my only available option I was happy with the results. My skin partially cleared up and before Matt and I left Mexico we were able to stock up on more boxes.


Psoriasis Treatment in the USA

When we moved to the US and set up health insurance, I was able to see the dermatologist and after explaining what I’ve been taking, showing photos and the stages of my skin, I was able to receive the correct biological drugs without any issues.

I’ve been wanting to quit Methotrexate, as you cannot take it for 6 months before even thinking of getting pregnant. (I wrote more on psoriasis and pregnancy here)

No one has asked me to show proof of previous medical history (which would be difficult, as the Netherlands won’t send your medical history to the US for instance), told to try stupid not working topical treatments all over again. 

My doctor and I decided to try Stelara, one dose every three months that I had to inject myself with. Truth to be told it worked miracles. Within a month my psoriasis has cleared completely. While we paid a significant amount of money for US health insurance as self-employed, my insurance had no issues with anything and I was happy.

psoriasis

Left: before Stelara. Right: after 2 doses of Stelara.


Until We Moved to Europe…

As Stelara, Humira and other biological drugs for autoimmune diseases got finally approved in some places in Europe, they’re officially being subsidized by the national public health system. 

After we canceled our US insurance we were denied residency in Italy and as a result, couldn’t enter the Italian health system. Our only option was getting private insurance, which isn’t actually a bad option for more people – just not for those who require biological treatment.

The problem is that biological immunosuppressant drugs are insanely expensive due to patent issues, hence why affordable alternatives cannot enter the market until 2022. Hence why no insurance company wants to pay for them.

Due to my pre-existing conditions and Stelara treatment I had to disclose, basically all expat insurances and private insurance companies in Europe decided to reject me. I’m not talking about not covering my biological drugs but rejecting me from the insurance.

It actually caused a giant mess that forced me to fly very last-minute from Italy to Poland to give birth in a private hospital, as Italian hospital decided not to accept me without insurance that I couldn’t obtain.

When I finally give up on signing up for national health insurance in Italy and Poland, as we weren’t able to do either, I thought I’d just use my savings and pay for my medicine out of pocket until we’re able to get on the US health insurance again.

Truth to be told, I’m one of a few people who like the US insurance but despises US pharmacological companies’ greed. The system isn’t ideal, leaving many without health coverage due to high insurance prices, but as pharma companies keep increasing prices of drugs out of green, the insurance gets more expensive. However, if you actually need specific treatment or surgery, it works. At least it always worked for me.

Speaking from my experience with European public insurances (which nota bene aren’t “free” as Americans like to state, because your employer actually pays for it out of your payslip), I remember even my family members waiting 2 years for surgery or over 6 months for a specialist visit and yes, that also includes oncologists. This is why many people go privately and pay out of pocket if they need to get something done quickly and efficiently. Which proved to be true…


Trying to Get Biological Drugs in Europe

Everyone’s impression was that once you actually have the insane amount of money to pay for a medicine you need, you’ll be able to get it. This wasn’t exactly true.

I visited various doctors in Italy, Poland, UK and heard the same thing over and over again: we won’t prescribe it to you

Dermatologists I visited either had no clue about Stelara’s existence or told me they don’t support biological drugs and won’t prescribe them. One doctor said the only way I could get it would be to go through the entire therapy with topical creams, UV lights, and Methotrexate, confirm its failure again, then check myself to a hospital and ‘maybe’ I’d be able to receive it there.

This is when I turned to my good old Mexico for help again…


Getting Stelara in Mexico

Upon my research and help of my friends, I was able to get a confirmation that I could get a prescription for Stelara, assuming I’m paying for the drug itself out of pocket. 

I ended up calling up multiple pharmacies in Mexico and found out that I can pick up Stelara from a pharmacy in Mexico City. And more importantly, it costs only 68,500 MXN (approx. $3530). I specifically said ‘only’, because in the US since January 1st 2019 when pharmaceutical companies increased prices, the retail price of a supply of 0.5 milliliters of Stelara is around $10,770. I need 4 doses per year. 

Psoriasis is extremely expensive.

farmacia de paris zocalo

I’m not surprised that Utah insurance companies prefer to send people to Mexico to get their drugs and come back. While I’ve had experience with buying drugs in Mexico before, I had no clue how would it look like to get a special drug. But, it turned out to be easier than ever, but frankly, if I didn’t speak fluent Spanish I would have had to ask someone to do it for me. 

Upon my arrival in Mexico City I checked the pharmacy website in the morning to see if Stelara is available – It was. I then called them to ask which branch I should visit and found out that Zocalo pharmacy has one. 

Even though I’ve lived in Mexico City before and wandered around Zocalo (historic center) a bunch of times, I never noticed a whole street filled mostly with pharmacies. To the extent, there were 3 pharmacies at one intersection, one of which was the one I was looking for – Farmacia Especializada. 

Sidenote: I later found out that a pharmacy next door – Farmacia de Paris, is actually a historic spot from 1944 that continues to develop more than 100 remedies on site. It also has a pretty historic system of getting the medicine out of the cellar, which works like the carousel – you should see it for yourself. 

Farmacia Especializada sells a lot of expensive medicine, but it’s still a ‘Mexican-style’ pharmacy which means it’s a pretty open-air type of shop with counters almost on the street. Hence why it was surrounded by a few security guards. 

The whole process took about 10 minutes, no questions asked. I received Stelara packed perfectly in a big cooler. As I wanted to stock up I asked for another one, but as they needed to order it I was told to come back in 2 days. What, ironically, was faster than when I had to order it in California. 

Farmacia Especializada

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As you can see medical tourism in Mexico has saved me twice. When I shared my story on my Instagram post, many of my followers decided to share their medical tourism stories. Do you have any questions? Want to share your story or concern? Write it below in the comment section.

Ilya Z

Sunday 17th of July 2022

Thanks for the post. I get Stelara, but not as often as I need due to insurance restrictions. I am traveling to Mexico anyway and wanted to try getting a Stelara medication much in the way you are doing it. I have a couple questions :

1. I noticed you got the prescription at the pharmacy. What documentation do you need to present the need for Stelara? I require 90mg / 4 weeks, but get it every 8 weeks instead.

2. Do you have a referral for a reputable Cancun pharmacy. I am quite familiar with US Stelara packaging and does one in Mexico look the same?

3. Stelara will reimburse up to $20,000 in costs per year in US. Have you or anyone else ever tried to get that reimbursement for purchases made in Mexico?

Anna Karsten

Monday 18th of July 2022

1. Just yourself, nothing ;-) 2. Not for Stelara I'm afraid. Call Farmacia Especializada and ask if they could deliver to you (https://www.farmaciasespecializadas.com/medicamentos/detalle/21997-stelara-45-mg-jgp-c1). Last time they only had Stelara in branches in Mexico City. Packaging looks the same, because there's no generic version. 3. I have that card now, and unfortunately no - that won't work, because you cannot use this card to pay for the medicine abroad.

Karren

Tuesday 5th of July 2022

Thank you for all you knowledge about the prescription woes! Do you happen to know anything about Tremfya? I’m retired and on Medicare and have just been prescribed this for my psoriasis. Insanely expensive even with my Medicare and secondary insurance coverage… really cost prohibitive! I’m approximately 2 hours from the Juarez, MX border… Also curious if you have to see a dermatologist in Mexico for a scrip before purchasing the biological from a pharmacy and how I’d go about finding a dermatologist that could write a script for it. Obviously would like to know a cost for a dosage which is every 60 days. Thank you for any help you could give… BTW, I speak zero Spanish and am really nervous about traveling and being able to communicate. Thank you!

Anna Karsten

Friday 8th of July 2022

I don't know about dosing Tremfya and prices out of pocket for you on Medicare, but I know it's available in Mexico for 3040 USD - that's the cost per shot. It's easy to get a prescription in Mexico, but you would need someone who speaks Spanish because it's not available at every pharmacy. Especializada could probably ship it somewhere closer to Juarez. P.S. Have you checked the Janssen program? https://www.tremfya.com/plaque-psoriasis/cost-support-and-more

Roberto

Thursday 30th of June 2022

@Anna Karsten,

Hi Anna, thanks for sharing your experiences with psoriasis and making this information available.

I'm in the US (Austin, TX) and have been taking Humira for decades. It IS very expensive and the prices has steadily gone up. Even with insurance, I was paying about $10K/yr up until last year.

I've been on Medicare (retied senior) for the past five years and this year AbbieVie, through my dermatologist and pharmacy, offered my prescription FREE to me. zilch, nada, zero.

It is a NEW program (for 20220 that you apply for in October in the preceding year). You must have a dermatologist file additional forms in your behalf but I received approval in about three business days and everything was done online.

Some comments:

First: I think AbbieVie is doing this because they will have competition here in the states going forward. My insurance company pays but my portion of the bill is eliminated.

Second: AbbieVie did offer the program in the past but this year they eliminated the need to report your 'net worth.' (Because home values have been increasing here in the states, this and a small nest egg would disqualify many applicants from this program in years past.) I believe the total earned income for two is capped at $140,000 -- don't recall the deductible amount when applying as single.

Third: Your existing pharmacy may offer to help you file your application. Don't do this. I found mine made errors and this may be common. Work with a dermatologist.

Note One: Use the AbbieVie website for the most current form YOU will need to file. This form does not ask what your net worth is. The old forms (asking the net worth question) are still floating around so be sure to get the newest application form. In prior years many people were disqualified based on the savings/net worth.

Note Two: If you want to take advantage of the program I would suggest that you start by finding a dermatologist who currently prescribes HUMIRA. Find one who has been doing this for a number of years if you can. Find one with lots of HUMIRA patients, if you can. Discuss your goals in your very first appointment. Talk to one of the physician's assistants before your first meeting if you can. A good dermatologist will know the situation you are dealing with and do everything they can to help you.

Good luck.

Roberto

Eric

Thursday 9th of December 2021

Hey Anna, thanks for sharing your wonderful story!

I've got an autoimmune disease that's so rare there aren't many treatments indicated for it yet aside from Prednisone. There are some people who've had luck with Humira so I've been trying to find a doctor to prescribe it.

Would you mind sharing how/where you finally managed to get your prescription for Stelara? Speaking Spanish, traveling, and paying for the drug are no problem if I can find a way to get a prescription.

Anna Karsten

Thursday 9th of December 2021

At the pharmacy directly :)

Walter L Johnson

Wednesday 27th of October 2021

Remember that stress is the biggest factor in aggravating psoriasis and moving so often is stressful. Growing up I did that a military dependent but as an adult I have moved sharply less often being in my 2nd home in 44 years of marriage.

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