Diabetic Wanting to Work in China

[cueball]

Hi,

I want to work in China long-term but I have Type 1 Diabetes (fully insulin dependent). This condition requires constant medication and is costly. I reckon about £2000 per year. In the UK all medication for T1 diabetics is free but of course in China the situation is much different.

I just wondered if anyone can give me some info about this? Do some company's support expats with this condition? Chinese/home government government subsidies?

Would really appreciate your help!

Best,

Callum

[anonymoose]

What kind of work are you thinking of doing?

[JenniferW]

I used to work - teaching English in a university in a provincial capital - alongside someone with type 1 diabetes. He'd been working in China for several years, and is still there, and expects to be there many more years. I can't tell you how he handled his insulin supplies, but do remember from another diabetic friend visiting China that she thought he was a bit behind the times as regards what he was getting in China compared to what was now common in the UK - I assume with regard to technology for delivery.

His only problem was in travel - in and out of the country at customs he'd sometimes get stopped and have to hang around for ages because people didn't initially understand what his supplies were. Travelling within China, he had problems with insulin storage - issues of refrigeration really not being understood, I think, and not always available.

[cueball]

@anonymoose *What kind of work are you thinking of doing?*

Something office based perhaps in Human Resources or Marketing. In the short-term I may teach English. I have no idea about how T1 diabetics are supported within Chinese or Multinational company's - if they are at all or if there are disability regulations in place to support people like me. I also have a Chinese friend helping me but waiting for her response. Her brother has a company in China.

@JenniferW *I can't tell you how he handled his insulin supplies*

I lived in China for over a year and bought insulin etc. Everything was the same except glucose testing kit, which was out-of-hat (by UK standards) by 8 years. Getting access to supplies is straightforward but funding I'm still not sure.

[abcdefg]

Do some company's support expats with this condition? Chinese/home government government subsidies?

It would be very surprising to learn that the Chinese government subsidized an expat's expenses related to the care of a chronic medical condition.

As to the company you work for picking up the tab, I'm not sure but I doubt it unless your father-in-law happened to be the CEO. Most likely you'll have to cover such expenses on your own like you did last time.

[gato]

I have no idea about how T1 diabetics are supported within Chinese or Multinational company's.

Some multinationals will provide their expat employees international health insurance policies, which probably would cover expenses for diabetic treatment. This will be a good question for your potential employers.

[xiaocai]

How long do you plan to stay in China this time? And if you don't mind me asking how much insulin you have to use in one year? Is possible for you to bring a full year supply from UK over to China? If the cost of transport is less than £2000 per year and you can't find a suitable funding here then it may worth a try.

[cueball]

[This will be a good question for your potential employers.

yes, will need to make some inquiries..

How long do you plan to stay in China this time? And if you don't mind me asking how much insulin you have to use in one year? Is possible for you to bring a full year supply from UK over to China? If the cost of transport is less than £2000 per year and you can't find a suitable funding here then it may worth a try.

Plan to work in China indefinately. The UK NHS will provide only 3 month supply for UK citizens outside of the EU due to UK-(non other) governmental partnerships in this area. Shipping insulin would be a big problem as it needs constant refrigeration (and a maximum 12 hours exposure). Another option would be to traverse home every 6 months or so but of course this could affect my carrer prospects. The would be plane ticket expenses could be used for the insulin I guess.

My next is to contact employers directly and see what they say.

[Iqbar]

Hi Callum,

The figure of £2000 seems inflated to me. On the British National Formulary, a 5 pack of insulin cartridges (Lantus/NovoRapid) works out at around £40 (more if you're pumping the same volume). Commercial prices are obviously higher, but you'd have to be getting through an awful lot of insulin for that to be the major expense. Testing strips are expensive but you can cut your usage to around 2 a day (I use c. 1.5 a day in the UK, but in China I used a lot more because the climate was so different from what I'm used to - as you get used to how you react to the climate this would be less of a problem). Some meter strips are much cheaper than others - ask a doctor, peek around in Boots or check the BNF.

A lot of the cost to the NHS is in the staffing. If you're only going for a year or so, I'd just go without your regular consultancy check up, assuming your control is good and you're not at the stage in life where you're expecting your kidneys to pack up or your feet to fall off.

So, assuming 50 units a day you're looking at about £280-£400 on insulin. 2 strips a day works out at around £300. Much less than £2k.

In theory, you shouldn't take more than 3 months with you on the NHS (but you can take that much and a doctor isn't going to notice you taking much more)

[xiaocai]

Maybe shipping insulin from UK to China is not that practical now due to the 3 month supply restriction.

As for the price, I think 110RMB per 3 ml is reasonable for Lantus, Novorapid (and any other fast acting ones) should be significantly cheaper (about 65-70 RMB). If you want to get them from a more "reliable" supplier then they may charge you up to 50% premium on top; any figure more than that is ripoff.

But strips are much easier to transport. You definitely should consider bring them over if they are subsidised in UK, even not the full year supply at once.

[smalldog]

A friend of mine worked in China for two years and relied totally on insulin and glucose-testing stuff brought from the UK. Technically he shouldn't have got that on the NHS but a GP who knows you well can bend the rules. He said that the most liberating thing he discovered about diabetes is that insulin keeps for a lot longer without refrigeration than people say. He even spent seven months afterwards cycling from Beijing back to London with little access to refrigeration or supplies of insulin on the way.

[cueball]

Hi Iqbar!

The figure of £2000 seems inflated to me..

The total medical bill for 1 year stay in China was actually £1300 and this was in 2008 before UK-RMB exchange rate took a hit. That was inclusive of all medication and checkups. The strips were the main drain (5 per day) @ £800. Your quite right in that there are cheaper testing kits available and 2 strips per day would reduce expediture massively! However, for a T1 diabetic, optimal health is compromised based on 2 strips per day and not an option (for me) at any cost. The evaluation at £2000 is high but very safe (perhaps too safe but would have to recalculate). In terms of the savings implied you make some very good points.

..the most liberating thing he discovered about diabetes is that insulin keeps for a lot longer without refrigeration than people say..

He he, I would agree with that point although not sure about long-term retainability. Any surplus cartridge I misplaced in the past just got disposed of. Apparently, the insulin will go cloudy when it deteriorates, but I have yet to see this happen with the sythetic insulins I use. Now that you have mentioned it, I will conduct a trial! Besides, wont be going to China for another few months! Nice one! B)

[anonymoose]

So is it possible just to walk into a pharmacy in China and buy insulin without a prescription or anything?

[cueball]

So is it possible just to walk into a pharmacy in China and buy insulin without a prescription or anything?

From my experience in Shanghai (which was the only place I needed to buy insulin) the doctor needn't be consulted prior. As long as you know what you want they can just sell it over the counter within the hospital pharmacy. Not sure why insulin is so easily accessible although I could infer several propositions.

[zhwj]

As for the price, I think 110RMB per 3 ml is reasonable for Lantus, Novorapid (and any other fast acting ones) should be significantly cheaper (about 65-70 RMB).

In my experience (Beijing), Lantus runs around three times the price of Novorapid, 290 RMB vs. 95-110 for 3ml. I'd be quite interested in learning about a cheaper source.

My local hospital in Chaoyang District doesn't carry the more advanced formulations in-house, but there's a private pharmacy next door. They'll sell insulin without a doctor's prescription so long as you bring in an existing box or cartridge.

[xiaocai]

This is the wholesale price if you buy 25 cartridges or pens (i.e. Solostar) at once. But I don't think I can release the source, or I may get in trouble, . Even if the retail pharmacy charges you 100% markup it would still be no where near 290RMB. I have to say Lantus is seriously over priced in Beijing. Well, retail pharmacy is not really my expertise after all...