Questions on cost of PEP at DSC vs Public Hospital

[Guest Guest Anxious]

I had unprotected sex in a folly. I was the top. Btm says he is clean, but I don't want to take the risk.

 

I am considering going to DSC Clinic tmr to enquire about PEP. 

 

May I check with you guys on what the total cost is at DSC clinic? I see their website states $500-$800. Under what circumstances is it $500.

 

Also, I do have CHAS blue card. Is going to NCID or NUH a better option, if there are subsidized medication, test and consultation, that could work out cheaper than DSC Clinic?

 

Sorry about all my questions about cost. I'm kinda cash strapped at the moment

 

Thank you

[Guest hmm]

I paid 550 for two-drug regimen. This is not including consultation fees. 

 

[Dr T]

On 10/29/2021 at 12:16 AM, Guest Guest Anxious said:

I had unprotected sex in a folly. I was the top. Btm says he is clean, but I don't want to take the risk.

 

I am considering going to DSC Clinic tmr to enquire about PEP. 

 

May I check with you guys on what the total cost is at DSC clinic? I see their website states $500-$800. Under what circumstances is it $500.

 

Also, I do have CHAS blue card. Is going to NCID or NUH a better option, if there are subsidized medication, test and consultation, that could work out cheaper than DSC Clinic?

 

Sorry about all my questions about cost. I'm kinda cash strapped at the moment

 

Thank you

Can contact me via Line: Genethica

or email dr.taufiq@pulse-clinic.com

I can advise you further on the details

[Guaiguaihunk]

On 10/29/2021 at 12:22 AM, Guest hmm said:

I paid 550 for two-drug regimen. This is not including consultation fees. 

 

 

Does this include all the test they ask you to take? Consultation is only $20++ right?

[30yochinese]

On 10/29/2021 at 12:16 AM, Guest Guest Anxious said:

I had unprotected sex in a folly. I was the top. Btm says he is clean, but I don't want to take the risk.

 

I am considering going to DSC Clinic tmr to enquire about PEP. 

 

May I check with you guys on what the total cost is at DSC clinic? I see their website states $500-$800. Under what circumstances is it $500.

 

Also, I do have CHAS blue card. Is going to NCID or NUH a better option, if there are subsidized medication, test and consultation, that could work out cheaper than DSC Clinic?

 

Sorry about all my questions about cost. I'm kinda cash strapped at the moment

 

Thank you

Hi Guest Guest Anxious,

Sorry to hear about ur plight, 🥰😍Hugs, i have an alternative for u, which i did in 2019 & becoz i did this... That is why i am H.I.V. negative today. 1hour after gtg exposed as a Top, i went straight to N.U.H. A&E & was prescribed P.E.P(it was hassle free for me...mite be different for U...)

               

i can't remember how much the subsidised price is, but its def exceeds $150, for 1 week of the Post-Exposure Drug.

                                   

Hope that helps...😘take care!

Edited October 29, 2021 by 30yochinese
.

[Guest guest 123]

Hi, Guest Guest Anxoius,

 

Sorry to hear about your situation. You must be feeling extremely anxious.

 

Please note that if you want to take PEP, you should take it within 72 hours of potential exposure. The longer you wait, the effectiveness of PEP drops.

 

The comparison of public vs private

 

1. Public

DSC clinic is only open from mondays to fridays from 8am-11am and 1pm-4pm. it is closed on saturdays and sundays. Since time is of the essence, and if this happens over the weekend, it is suggested that you head to any of the A&E at the government hospitals (doctors and nurses will have PEP on standby as they themselves might have to take in situations where they have been in contact with blood from from a HIV patient). They should be able to prescribe you at least days' worth of PEP. Thereafter, you can head down to DSC on a weekday. The cost should be around $600-$700. I can't remember if this includes tests for other STDs.

 

2. Private.

Private clinics do charge a premium and my experience is that they charge about $2000 (excl GST). They charge additional if you do tests for different STDs and further charges apply for different methods (throat swab, anal swab and urine).

 

Hope the above helps!

 

[SimeiEast]

Out of curiosity, is PEP offered at A&E of all public hospitals? The below website says it's only available at TTSH.

 

https://www.nsc.com.sg/dsc/prevention-education/prevention/Pages/Post-Exposure-HIV-Prophylaxis.aspx

[Guest upset]

Is there a minimum period for drugs to be dispensed before it expires?

 

I was prescribed pep which is going to expire in a month time by private clinic. It's manufactured in year 20 but going to expiry in Jun 23 The doc said the drug is effective and can be consumed.

I explained that I would prefer to get pep which has a longer expiry date to be certain the drug is still effective especially we are preventing the infection of HIV and i spent $2.4k on it. In the end, the clinic obliged to change another bottle for me but i have to pay for the 1 tablet which i already took before discovering the expiry date.

 

[Guest PepOrPrep]

4 hours ago, Guest upset said:

Is there a minimum period for drugs to be dispensed before it expires?

 

I was prescribed pep which is going to expire in a month time by private clinic. It's manufactured in year 20 but going to expiry in Jun 23 The doc said the drug is effective and can be consumed.

I explained that I would prefer to get pep which has a longer expiry date to be certain the drug is still effective especially we are preventing the infection of HIV and i spent $2.4k on it. In the end, the clinic obliged to change another bottle for me but i have to pay for the 1 tablet which i already took before discovering the expiry date.

 

Are you talking about truvada prep for HIV or doxy pep for other STIs? They aren’t the same thing.

 

didn’t realise it was so expensive here. I bought mine online.

 

prep- $80 3 months daily use

pep- $50 15 doses

[Guest upset]

it's pep for hiv, cost me $2.4k for 28 days

 

[sgwildfire18]

I would like to share my experience getting PREP at DSC which I thought of taking to protect me and my partner.

 

1. I called up DSC and asked about the process of getting PREP. They told me to go down to see a doctor and that I can get PREP on the same day.

 

2. I went down the next day. The receptionist told me I was given the wrong information and that I needed an appointment to see a doctor. She told me I can get PREP on the same day as the consultation.

 

3. I went down today for my appointment and had to wait nearly 1 hour to see the doctor. He told me I needed to test for HIV and kidney (both of which I know) and that I can only get the PREP 2 weeks later (so much for preventing AIDS). He asked a whole bunch  of questions and then sent me outside to wait for my blood tests.

 

4. Outside, I waited another hour before I got called in for my blood test. The doctor told me that the other doctor had ordered a whole bunch of tests for me. I asked for the cost and was told it would be nearly $300. I said "NO. Forget it" .. he then lowered the number of tests to HIV and syphilis and said it would cost about $150. I said "No. Forget it" (the cost of HIV and syphilis would only be about $70 and I can get the results immediately). So he checked with the first doctor and they agreed to charge me for consultation which is $23.

 

5. I waited another 30 min to get my bill and passed the cashier $50. She waited to give the change in (10 cent / 20 cent) coins. Her excuse? She got no change.

 

6. I told her I would post my whole experience on the internet for all to know

 

[keyboard]

 

I would like to share my experience getting PREP at DSC which I thought of taking to protect me and my partner.

 

1. I called up DSC and asked about the process of getting PREP. They told me to go down to see a doctor and that I can get PREP on the same day.

 

2. I went down the next day. The receptionist told me I was given the wrong information and that I needed an appointment to see a doctor. She told me I can get PREP on the same day as the consultation.

 

3. I went down today for my appointment and had to wait nearly 1 hour to see the doctor. He told me I needed to test for HIV and kidney (both of which I know) and that I can only get the PREP 2 weeks later (so much for preventing AIDS). He asked a whole bunch  of questions and then sent me outside to wait for my blood tests.

 

4. Outside, I waited another hour before I got called in for my blood test. The doctor told me that the other doctor had ordered a whole bunch of tests for me. I asked for the cost and was told it would be nearly $300. I said "NO. Forget it" .. he then lowered the number of tests to HIV and syphilis and said it would cost about $150. I said "No. Forget it" (the cost of HIV and syphilis would only be about $70 and I can get the results immediately). So he checked with the first doctor and they agreed to charge me for consultation which is $23.

 

5. I waited another 30 min to get my bill and passed the cashier $50. She waited to give the change in (10 cent / 20 cent) coins. Her excuse? She got no change.

 

6. I told her I would post my whole experience on the internet for all to know

 

That experience does not sound good at all. There's also an expectation in Singapore that things are a lot more efficient than they actually are.

 

Here's some info from their website, https://www.nsc.com.sg/dsc/prevention-education/prevention/Pages/Post-Exposure-HIV-Prophylaxis.aspx

Had a colleague mentioned that in his country, the doctor treats the smallest thing then come back and check again if it worsens. In Singapore, the doctor treats the most serious thing then come back and lessen the condition.

[StockBottom]

 

I would like to share my experience getting PREP at DSC which I thought of taking to protect me and my partner.

 

1. I called up DSC and asked about the process of getting PREP. They told me to go down to see a doctor and that I can get PREP on the same day.

 

2. I went down the next day. The receptionist told me I was given the wrong information and that I needed an appointment to see a doctor. She told me I can get PREP on the same day as the consultation.

 

3. I went down today for my appointment and had to wait nearly 1 hour to see the doctor. He told me I needed to test for HIV and kidney (both of which I know) and that I can only get the PREP 2 weeks later (so much for preventing AIDS). He asked a whole bunch  of questions and then sent me outside to wait for my blood tests.

 

4. Outside, I waited another hour before I got called in for my blood test. The doctor told me that the other doctor had ordered a whole bunch of tests for me. I asked for the cost and was told it would be nearly $300. I said "NO. Forget it" .. he then lowered the number of tests to HIV and syphilis and said it would cost about $150. I said "No. Forget it" (the cost of HIV and syphilis would only be about $70 and I can get the results immediately). So he checked with the first doctor and they agreed to charge me for consultation which is $23.

 

5. I waited another 30 min to get my bill and passed the cashier $50. She waited to give the change in (10 cent / 20 cent) coins. Her excuse? She got no change.

 

6. I told her I would post my whole experience on the internet for all to know

 

 

This is truly ridiculous, and DSC is not even an underfunded NGO like AfA. It's an official MOH funded clinic, with bad service to boot (read the Google reviews)!  

[obgdcriv]

 

I would like to share my experience getting PREP at DSC which I thought of taking to protect me and my partner.

 

1. I called up DSC and asked about the process of getting PREP. They told me to go down to see a doctor and that I can get PREP on the same day.

 

2. I went down the next day. The receptionist told me I was given the wrong information and that I needed an appointment to see a doctor. She told me I can get PREP on the same day as the consultation.

 

3. I went down today for my appointment and had to wait nearly 1 hour to see the doctor. He told me I needed to test for HIV and kidney (both of which I know) and that I can only get the PREP 2 weeks later (so much for preventing AIDS). He asked a whole bunch  of questions and then sent me outside to wait for my blood tests.

 

4. Outside, I waited another hour before I got called in for my blood test. The doctor told me that the other doctor had ordered a whole bunch of tests for me. I asked for the cost and was told it would be nearly $300. I said "NO. Forget it" .. he then lowered the number of tests to HIV and syphilis and said it would cost about $150. I said "No. Forget it" (the cost of HIV and syphilis would only be about $70 and I can get the results immediately). So he checked with the first doctor and they agreed to charge me for consultation which is $23.

 

5. I waited another 30 min to get my bill and passed the cashier $50. She waited to give the change in (10 cent / 20 cent) coins. Her excuse? She got no change.

 

6. I told her I would post my whole experience on the internet for all to know

 

 

Thanks for sharing. This is terrible. No wonder people I know are getting prep online.

[mallow]

I’d like to share my recent experience. I struggled for a day with various thoughts and dilemmas—feeling embarrassed, ashamed, and concerned about possible HIV exposure. Eventually, I decided to go to Tan Tock Seng Hospital (TTSH) A&E.

I arrived and registered by 8:55 PM. The staff and nurses were very professional. When they asked about the issue, I simply said, “I may have had possible exposure to HIV.” I’m not sure if it was intentional, but the receptionist asked me to wear a mask before proceeding—perhaps to protect my privacy. I think this was actually necessary, given the circumstances.

I was soon called into a room for further evaluation by a nurse, with another nurse standing by. The questions included: “What happened? Why do you think you were exposed? Was it with a man or a woman? Do you have any fever, rashes, or sore throat? When did this happen? Have you traveled abroad recently?” After answering, I was directed to a waiting area with about 8–9 other people.

Around 50 minutes later, I saw the doctor. He was friendly, made me feel comfortable, and showed great understanding. He drew four small vials of blood for tests, including liver, kidney, hepatitis, and HIV panels (among others I can’t recall). As I have some kidney issues, he couldn’t prescribe the full 7-day course of medication. Instead, he gave me a 3-day supply and asked me to return the next day for additional blood work at the CDC, to reassess the results and adjust the treatment if necessary.

About 10 minutes later, I was called to pay for my bill and receive the medication. The bill amounted to $320+ due to the various blood tests which were not subsided. 

The Next Day

Due to my condition, I had to visit the CDC for further evaluation. The doctor there was a bit eccentric but still helpful. He switched my medication to one that’s safer for my kidneys, although it’s significantly more expensive—around $387 (with GST) for a 28-day supply. Other medications were more affordable, and the most expensive was Dolutegravir ($950+!! but luckily got govt. subsidy). I received a 14-day supply and will follow up again to continue the remaining 14 days, if necessary. The total cost for consultation, after government subsidies, was $327. So, for a full 28-day treatment, the total would be around $650. This doesn’t include the A&E visit. So, the total cost should be about $950 or just under $1,100.

For those without any issues, you may receive the full 28-day supply on the first day, and with A&E fees, I estimate the total cost would be around $730 or slightly more.

Before visiting TTSH, I called PULSE to inquire about PEP costs, which are $2,100 just for the medication. I’m not sure about DSC as their hours are very limited, and they’re closed on weekends. But based on my experience, TTSH seems like a solid choice.

Post thoughts

Honestly, I still feel intimidated and embarrassed by the experience, despite the overall positive outcome so far. I keep reminding myself that no one will remember me (which I’m pretty sure is true), and that this is just a short phase to get through for long-term benefits.

Thankfully, the costs weren’t as high as I’d seen on other websites. I do hope the government can provide more subsidies, if possible!

And lastly, always play it safe—no matter what!

Edited December 15, 2024 by mallow

[doncoin]

@mallow I am curious. Were you required to disclose the name or information on the sexual partner whom you believe to have exposed you to HIV? (For contact tracing purpose). 

 

There is nothing embarrassing about having sex. I think many people over concerned themselves with what strangers think. 

 

 

[StockBottom]

@mallow How long between your possible exposure to hiv and the start of pep? Do you have to go back after pep to follow up and test for hiv again? 

 

What are the medication given for pep besides dolutegravir? I know tenofovir disoproxil (not sure about alafenamide) can be quite bad for kidneys.

 

Yeah there's nothing embarrassing about having sex, it's a most normal condition.

 

That said, once you get hiv medication in Singapore, your record will be with the government.

Edited December 15, 2024 by StockBottom

[mallow]

@doncoin that’s a good point.  I didn’t consider that since it was with a stranger. But if it were someone I knew and they were HIV-positive, I’d like to think I could protect their identity. However, now that I think about it, if the doctor asked about their HIV status, it could be to check if they’re on medication and undetectable, in which case they wouldn’t be able to transmit HIV, and I wouldn’t have needed PEP.

 

And you’re probably right… it’s still somewhat of a cultural thing in many Asian communities where talking openly about sex is considered taboo. 

 

@StockBottom for me, it was about 28 hours. Yes, a follow up will be needed indeed. 

 

Also yes, I only realized the government records part when I was at the hospital. But I’d like to think I made the right choice in the end, haha!

Edited December 15, 2024 by mallow

[mate69]

41 minutes ago, mallow said:

@doncoin that’s a good point.  I didn’t consider that since it was with a stranger. But if it were someone I knew and they were HIV-positive, I’d like to think I could protect their identity. However, now that I think about it, if the doctor asked about their HIV status, it could be to check if they’re on medication and undetectable, in which case they wouldn’t be able to transmit HIV, and I wouldn’t have needed PEP.

 

And you’re probably right… it’s still somewhat of a cultural thing in many Asian communities where talking openly about sex is considered taboo. 

 

@StockBottom for me, it was about 28 hours. Yes, a follow up will be needed indeed. 

 

Also yes, I only realized the government records part when I was at the hospital. But I’d like to think I made the right choice in the end, haha!

 

Thanks for sharing

[singalion]

But at the A&E wouldn't you need to register with your NRIC, pass or other identity document?