How much are the drugs you prescribe worth on the black market?

Medicolegal

By Michael Woodhead

20 Jan 2020

An Australian study has provided a rare insight into the economics of the illicit market for prescription pharmaceuticals.

A survey of 51 people involved in the supply of ‘diverted’ pharmaceuticals shows that some prescription medicines such as opioids fetch prices of $20-25 per pill on the black market, with the average selling price of diverted drugs being $14.

But the overall picture of illicit pharmaceutical trading was one of mostly small value deals often involving family and friends and with two out of five transactions being ‘gifting’ of prescription drugs to others for no profit, according to the study conducted by researchers at the National Drug and Alcohol Research Centre at the University of NSW

Their financial analysis of 111 illicit pharmaceutical drug transactions showed that the most common involved hypnotic-sedatives (38%), followed by pharmaceutical opioids (32%), stimulants (18%) and others such as gabapentin (12%).

About half the illicit pharmaceuticals (54%) were sourced directly on prescription from doctors, of which most (80%) were legitimate prescriptions and 20% involved illicit activities such as doctor shopping.

Where pharmaceuticals were not obtained directly from the medical system, 33% came from family and friends, 41% were obtained from illicit drug dealers and only 8% were bought online.

The study also showed that a 20% of the illicit pharmaceuticals were given away for free and 15% were traded for other drugs, alcohol or sexual services.

Diverted pharmaceutical Purchase cost per unit (eg tablet) Sale cost per unit
Opioids $9.60 $25.80
Sedative/hypnotics $1.25 $8.20
Stimulants $3.10 $7.40
Other $0.70 $10.10
Total $4.20 $13.70

 

Markups on sales of diverted pharmaceuticals were high, with suppliers earning a median of $3 for every $1 spent on purchasing drugs.

However for most of the suppliers interviewed the volume and frequency of sales of illicit pharmaceutical were modest. The study authors said the illicit pharmaceutical market was characterised by a few outlier suppliers making large profits, whereas three quarters of deals involved a profit of $120 or less.

The quantity sold per transaction was a median of five, with a gross revenue of $90 and the median profit of $58.

The median number of transactions was three over a six month period, which meant the average supplier would make a profit of $30 a month.

The study authors said that with pharmaceutical diversion on the increase, their survey findings provided unique evidence that the practice was complex and not always done on a large scale for personal profit. Therefore more nuanced responses may be needed to target diversion and reduce harms.

“These findings contribute to the growing discourse challenging traditional notions of ‘drug dealing’ as a highly profitable venture,” they noted.

“For most suppliers in our sample, diversion was not as financially lucrative as end-user studies have suggested.”

The findings are published in the International Journal of Drug Policy.

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