A growing number of Australians are opting to personally import prescription medicines from abroad in what researchers are calling a drastic measure to manage healthcare costs.

Primary conditions for which prescription medicines are most commonly imported include diabetes, pain, arthritis and asthma, with patients frequently turning to overseas pharmacies on the advice of their doctors, according to a study.

The data were based on an online poll of Australians aged 45 years or older, which also found 22% had delayed or avoided taking a prescription medicine due to cost in the 12 months to December 2022.

Among the 1180 respondents, the same proportion also described medicines as unaffordable/very unaffordable, while 18% said they had needed to cut other spending to pay for them.

Some 21 respondents – or 1.8% of the sample – had imported at least one prescription medicine in the previous 12 months.

Extrapolated to the broader population, this indicated there could be hundreds of thousands of Australians importing prescription medicines each year, with millions more potentially willing to do so for financial reasons, said the study authors led by bioethicist Dr Narcyz Ghinea (PhD) from Macquarie University.

“Close to half of participants revealed they would consider importing medicines to save money, and almost a quarter of those who did not import medicines stated the primary reason was because they could currently afford to pay for them,” they wrote in Australian Health Review (link here).

“People who paid more than the maximum PBS co-payment for an individual medicine, who spent more on medicines per month, and who delayed or did not take a medicine due to cost were all more likely to import medicines.”

Interestingly, the most significant predictor of a patient importing medicines was whether their doctor had raised it as an option, with one-third of those who had done so reporting doctors had directed them to an online suppler.

Other key drivers were awareness of the federal government rules around medicine imports, confidence in the safety of imported products and cost pressures.

Those who were paying above the maximum PBS co-payment for any individual medicine and who spent above $100 on medicines per month were also significantly more likely to turn to imports, the study found.

“Our data also showed doctors were the most important source of information for patients about overseas suppliers of medicines,” the authors wrote.

“This suggests that many doctors are willing to help patients gain access to needed medicines through alternate means.”

“While our data does not provide insight into the reasons for doctors helping their patients, given the importance of cost in driving importation behaviour, it is possible this is an attempt to help patients bypass cost-barriers to care.”

The research also highlighted the importance of the TGA’s Personal Importation Scheme, which regulated medicine imports for personal use but did not collect complete data. While awareness of the scheme was strongly correlated with a patient having imported prescription medicines, the direction of causation was unclear, according to the authors.

“It is important to note that many platforms already exist to help patients navigate the online medicines market, for example: PharmacyChecker.com, which for two decades has provided customers with price comparisons across verified international pharmacies; the Alliance for Safe Online Pharmacies which provides information on reputable pharmacies (but currently excludes pharmacies outside of Canada, United States, or the European Union); the independent medicines intermediary and international pharmacy Everyone.org registered with the Dutch Ministry of Health; and various buyer clubs that connect patients to affordable medicines.”

“Online trading platforms such as IndiaMART, can also help patients find suppliers for almost any medicine, including heavily discounted versions of high-cost medicines for cancer and other conditions.”

“Such platforms represent the inevitable expansion of e-commerce into the medicines marketplace and forecast things to come.”