Register      Login
Australian Health Review Australian Health Review Society
Journal of the Australian Healthcare & Hospitals Association
RESEARCH ARTICLE

The incidence of personal importation of prescription medicines among Australians 45 and older: a cross-sectional survey

Narcyz Ghinea https://orcid.org/0000-0002-1457-7252 A B * , Andrew Roberts A , Tania Prvan C and Wendy Rogers A B D
+ Author Affiliations
- Author Affiliations

A Department of Philosophy, Faculty of Arts, Macquarie University, North Ryde, NSW, Australia.

B Macquarie University Agency and Ethics Research Centre, Macquarie University, North Ryde, NSW, Australia.

C School of Mathematics and Physical Sciences, Faculty of Science and Engineering, Macquarie University, North Ryde, NSW, Australia.

D School of Medicine, Macquarie University, North Ryde, NSW, Australia.

* Correspondence to: Narcyz.ghinea@mq.edu.au

Australian Health Review 47(6) 694-699 https://doi.org/10.1071/AH23143
Submitted: 23 July 2023  Accepted: 3 November 2023  Published: 20 November 2023

© 2023 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of AHHA.

Abstract

Objective

This study is the first to investigate the incidence of personal importation of prescription medicines among Australians aged 45 years or older, and the reasons driving this behaviour.

Methods

An online survey was distributed to Australians, aged 45 years or older, who were taking prescription medicines. Recruitment was conducted via Qualtrics. The survey was completed by 1180 respondents.

Results

In our sample, 1.8% of respondents had imported prescription medicines in the previous 12 months, 21.9% had not taken, or had delayed taking, a prescribed medicine due to cost, 21.9% described medicines as unaffordable/very unaffordable, and 17.7% took some budgetary measure to pay for their medicines. The most significant predictors (P < 0.001) of importation were doctors raising it as an option (1.0% vs 42.9%), awareness of the Personal Importation Scheme (0.8% vs 22.6%), believing that importing was safe (1.6% vs 20.9%), paying more than the maximum PBS co-payment for any individual medicine (0.4% vs 8.1%), higher monthly spend on medicines (1.0% vs 6%), and delaying or not taking a medicine due to cost (0.9% vs 5.0%). Almost half (44.4%) would consider importing medicines to save money.

Conclusions

Potentially hundreds of thousands of Australians are importing prescription medicines from abroad, and many Australians indicate they are willing to import medicines to save money.

Keywords: e-health, financial toxicity, health policy, health services research, non-adherence, parallel importation, personal importation, pharmaceuticals, quality and safety.

References

Australian Institute of Health and Welfare. Health expenditure Australia 2020-21. Overview. Australian Institute of Health and Welfare. 2022. Available at https://www.aihw.gov.au/reports/health-welfare-expenditure/health-expenditure-australia-2020-21/contents/main-visualisations/overview [cited 25 January 2023].

Australian Institute of Health and Welfare. Health expenditure Australia 2020-21. Non-government sources. Australian Institute of Health and Welfare; 2022. Available at https://www.aihw.gov.au/reports/health-welfare-expenditure/health-expenditure-australia-2020-21/contents/spending-trends-by-sources/non-government-sources [cited 25 January 2023].

Australian Bureau of Statistics. Patient Experiences, 2021-22 financial year. 2022. Available at https://www.abs.gov.au/statistics/health/health-services/patient-experiences/latest-release [cited 25 January 2023].

Cutler RL, Fernandez-Llimos F, Frommer M, Benrimoj C, Garcia-Cardenas V. Economic impact of medication non-adherence by disease groups: a systematic review. BMJ Open 2018; 8(1): e016982.
| Crossref | Google Scholar | PubMed |

Van Alsten SC, Harris JK. Cost-Related Nonadherence and Mortality in Patients With Chronic Disease: A Multiyear Investigation, National Health Interview Survey, 2000-2014. Prev Chronic Dis 2020; 17: 200244.
| Crossref | Google Scholar | PubMed |

Cutler RL, Torres-Robles A, Wiecek E, Drake B, Van der Linden N, Benrimoj SI (Charlie), et al. Pharmacist-led medication non-adherence intervention: reducing the economic burden placed on the Australian health care system. Patient Prefer Adherence 2019; 13: 853-62.
| Crossref | Google Scholar | PubMed |

Kleinsinger F. The Unmet Challenge of Medication Nonadherence. Perm J 2018; 22: 18-033.
| Crossref | Google Scholar | PubMed |

Ghinea N. Personal Importation and the law: protecting patients who import medicines for legitimate health care needs. J Law Med 2022; 29(3): 829-46.
| Google Scholar | PubMed |

Ghinea N. Do doctors have a responsibility to help patients import medicines from abroad? J Med Ethics 2022; 49: 131-5.
| Crossref | Google Scholar | PubMed |

10  Ghinea N, Lipworth W, Day R, Hill A, Dore GJ, Danta M. Importation of generic hepatitis C therapies: bridging the gap between price and access in high-income countries. Lancet 2017; 389(10075): 1268-72.
| Crossref | Google Scholar | PubMed |

11  Australian Institute of Health and Welfare. Medicines in the health system. 2022. Available at https://www.aihw.gov.au/reports/medicines/medicines-in-the-health-system#Non-PBS/RPBS [cited 25 January 2023].

13  Hong YR, Hincapie-Castillo JM, Xie Z, Segal R, Mainous III AG. Socioeconomic and Demographic Characteristics of US Adults Who Purchase Prescription Drugs From Other Countries. JAMA Netw Open 2020; 3(6): e208968.
| Crossref | Google Scholar | PubMed |

14  Lifeline. Cost-of-living pressures trigger record demand for lifeline’s resources. March. 2023. Available at https://www.lifeline.org.au/media/qhmfdsit/lifeline-is-here-to-support-people-struggling-with-the-mental-wellbeing-effects-of-cost-of-living-pressures.pdf

15  Ghinea N. Physicians’ legal duty to disclose more cost-effective treatment options: an examination of Australian civil law applied to personal importation. Aust Health Rev 2023; 47: 314-21.
| Crossref | Google Scholar |

16  McManus D, Naughton BD. A systematic review of substandard, falsified, unlicensed and unregistered medicine sampling studies: a focus on context, prevalence, and quality. BMJ Glob Health 2020; Aug Aug 5(8): e002393.
| Crossref | Google Scholar | PubMed |

17  PharmacyChecker.com. Drug Price Comparisons & Online Pharmacy Safety. 2023. Available at https://www.pharmacychecker.com/ [cited 14 February 2023].

18  ASOP Global. Find Safe Online Pharmacies. 2017. Available at https://buysaferx.pharmacy/find-safe-online-pharmacies/ [cited 14 February 2023].

19  Everyone.org. Every day, medicine access delays cost lives. 2023. Available at https://everyone.org/catalog/category/view/s/about-us/id/105/ [cited 14 February 2023].