People are turning to the black market for their medicine – but why?
New research has shown that altruism, a lack of access, and affordability are three reasons why people with chronic conditions are turning to the black market for medicine and supplies.
Scientists at University of Utah Health and University of Colorado ran surveys to understand why individuals are looking beyond pharmacies and medical equipment companies to meet essential needs.
Results from the study were published online in the Journal of Diabetes Science and Technology.
Traditional healthcare is failing
In the research a single theme was common: traditional healthcare is failing people with chronic illness.
Today, many people with chronic conditions such as diabetes, are turning to online portals such as craigslist, eBay and social media to find medicine.
Michelle Litchman, lead author of the study and a nurse practitioner and researcher at the College of Nursing at University of Utah Health, said: “People have to make a decision. Do they want to maintain their health? And if so, what are the medications and tools that they need in order to stay healthy?
“In some cases, people have had to go to extreme measures and find a network that can supply their healthcare needs.”
An online survey of 159 people with diabetes and their caregivers showed the group had participated in different types of underground exchange activities, from donating (56%) to receiving donated goods (34%) to trading (24%), borrowing (22%) and purchasing (15%). Many had taken part in more than one kind of transaction.
Those who were engaging in this activity said it was due to lack of affordability and accessibility of the medicine. These comments supported statistics showing that over half of participants in the study engaged in underground exchange activities out of financial necessity.
In other instances, it was bureaucracy that got in the way. Delays in approval, filling a prescription or shipping prevented some individuals from getting supplies by the time they were medically needed. As a result, some resorted to making trades or accepting donations in order to meet their needs quickly and avoid hospitalisation.
“I most likely would have ended up with ketoacidosis but I was lucky enough to get insulin from another person,” wrote one survey participant.
The study’s senior author Sean Oser, University of Colorado, said: “People with diabetes resort to underground exchange of diabetes supplies and medications not because they want to, not to turn a quick profit, but because their needs aren’t being met.
“Some turn to others to get what they need to feel safe.”
Many weren’t engaging in underground trading for themselves, but rather had excess items they knew others could use.
“I… donate supplies to people who need them because it’s not fair for me to have excess while they struggle to survive, or even die, because our healthcare system is broken,” wrote another participant.
In fact, altruism was a prevailing motivation behind underground exchange. Some reported feeling a strong desire to help others within the diabetes community but at the same time were aware that circumstances are volatile.
Risks with black market medicine
A downside to acquiring medications and supplies outside the traditional health care system is lack of safety oversight, the study’s authors say. However, fewer than 1% of study participants who made transactions through underground markets reported safety concerns.
Poor shipping conditions could spoil medications without the recipient knowing. Another risk could be someone taking the wrong medication if it were inadvertently provided to them. Despite these risks, people continue to use underground exchanges because at this stage there are few alternatives, says Litchman.
Participants of the survey were mostly Caucasian women with a college education.
Litchman says that the black market for medications doesn’t appear to be going away soon.
Litchman said: “Underground trading of medications and supplies isn’t ideal, but what other real solutions exist so that people can actually get what they need without increasing bureaucratic delays and burden?”
“Our study points to an urgent need to improve access to medications that are essential for life.”