Black market prescription drugs: Illegally sold drugs may save lives

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  Quantumrun Foresight
• January 12, 2022

Insight summary

The black market serves as an alternative for individuals who struggle to afford or access necessary medications, despite the risks associated with unregulated products. This illicit trade can put pressure on pharmaceutical companies to lower prices, but it also poses health risks due to the lack of quality control and can fuel organized crime. To combat these issues, future reforms may focus on allowing government negotiation of drug prices, increasing law enforcement resources and establishing state-level initiatives to ensure medication accessibility.

Black market prescription drugs context

A black market is a kind of commerce that occurs outside of government-approved avenues, due to the sale of unlawful products and services. Either their acquisition and auctioning are banned by law, or they might be legal but exchanged to evade taxes. Meanwhile, the need for black market drugs often arises due to insufficient health insurance coverage, a sudden hike in drug costs, postponed physician refills, insurance plans that require prior permissions, or living in a country that lacks public healthcare. 

For example, in 2018, Trusted Source reported that 16 percent of diabetic patients took less medicine than recommended because they could not afford their prescription costs. Meanwhile, a 2018 research study concluded by PubMed Central also found that just around 1 percent of participants had problems obtaining drugs illegally, revealing the benefits of black markets for low-income patients in need.

Healthcare advocates worry that purchasing black market drugs may incentivize organized crime to target drug shipments or that consumers may be tricked into purchasing spoiled or outdated drugs. Likewise, it's often difficult to tell if packed, unopened drugs purchased from an online pharmacy are genuine, due to the growing sophistication of knock-offs.

Disruptive impact

The organization Patients for Affordable Drugs is working to reform a US statute prohibiting the government from bargaining drug prices with producers. If successful, the US may adopt laws allowing the government to bargain total medication costs, as is internationally acceptable. 

For instance, between 2012 and 2016, the cost of an insulin prescription in the US quadrupled, rising from $2,800 to roughly $6,000 per year. Given this escalation, there will likely be pressure on lawmakers during the 2020s to ensure essential drug prices do not become inaccessible to a majority of the population. Likewise, by the 2030s, as boomers age deeper into retirement and millennials grow in their electoral influence, US lawmakers will likely introduce laws to establish state-level initiatives to provide essential medications. 

Nationwide, many local US police departments lack the resources or mandate to investigate sales of illicit pharmaceuticals. It is likely that future reforms within this domain will help stop the inflow and increase the number of arrests associated with the sale of unauthorized drugs into the US.

Implications of black-market prescription drugs

Wider implications of black-market drugs may include:

• Encouraging deflationary pressures on drug costs as the pharmaceutical industry may be forced to compete more aggressively against black-market pharma competitors. 


• Increased funding for specialized police task forces and customs officers to implement stricter crackdowns again black-market drugs from outside the country. 


• The establishment of state-level initiatives to reduce the incidence of preventable mortality due to drug inaccessibility based on cost (e.g., ensuring insulin supply to diabetic patients). 


• An increase in health risks among users due to the lack of regulation and quality control, resulting in a greater burden on the healthcare system.


• The use of technology in the black market for prescription drugs, such as online sales and distribution, leading to an increase in cybercrime and challenges for law enforcement agencies in tracking and prosecuting these activities.


• An increased demand for professionals in law enforcement, cybersecurity, and healthcare to address the associated challenges.


• The production and disposal of black market prescription drugs leading to pollution and other environmental damage.

Questions to consider

• Do you believe black-market prescription drugs are generally safe?


• Do you believe that lower-cost, government-issued pharmaceutical drugs can act as a barrier to persuade people from purchasing such drugs on the black market?