Unregulated Craiglist drug market rising due to sky-high prices

More Americans afflicted with chronic disease are turning to unregulated markets such as Craigslist to find insulin and other necessary medications because they can’t afford to purchase them at the pharmacy­­.

Seeking out discounted products outside of legitimate drug distributors is becoming more popular, and researchers from the University of Delaware, Cooper Medical School of Rowan University, Jefferson College of Population Health and ChristianaCare, sought to quantify and characterize the advertisements on Craigslist for insulin, albuterol and epinephrine (EpiPen). Researchers published their findings in JAMA Internal Medicine.

The researchers conducted a mixed method, cross-sectional analysis of Craigslist ads, categorizing them by drug type and calculating the price per unit. They also calculated the price difference between drugs sold on Craigslist versus the retail price as listed on Drugs.com.

Researchers searched for the three drugs on Craigslist in all 50 states from June 12, 2019 to June 24, 2019, uncovering 432 ads for insulin and albuterol in 240 cities in 31 states. They didn’t find any ads for EpiPens, which have seen a significant mark-up over the last several years that eventually landed one pharmaceutical company in front of Congress for questioning.

The vast majority of ads on Craigslist were for insulin­­, 327 out of 432. Insulin in particular has come under the limelight as its price has sky-rocketed, leaving those in need of the medication to ration their supplies or even travel to Canada to find the drug at a more affordable rate. On Craigslist, the price per vial of analog and human synthetic insulin were $372.30 and $123.19 less expensive than prices listed on Drugs.com, respectively, according to researchers.

Albuterol inhalers, by contrast were marked up on Craigslist advertisements––$18.77 more on average than retail prices.

Researchers also looked at the content of the ads in addition to the prices.

“Sellers were frequently motivated by altruism and aversion to wasting medication,” first author Akram Ahamed, of the College of Engineering at the University of Delaware, et al. wrote.

However, the unregulated aspect of Craigslist brings more safety concerns. Not to mention, selling prescription medications online or in any unregulated market is illegal.

“The content of many advertisements raised safety concerns about the quality and safety of the medications being sold,” Ahamed et al. wrote.

For insulin, selling through an unregulated market comes with additional health risks, as the handling and care of the medication is critical to its effectiveness.

“Unregulated resale of prescription medications is illegal and in the case of insulin, may be dangerous because improper storage can lead to loss of potency or contamination of the product,” Ahamed et al. wrote.

While researchers couldn’t confirm that sales happened and medication was exchanged based on the Craigslist ads, the study does confirm that seekers can likely find insulin and other necessary medications through unregulated online markets.