A Vicious Cycle of Access to Excluded Medicines: Evidence from a Qualitative Study

Aim: Medications procured through out-of-pocket payments from abroad are often more expensive compared to local treatment options, and the process is further prolonged even when medications are brought in. This situation generates a vicious cycle for both those with purchasing power and those without. This study aims to examine the challenges associated with accessing medications procured from abroad and to provide stakeholders with evidence-based solutions to these challenges. Method: This study was conducted using a qualitative content analysis method with complaints of 68 patients in Türkiye about challenge to access their medications. Visual analyses were conducted using the MAXQDA program. Results: The most frequently encountered themes in patient statements are "victimization," "communication issues", "delays in medicine supply," and "addressing authorities to politicians." Patients with genetic disorders, dermatological conditions, those undergoing transplants, as well as individuals suffering from cancer, neurological diseases, cardiovascular issues, rheumatological conditions, and psychiatric or addiction-related disorders reported that delays in medication supply hindered their treatments or forced them to discontinue them. Additionally, patients indicated ongoing communication problems with foreign drug supply units, expressing difficulties in accessing medications and frustration due to their inability to receive treatment. Conclusion: In seeking solutions to these issues, they often held authorities and politicians accountable. This finding highlights the need for a more effective communication network between drug supply units and patients. A new system or reorganization of the current system is necessary to quickly address patient needs and make processes more understandable. Patients have expressed concerns about a lack of information regarding drug supply abroad.