A Kiwi dad who's dying of lung cancer has been bypassing the Pharmac system to get cheap pharmaceuticals directly from India - and says thousands of other patients could do the same.
Baden Ngan Kee was diagnosed with terminal lung cancer - despite having never smoked - in 2016. By October last year the cancer had spread to his brain.
His doctor suggested three cancer-fighting drugs that could extend his life, including one targeted therapy. But none were funded by Pharmac, the Government's drug-buying agency, so they would cost him a prohibitive $23,000 a month.
Desperate for more time with his wife Katherine and their three young children, Ngan Kee turned to Google.
"When you're terminal, with a young family, time is everything," he said. "My mission is to build memories for my kids."
The Remuera 54-year-old found the brand-name drugs were available cheaply in India, and generic versions would cost even less.
India is lax about patent laws and has a flourishing generic drug industry, which keeps prices low. All three drugs would cost Ngan Kee less than $1300 per month.
He turned to New Zealand's Indian community, who pointed him to a trusted oncologist in India. Ngan Kee emailed the doctor his medical records, and was prescribed the required drugs.
Kiwi Indian contacts brought the medicines back, along with prescriptions from New Zealand and India and a doctor's letter of compassion. They declared the pharmaceuticals at Customs, and were allowed through.
Ngan Kee has also had the drugs posted directly to a Kiwi pharmacist willing to dispense them.
The Herald has not named the drugs Ngan-Kee has imported, as he is concerned about breaching patent law.
Using mass spectrometry, a contact tested both the brand-name and generic drugs he'd imported. They were chemically identical to the branded versions available here.
Ngan Kee believes the drugs gave him at least an extra year of life, but they have now stopped working and he expects to live a few weeks or months. He is on chemotherapy and funding his own Keytruda injections, but has little hope they will work.
"This is not against Pharmac. I just want people to know, if you're in a situation where you can't access drugs, there's a way you can do it. Do what you need to do to stay alive," he said.
"In my experience the Indian community is a big one and a kind one. There was someone on the other side who helped me out of compassion."
Pharmac funds many generic medicines but only once their patents expire.
Chief executive Sarah Fitt said once a patent expires other suppliers could sell a generic version which allows for competition and can lead to significant price reductions.
A Pharmac spokesman said one of Ngan Kee's three imported medicines, Pregabalin, would be fully funded from May 1. A drug company had also applied for one of the drugs to be funded for non-small-cell lung cancer.
Dr Ken Romeril, chief executive of blood cancer advocacy group Myeloma NZ, said blood cancer patients were also forced to go overseas for cheap knock-off drugs.
Some had moved to Australia to access Daratumumab, a new myeloma treatment. It costs $100,000 a year in New Zealand but is available in Australia on a compassionate access programme.
Another blood cancer drug, Lenalidomide, can cost $10,000 per month in New Zealand, but people import it from India for 10 per cent of that, Romeril said.
It is legal to import the drugs with a prescription, Romeril said. But there are serious questions around the efficacy of some generic drugs, he said.
"As long as there's a script, and a doctor, and that patient sends their script to India, it's OK," he said. "It's a legitimate option - but it's not ideal."
Most medicines in New Zealand are registered for use by Medsafe, which ensures generic versions are safe and work the same as the original brand.
Doctors can legally prescribe medicines that have not been approved by Medsafe, as long as they are an authorised medical professional. Three months' supply can be imported at a time for personal use as long as the person has a "reasonable excuse", Medsafe says.
Customs often intercepts packages thought to contain prescription medicines. Medsafe says it usually holds them until the importer can provide a valid authority from their doctor or prescriber.