Medical freedom / M2
Drug approved abroad
The person wants to take a drug approved by the EMA or FDA but not approved in their own country, for a non-terminal condition.
What we score
Can they obtain or import it?
Default assumptions: Unless a vignette says otherwise, the person is a 30-year-old citizen of sound mind with no criminal record, acting alone, on their own behalf and not for profit, in an ordinary residential area. Where subnational units (states, provinces, cantons, Länder) make their own law, each unit is scored and the result is weighted by population. 'The state' includes police, prosecutors, courts, regulators, tax authorities and anyone acting on their orders, including platforms obeying takedown orders.
Score anchors
Both the law score and the practice score use these anchors. Half points are used when a country sits between two of them.
| Score | What it means for this vignette |
|---|---|
| 10 | Buy or import freely. |
| 8 | Personal import allowed with notification. |
| 6 | Personal import allowed with a local prescription, or recognition of foreign approval. |
| 4 | Only through a discretionary special-access scheme. |
| 3 | Import seized; administrative penalty. |
| 2 | Crime: fine or under 1 year. |
| 1 | Crime: 1 to 5 years. |
Evidence used: Personal-import rules; reliance or recognition pathways; special-access schemes; customs enforcement.
How each country scores
| Country | Law | Practice | Process | Score | Why |
|---|---|---|---|---|---|
| Switzerland | 8.5 | 8 | 0 | 8.2 | AMBV Art. 48 lets an individual import ready-to-use medicines not authorised in Switzerland in the small quantity needed for personal use (one month), with no notification or permit. Swissmedic says no documents are needed. Shipments of counterfeit or dubious products are seized, with fees from CHF 540. |
| Denmark | 7 | 7 | 0 | 7.0 | An EMA-approved drug is already authorised in Denmark through the central procedure. For a drug approved only by the FDA, personal import is allowed if the person can document it is for their own use: by post or luggage from the EU/EEA, and in luggage up to 3 months' supply from elsewhere (narcotics and doping drugs excepted). A Danish doctor can also seek a § 29 named-patient permit. |
| Czechia | 6 | 6 | 0 | 6.0 | EMA centrally authorised drugs are automatically valid in Czechia. A drug approved only by the FDA or another state can be prescribed by the treating doctor under Medicines Act § 8(3) if no equivalent is marketed in Czechia, it is registered in another state, and use is scientifically justified. The doctor must notify SÚKL. Patients cannot lawfully order prescription medicines by post themselves (§ 85). |
| Mexico | 6 | 6 | 0 | 6.0 | Reglamento de Insumos para la Salud art. 196 IV and COFEPRIS procedure 01-010-D allow importing a medicine with no Mexican registration for personal use. The patient files online with a Mexican prescription that includes the doctor's licence number. The permit is free, with a 10-business-day maximum resolution time. |
| Germany | 6 | 6 | 0 | 6.0 | EMA-authorised drugs are authorised in Germany automatically. A drug lawfully sold abroad but not authorised in Germany can be imported by a pharmacy on an individual order with a doctor's prescription, if no comparable German product exists (§ 73(3) AMG). Travellers may bring in amounts for personal use, and personal-need quantities may be obtained from EU/EEA countries (§ 73(2) Nr. 6, 6a AMG). |
| United Kingdom | 6 | 6 | 0 | 6.0 | Individuals may import an unlicensed medicine for personal use (typically up to 3 months' supply, not controlled drugs) without notifying the MHRA, but should hold a prescription. Border Force and the MHRA seize unlicensed products sent by post without one. A UK doctor can also prescribe an EMA- or FDA-approved drug as an unlicensed import ('special') from a licensed importer, at the doctor's discretion. |
| Singapore | 6 | 6 | 0 | 6.0 | Under HSA's personal-importation rules, a person may bring in up to 3 months' supply of an unregistered medicine for their own use, without prior approval, if they hold a valid prescription or doctor's letter. Controlled substances need HSA approval, and cannabis products and cell and gene therapies are banned outright. Supply through a Singapore clinic otherwise requires the Special Access Route. |
| New Zealand | 6 | 6 | 0 | 6.0 | An individual may import up to 3 months' supply of a prescription medicine, including one Medsafe has not approved, with a NZ prescriber's letter or prescription authorising the import. Customs may detain it until this is verified. Under Medicines Act s29, a doctor, nurse practitioner or pharmacist prescriber can also obtain an unapproved medicine for a patient under their care. The 2025 'consent by verification' pathway speeds approval of medicines approved by recognised overseas regulators, but it is open to sponsors, not patients. |
| Ireland | 6 | 6 | 0 | 6.0 | An EMA-approved drug is authorised in Ireland automatically, so the real case is an FDA-only drug. An Irish doctor, dentist or nurse prescriber can prescribe a medicine authorised abroad as an 'exempt medicinal product' for a patient under their responsibility, imported by a wholesaler that notifies the HPRA. Travellers may carry a reasonable personal-use quantity through customs, but Revenue says the personal-use exemption does not cover post or courier imports, which are detained. In 2025 the HPRA detained 13,898 individual consignments (763,027 dosage units) bought by members of the public, a 180% rise on 2024. |
| Netherlands | 4.5 | 5 | 0 | 4.8 | An EMA-approved drug is automatically authorised in NL, so the hard case is an FDA-only drug. Art. 40(2) Geneesmiddelenwet bans importing or supplying unauthorised medicines, so personal mail-order import is unlawful and subject to seizure. The legal route is a pharmacy import on a doctor's declaration (artsenverklaring) certifying that no Dutch-authorised medicine will do. The Inspectorate (IGJ) must approve it, within 8 weeks by law and about 4 weeks on average. |
| United States | 4 | 5 | 0 | 4.6 | FDA states that importing unapproved drugs is illegal in most circumstances. It may use enforcement discretion for a 3-month personal supply for a serious condition with no US treatment, under a US doctor's care. That is discretionary and does not cover drugs that have a US alternative. Small mailed shipments are often let through, but CBP and FDA can detain and refuse them. |