Hong Kong retiree Donika Liu leaves her home in Tsuen Wan at 8am and starts a 90-minute train journey across the border to Shenzhen. At the University of Hong Kong–Shenzhen Hospital in Futian, she sees a doctor and collects a month’s supply of a targeted therapy drug for her cancer. She is done by noon, and then begins her journey home.

“I make these long, arduous trips across the border to get life-saving medication I cannot afford in Hong Kong,” 59-year-old Liu said. Single and living alone, she quit her job in social services after she was diagnosed with lung cancer more than two years ago. Then the cancer spread to her brain.

She was told she needed a targeted drug which would cost more than HK$30,000 (US$3,800) a month in Hong Kong. Unable to afford it, she went to mainland China, where the same medicine cost about 5,000 yuan (US$687) a month, less than a fifth of that in Hong Kong. She said she had been making her monthly trips across the border since last September.

Liu is among thousands of Hong Kong residents seeking medical care on the mainland, where waiting times are shorter and consultations and medicines cost much less. The trend has picked up since the reopening of the border last year after the Covid-19 pandemic, and includes not only low-income residents and the elderly, but more well-off Hong Kong residents too. Experts said the trend was largely market-driven, but also reflected the state of Hong Kong’s overwhelmed public medical system, with its .