The research has fuelled calls for Australia's two most populous states to introduce the measure in a bid to reduce the growing number of fatal incidents at festivals.
A Monash University-led analysis of 64 drug-linked festival deaths across the country between 2000 and 2019 found the majority had consumed dangerously high levels of MDMA, commonly known as ecstasy.
Researchers said the results highlighted the scope for drug-checking services to inform people about the content of their drugs and "influence behaviour change, minimise harm and reduce mortality".Â
The overwhelming majority of deaths were recorded in NSW and Victoria, both of which have resisted calls to introduce pill-testing services or trial the scheme at high-risk events.
The states have instead focused on other harm-minimisation tactics such as increasing first aid, ensuring access to water and improving messaging at festivals.
Advocates acknowledge testing is not a panacea but does reduce the risk of harm because people could discard potentially lethal substances.
Queensland and the ACT are the only states and territories to have legalised a rollout.
Victorian Premier Jacinta Allan said she would wait until the findings of a Department of Health investigation into nine deaths at a music festival this month were released before introducing any changes.
"We have no current plans to change the policy setting on drug checking, however it is important to wait and get that additional information and consider that in the context of those policy settings," she said on Tuesday.
Findings from the investigation were published on Friday.
Six of the people who died had very high concentrations of MDMA in their systems, while some were exposed to other drugs such as synthetic stimulants and methamphetamine, the department said.
ACT Population Health Minister Emma Davidson earlier said more pill-testing sites would mean more lives saved and called for a national drug testing network.
But NSW Health Minister Ryan Park pointed towards jurisdictional differences, noting his state had a much larger population and held many more festivals than the ACT.
The NSW Labor government has said it will examine pill testing and other harm-reduction measures at a drug summit this year, although no date has been announced for the forum.
NSW Greens MP Cate Faehrmann applauded the Queensland and ACT governments for their "courage and common sense", adding a drug summit was not needed to show pill-testing worked.
She said the latest study "adds to a mounting body of evidence of what needs to be done to save lives at music festivals".
Her Victorian counterpart, Aiv Puglielli, echoed the sentiment, accusing the state government of refusing to listen to expert health advice.
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