Counterfeit Medication: The Silent ECpidemic

Counterfeit Drugs: The Silent Epidemic | Do No Harm – May 27, 2012 – by Do No Harm Inc.

As much as 15% of medicines in the world are counterfeit thus causing 100,000 deaths worldwide according to the WHO. The increase of counterfeit drugs across the world in the last decade is both a consequence and a symptom of one phenomenon: the globalization of drugs production and distribution. The supply chain of medicines has become increasingly fragmented and scattered across the globe with raw material extraction taking place in one country and ingredients synthesis and formulation in another country. This globalized supply chain has two implications:

It makes the counterfeit drugs problem not an exclusivity of developing countries: developed countries are as much exposed to this risk as least developed countries.

If the problem is global, the solution has to be global too. As long as pharmaceutical companies source their active pharmaceuticals ingredients (APIs) in other countries any regulation which  is purely domestic is bound to be ineffective. 

The Real Impact of Counterfeit Medications – June 19, 2014 – US Pharm. 2014;39(6)(Generic Drug Review suppl):44-46.

Counterfeit drugs have been defined as products deliberately and fraudulently produced and/or mislabeled with respect to identity and/or source to make it appear to be a genuine product.1-4

Counterfeit medications include drugs that contain

  • no active pharmaceutical ingredient (API),
  • an incorrect amount of API,
  • an inferior-quality API,
  • a wrong API,
  • contaminants, or
  • repackaged expired products.

Some counterfeit medications may even be incorrectly formulated and produced in substandard conditions.

Counterfeiting can apply to both branded pharmaceuticals and their less expensive generic counterparts.

In fact, generic drugs are sometimes confused with counterfeit medications, which may pose an obstacle to the widespread use and acceptance of generic medications. This may create a particular challenge for pharmaceutical industries in places such as India, Europe, and Japan—countries in which generic drugs are manufactured.

Moreover, any impact on generic-drug use is potentially far-reaching. It is estimated that half of all prescriptions in the United States, for example, are now filled with approved generic drugs, with expenditures estimated in the billions.

Counterfeit Drugs: A Global Problem

For years, the number of counterfeit medications that have made their way into trusted pharmacies and subsequently to patients’ medicine cabinets has been on the rise.

Imagine the scenario in which a patient takes a medication for a life-threatening illness, only to become aware later that the doses contained no APIs. It is estimated that this misfortune has occurred with thousands of people worldwide and continues to happen.

Since the crimes of producing and selling counterfeit drugs generally become known only when the perpetrators are caught, any accurate determination of prevalence is difficult. The World Health Organization (WHO) has estimated that 10% of global pharmaceutical commerce, or $21 billion worth, involves counterfeit drugs.

Drug counterfeiting, although not a new phenomenon, has provoked greater concern because it has become so widespread in recent years

A WHO study revealed that nearly one-half (48.7%) of the documented cases of drug counterfeiting were reported in developing countries of the Western Pacific (China, the Philippines, and Vietnam), followed by developing countries grouped within WHO’s Regional Office for Africa, with 18.7%.

The industrialized areas of WHO’s Regional Office for Europe came in third, with 13.6% of reported cases. It is estimated that approximately 1% of counterfeit medications are sold in the U.S, but the numbers are increasing annually.

Most U.S. counterfeit medications are purchased online; however, others have infiltrated legitimate supply chains.

Drugs Most Often Counterfeited

High-demand, expensive medications such as various chemotherapeutic drugs, antibiotics, vaccines, erectile dysfunction drugs, weight loss aids, hormones, analgesics, steroids, antihistamines, antivirals, and antianxiety drugs are common counterfeiting targets.

Among those deceived into buying counterfeit drugs are consumers who use medicines inappropriately or who seek to purchase medications at discounted prices. In addition to being very cheap to make, counterfeit medicines often closely resemble actual medications, with nearly identical labels and tablets, thus duping unsuspecting pharmacists and patients

It has been reported that oftentimes drug counterfeiters use cheap and sometimes harmful materials such as brick dust, sheetrock, and flour to create their bogus tablets.

Pfizer reported discovering 14 of its counterfeited pharmaceutical products in at least 36 countries, including the U.S., in the first 9 months of 2009 and reportedly seized more than 11 million counterfeit tablets, capsules, and vials that year.

Also in 2009, a U.S. government crackdown uncovered some 800 packages of counterfeit medications, including Viagra (sildenafil citrate), Vicodin (hydrocodone bitartrate and acetaminophen), and Claritin (loratadine).

Mui and Ylan state that some of the drugs had as much as three times the amount of API than is typically prescribed, while others contained no API at all or harmful substances.

Internet Sites the Largest Suppliers

Thousands of websites openly sell unapproved and/or counterfeit drugs, as well as prescription drugs without requiring a valid prescription, all in violation of federal and state laws.

Many of these sites are hosted by U.S. registrars, accept payment by U.S. payment processors, and ship their products via U.S.-based express courier companies or the U.S. Postal Service (USPS)

Counterfeit Drugs: A Public Health Concern

Counterfeiting drugs is not only illegal, but it is also a major public health concern. Counterfeit drugs often contain the correct ingredients in incorrect quantities; however, they may also contain either a wrong API—which may even be toxic—or no active substance at all

Many anticounterfeiting technologies are being utilized by pharmaceutical companies to ensure distribution of the authentic product from the manufacturing site to the pharmacy.

Among these technologies used by pharmaceutical manufacturers are holograms, color-shifting inks, and embedded codes, images, and dyes. These anticounterfeiting features allow pharmacists to identify suspicious medications as possible counterfeits.

Protecting Consumers

According to the Pharmaceutical Research and Manufacturers of America, consumers who purchase medications online should avoid the following:

  • sites that are located outside of the U.S. that do not indicate any physical address;
  • sites that do not have a license by the relevant State Boards of Pharmacy;
  • sites without a licensed pharmacist to answer questions; and
  • websites that do not require a prescription.

Consumers who wish to purchase drugs over the Internet should look for websites that have the Verified Internet Pharmacy Practice Sites seal.

These sites, which are created by the National Association of Boards of Pharmacy, are licensed pharmacies selling FDA-approved medications to discourage the sale of counterfeit drugs from illegitimate online sources


2 thoughts on “Counterfeit Medication: The Silent ECpidemic

  1. Kahty C

    There were Counterfeit Drugs being sold in the US, back before the 2009 Crackdown. I remember reading about a factory in India, that found Dry Wall dust in the Medication and no active ingredients. The amount that was sold up to that point here in the U.S was never released to the Media. There were also problems with some of the Generic Formulas. They busted Pharmacies where these fakes were sold. This Story was bad for the American Pharmaceutical Industry, so the Media suppressed it. There were also some Stories about he factories in India and China where American Pharmaceuticals are produced. In the U.S we have no idea where these Pharmaceutical are manufactured, so much of this has been “outsourced.” that is one more issue that has been deliberately kept out of the public view.

    There was a News Show recently on TV that showed a market in Benin, where they sell these counterfeits. The packaging was so sophisticated, even a side by side comparison, made them difficult to distinguish from the real ones. There is such a high profit margin on these fakes that, they are an easier scheme than real drug dealing, or other criminal activities. The packaging can even fool Doctors, and Pharmacists, so it certainly fools the people buying them.

    Liked by 1 person

    1. Zyp Czyk Post author

      We’re being fleeced: being sold medicines at ridiculously high prices from the expensive US market when the ingredients are sourced for pennies from unreliable third-world countries without effective controls or oversight.

      This is the result of unrestrained capitalism without any social requirements or limits. When the ONLY goal is to make money, all humanistic concerns get overruled.

      Pain patients are just collateral damage in the increasingly futile and damaging pursuit of the US drug war.

      I’ve noticed i respond differently to different batches of the same meds I’ve been taking for decades. Some batches work, but many don’t work as well, and with some, I wonder if they aren’t placebos – probably just plaster dust.



Other thoughts?

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Google+ photo

You are commenting using your Google+ account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )


Connecting to %s

This site uses Akismet to reduce spam. Learn how your comment data is processed.