Counterfeit medicines – to buy or not to buy? | Friday,28 May 2010
The pills that pay bills
Today, more people than ever put their health in danger by purchasing counterfeit medicines1,2. Up to 15 percent of all drugs sold worldwide are fake, and in some parts of Africa and Asia the figure exceeds 50 percent1. This illegal trade, which has been spurred by growth of the internet over the last decade3,4, is predicted to generate US$75 billion in revenue this year alone1,2. It’s a monstrous, money-making industry that has successfully infiltrated every corner of the globe.4 As Peter Pitts, President of the Centre for Medicine in the Public Interest, describes: “It’s nothing less than international healthcare terrorism [where] the profits are high and the risks are low.”2
Looks can be deceiving
Counterfeit medicines are medicines that are produced illegally with intent to deceive the recipient in some way. The labelling, information leaflet and packaging may look almost identical to the real version; so much so that very few people would be able to tell the difference. The same applies to the appearance of the medicine itself – but not to the content. Fake drugs can contain anything from inactive or ineffective ingredients to mixtures of toxic substances such as rat poison or lead-based road paint3,4.
Commonly faked medicines include anti-malarials, cholesterol-lowering and blood sugar-lowering drugs and antihistamines.3 The truth is, whichever drug you buy, if it’s come from an unknown source, you may be risking treatment failure and even death3.
A virulent plague
A large proportion of the world’s counterfeit medicines originate in Asia, particularly from China2,7. Across the country, between 50 and 85 percent of some drugs are fake and kill up to 300,000 people each year.2 Put into perspective, that’s the equivalent of wiping out the entire population of Iceland every single year8.
Currently, the State Food and Drug Administration of China doesn’t regulate the production or trading of active pharmaceutical ingredients (APIs), so it’s difficult to contain the problem2. This has an impact on countries all around the world as huge batches of fake drugs are shipped out to be sold for profit2. For example, in December 2009, at the height of the H1N1 flu pandemic, US customs officials seized more than 50 shipments of counterfeit Oseltamivir (the antiviral drug for H1N1 flu). The fake pills were found to contain no API and were therefore completely ineffective1,2.
Do they dare?
Counterfeiters have become so confident in their abilities that they have now moved on from just producing lifestyle drugs such as those for erectile dysfunction to replicating life-saving medications like the main cholesterol lowering blockbusters,. and even some cancer drugs3,9. Because of the recent surge in counterfeit cancer drugs, the US Food and Drug Administration is urging consumers not to fall for bogus claims made by the illegal distributors. False and misleading statements often include “non-toxic”, “doesn’t make you sick” and “treats all forms of cancer”9.
Sadly, the trade doesn’t stop at fake cancer treatments. There are even medicines available on the internet advertised as ‘miracle drugs’ for medically incurable diseases9. Although this is clearly exploitative behaviour, it can often be very difficult for authorities to shut down these illegal outlets because the contact details they provide are just as fake as the medicines they supply.
To buy or not to buy?
That really is the question. The best advice I can give is to cast judgement when you buy medicines and bear in mind that “All that glistens is not gold” ; that is, if it looks too good to be true, it probably is.
Obtaining prescription drugs should only be done through a trusted medical source. Buying them over the counter or across the web in certain countries can, at worst, be fatal, and until consumers cease such purchasing, the trade will unfortunately continue to flourish.
Sources
Dr Sneh Khemka
Medical Director
Bupa International
*Statements and opinions expressed in the article are those of the author and not those of Bupa International or its affiliates.
(1) Cockburn R, Newton P, Agyarko E, et al. The Global Threat of Counterfeit Drugs: Why Industry and Governments Must Communicate the Dangers. PloS Medicine 2005; 2(4):0302–0308. doi: 10.1371/journal.pmed.0020100 http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed. 0020100
(2) Counterfeit Drugs and China. The Centre for Medicine in the Public Interest. http://www.cmpi.org/in-the-news/testimony/counterfeit-drugs-and-china-new, published 31 May 2006.
(3) Medicines: counterfeit medicines. World Health Organization. http://www.who.int/mediacentre/factsheets/fs275/en/, published January 2010.
(4) Risks of buying medicines over the Internet. Medicines and Healthcare Regulatory Agency (MHRA). http://www.mhra.gov.uk/Safetyinformation/Generalsafetyinformationandadvice /Adviceandinfor mationforconsumers/BuyingmedicinesovertheInternet/index.htm
, published October 2009.
(5) Family Practice Management. Avoiding Counterfeit Drugs. Fam Pract Manag 2007; Mar 14(3):36 http://www.aafp.org/fpm/2007/0300/p36.html
(6) Counterfeit drugs and travel. Centre for Disease Control and Prevention. http://wwwnc.cdc.gov/travel/content/counterfeit-drugs.aspx, published November 19 2009
(7) Morris J, Stevens P. Counterfeit medicines in less developed countries: problems and solutions. London: International Policy Network. International Policy Press, 2006
(8) Statistics – population. Statistics Iceland. http://www.statice.is/statistics/population, published 1 January 2010
(9) Counterfeit medicine. U.S. Food and Drug Administration (FDA). http://www.fda.gov/Drugs/ResourcesForYou/Consumers/BuyingUsingMedicin eSafely/CounterfeitMedicine/default.htm, accessed 6 May 2010.