Making a killing with fake pills

Most counterfeits damage only the manufacturers whose designs are being copied but fake pharmaceuticals can kill

Appearances can be deceiving. Just because something looks like an original Picasso, a Gucci handbag or any other sought-after product, is not sufficient reason to buy it without checking on its authenticity.

Counterfeiters now have a new target – pharmaceuticals – and it is innocent people who are suffering, many of whom have died as a result.

Usually, but not always, the price is a good indicator of whether an item is real or fake.

Fakes in the supply chain


Selling to individual purchasers on line is not as profitable as selling in bulk and the counterfeiters have been quick to exploit this market, particularly in the developing world.

By finding ways of introducing fake pills into the supply chain they can – quite literally – make a killing.		  

"The evil of fake drugs is worse than the combined scourge of malaria, HIV/Aids, armed robbery and illicit drugs.”

- Prof Dora Akunyili, director of Nigeria’s food and drug agency

Of the one million malaria deaths each year, the WHO believes that one-fifth could be prevented if all the drugs used were genuine.

Most countries in the developed world believed until recently that they had effective controls in place to ensure only genuine medicines entered the pharmaceutical supply chain.

Since 2004, there have been a number of product recalls in the UK after fake pills were discovered – some of which had already reached pharmacies and patients.

In 2005, 120,000 packs of a drug to lower cholesterol were withdrawn when counterfeits were found in the UK supply chain with a valid batch number. Half of the retrieved stock turned out to be fake.

Among other counterfeit drugs discovered in the past few years among Europe’s legitimate supplies are Plavix, designed to assist patients after a heart attack or stroke, and Zyprexa, for the treatment of schizophrenia.

In the case of Plavix, half a million fake tablets were seized in a single swoop in 2006. Cement powder was found in some of them.		There are a number of ways in which fake pills could be introduced to the supply chain illegally and some experts put the blame squarely on what is known as the “parallel trade”.

This is a scheme which allows genuine medicines, protected by trademark, patent or copyright, to be placed into circulation in one market and then imported by an intermediary into a second market.

The attraction of “parallel trade” is that it is beneficial to buy in this way where there are significant price differences between countries, as there are in the 25 member states of the European Union, where prices are not governed by free competition laws but are fixed by the government of each country.

The weakness of such a system is that it requires repackaging of legitimate products – usually for language reasons – and that opens up the possibility of mistakes being made.

Over 140 million packs of medicines are parallel-traded each year, sometimes changing hands 20 or 30 times.

Now, in addition to errors that might occur, there is abundant evidence of infiltration of the legitimate supply chain by counterfeiters, through bribes or other means.

This heartless crime is providing counterfeiters with a multi-billion pound income. The WHO estimates it is currently worth £18 billion and likely to double within two years. Inevitably, it is believed that the proceeds are associated with other forms of organised crime as well as terrorism.

It is also adding to the cost of producing genuine medicines. American pharmaceutical giant Eli Lilly is among those fighting back, but the cost to this one company is more than US$1 million a day.

It is also busy collecting, collating and sharing evidence of the fake medicine trade with others. It has revealed, for example, that in the two years to January 2007 customs officers worldwide seized more than three million counterfeit or suspected fake tablets in more than 1,000 separate actions.

Those who buy “medicines” on line have only themselves to blame if they don’t get what they expect. But for those who were prescribed drugs by their doctor and purchased them at a pharmacy, the discovery that they have been consuming fakes is a very bitter pill to swallow.

Some, tragically, do not live long enough to learn the truth.
 
This page is an edited version of the Roy Stemman article featured in the September 2008 edition of International.
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