Counterfeit Prescription Drugs: How to Protect Yourself

by on December 5, 2012

The World Health Organization defines a counterfeit medicine as one "which is deliberately and fraudulently mislabeled with respect to identity and/or source. Counterfeiting can apply to both branded and generic products and counterfeit products may include products with the correct ingredients or with the wrong ingredients, without active ingredients, with insufficient (inadequate quantities of) active ingredient(s) or with fake packaging."

counterfeit drugsCounterfeit medicines are defined broadly throughout the world by the World Health Organization. On April 1-3, 1992, experts from the world over met in Geneva for the  first international meeting which gathered together member states and other organizations, such as INTERPOL, World Customs Organization (at the time known as Customs Cooperation Council), International Narcotics Control Board, International Federation of Pharmaceutical Manufacturers and Associations (IFPMA), International Organization of Consumer Unions, and the International Pharmaceutical Federation (FIP) in response to a World Health Assembly resolution (WHA41.16)."

The number of counterfeit drugs continues to grow. According to SafeMedicines.org, counterfeit drugs have killed an estimated 700,000 people from malaria and tuberculosis alone.

Up to a third of all anti-malarials are suspect, and around 10% of all essential drugs in emerging markets fail basic quality tests.

No country is safe. India is the world’s largest manufacturer of generic drugs, but it’s estimated that from 12-25% of their supply might be contaminated with substandard or counterfeit medicines. The WHO reports that many of those medicines find their way to Africa, where some nations may have up to 40% of their drug supply contaminated.

Which drugs are most commonly counterfeited?

Here in the U.S., certain drugs are more likely to be counterfeit.

Cardiovascular Medications

Cardiovascular drugs are for a serious need, one which many Americans turn to foreign drug-makers for. But, points out Haiken, the danger isn't that the Americans won't get the medications--rather it's that they will get a dangerous counterfeit instead.

Antibiotics

Of course a counterfeit version might very well not heal you--but it could also make you sicker, as fake meds can be tainted with heavy metals or some other dangerous ingredients.

Cancer Drugs

Fake cancer drugs have been found in both Israel and China--and just February of this year in the U.S.  In fact it's possible that doctors' offices and clinics might have bought counterfeit Avastin, containing no real drug, but rather acetone and water.

ED Medications

The Pharmaceutical Security Institute reports that 37% of all fake medicines seized are ED drugs.  ED drugs are offered for sale via thousands of fake online pharmacies without prescription requirements.  Writes Ms. Haiken, "The real danger of buying these drugs from a non-VIPPS approved pharmacy is that there is a very good chance they will not just be counterfeit, but poison."

Treatments for Chronic Ailments Like HIV, Diabetes & Alzheimer’s

Because chronic ailments respond slowly to treatment.  it's hard to know if the drugs are really fake.

Psychiatric Medications

A Google search for Xanax, Ativan, Adderrall, or Ambien reveals hundreds of websites offering these powerful drugs without a prescription.

It is a dangerous world out there, and one where you have to keep your senses about you, since the matter can very easily be the difference between life and death.

Common Sources of Counterfeit Drugs

India and China are most commonly the source of counterfeit drugs. Havocscope, which keeps track of counterfeit medicines worldwide, found that genitourinary medicines, anti-infective drugs, and central nervous system drugs are the most frequently counterfeited kinds of medications. Just this August, according to Scientific American, "$182,000 worth of fake medicines for diabetes, high blood pressure, and cancer were seized in China."

Dr Sneh Khemka, Bupa International's medical director, notes that so many of the world's counterfeit medicines come from Asia, particularly China, that it is a dangerous area when you're searching for medical purity. Khemka writes that across the country between 50-85% of some drugs are fake and kill up to 300,000 people per year, which is the equivalent of wiping out the entire population of Iceland every year.

Don't think you're safe if you buy your drugs in any other country, however.

According to the CBS news, the FDA found in April 2012 that a counterfeit version of Roche’s Altuzan (bevacizumab), an injectable cancer medication, contained no active ingredient.

In an article entitled “Fake pharmaceuticals: Bad medicine,”  in October 13, 2012's, issue of Economist, the authors determined that Pfizer found 20 counterfeit versions of their drugs in 81 countries in January 2009, and by July 2012, Pfizer reported finding 60 of their counterfeit drugs in 106 countries.

Create.org in a whitepaper on health and safety risks of counterfeits asserts that up to 40 million U.S. prescriptions are filled each year with counterfeits.

"Pharmaceutical counterfeiting is a low-risk, high-profit criminal enterprise that attracts entrepreneurs and organized criminals," says John P. Clark, vice president and chief security officer for the drug company Pfizer. "What was once seen as a problem limited to lifestyle medicines is now recognized as a threat from which no therapeutic area is immune."

In September/October, Computer World reportedan Interpol operation involving 100 countries seized $10.5 million worth of counterfeit drugs. Nearly 18,000 websites selling fake drugs were shut down during the operation, and 3.7 million doses of counterfeit drugs were seized.

Despite the way counterfeit drugs have encroached upon the U.S., CBS news points out that most of the ingredients in fake American medicines still come from other countries, including China and India, which are known to have weak regulatory systems. The FDA only inspects about 12% of overseas facilities a year.

How to know Whether Your Prescription Drugs are Counterfeit

The World Health Organization estimates that over half the drugs sold online via websites that hide their physical address are counterfeit. Writes the WHO:

"Criminal organizations manufacture these counterfeits, not in quality-controlled laboratories, but in hidden rooms with unsanitary conditions.  And instead of patented ingredients, these meds can contain a haphazard mix of chemicals and fillers like highway paint, floor wax and boric acid — ingredients and doses that can actually harm you and your family."

It is a serious problem, one which the Department of Justice recognizes poses great danger, and the government recognizes that they need help--our help.

Attorney General Eric Holder launched a massive public education campaign, calling for help from all corners, from the TV, the radio, the newspapers, and blogs."

Because the government can't stop the onslaught alone, in his public campaign, Holder has asked that all Americans be proactive when buying their medications.

He strongly encouraged online-prescription-buyers to follow these tips to avoid counterfeit and possibly harmful products, and these are his warnings verbatim:

  1. Don’t buy drugs from sites that sell prescription drugs without a prescription from your own physician.
  2. Consult the National Association of Boards of Pharmacy, which maintains a list of accredited online pharmacies" [to be sure that the pharmacy from which you're buying the medication is valid].
  3. If using an online pharmacy, make sure it has a legitimate brick-and-mortar street address, as well as a pharmacist on duty and available.
  4. Discard the medication if it is of a different size or color, or if it has a different or odd-looking brand insignia from the medication you are used to taking.
  5. Discard the medication if it dissolves differently or badly or has a strange or bitter taste that you are not accustomed to.
  6. If you suspect a website is selling counterfeit meds, report it here.
  7. And for more info on buying medicine on the Internet, go to fda.gov/ForConsumers/ConsumerUpdates or   nabp.net/programs/consumer-protection/buying-medicine-online/counterfeit-drugs/.

By following these simple tips suggested by the FDA, you can help ensure that the medication your family buys online is what it claims to be."

A new technology may aid in tracking down counterfeit medications.   This September, the Food and and Drug Administration unveiled the Counterfeit Detection Device #3 or CD3.

Battery-operated, the machine can emit up to 10 different wavelengths of ultraviolet and infrared light and can be used on capsules, tablets, powders,  and packaging  like inks, papers and covert markings. It's also capable of detecting products that have been tampered with, re-labeled, or re-glued. It has already analyzed nearly 100 counterfeit products, finding counterfeits masquerading as Crestor, Lipitor, Oxycontin, Viagra, Tamiflu, Singular, Plavix, and Wellbutrin.

Protecting Yourself

Huffington Post has a few ideas. Know that Pfizer has partnered with the National Association of Boards of Pharmacy® (NABP) and several other organizations on a YouTube channel, SpotFakeMeds, that allows consumers to hear firsthand from anti-counterfeiting experts about what to look out for and how to buy online safely.

Despite the threats posed by counterfeit medicines, it is possible to safely purchase legitimate, FDA-approved prescription medicines online if you keep your eyes open. For example, one way to purchase your meds if you have a valid prescription is to ensure that you are buying from a legitimate site. All legitimate sites receive VIPPS® (Verified Internet Pharmacy Practice Sites) accreditation from NABP, which indicates one can find there FDA-approved medications for purchase.  A list of VIPPS-accredited pharmacies can be found on the NABP website, www.AWARERx.org.

Dr. Sneh Khemka, publishing on Bupa International, runs through some clues to a counterfeit pill:

  • Spot the difference. Is the lettering on the packaging hazy and printed flat (rather than raised), or is the expiry date missing?
  • Read carefully. Are the labeling and patient information in a language you understand? If there are misspelled words, contact the manufacturers – it can be a telltale sign.
  • Use your senses. Is the medicine the same size, shape, texture, colour and taste as your previous prescription?
  • Feel for consistency. When you handle the drug does it fall apart easily? If so, it could signal a fake.
  • Do a price check. Does the cost of the drug seem very cheap in comparison with your official provider? If it’s much lower, it could be a scam.

Now, let's say you're buying the medicine online--what should you keep a close eye out for?

  • Prescriptions. Make sure the website you buy from requires a prescription and has a pharmacist you can contact for questions.
  • Licensing. Only buy from certified online pharmacies. Search the website for a declaration of authenticity or certification and double- check this with your country’s official drug regulatory agency. For example, pharmacies in the UK that are registered with the Royal Pharmaceutical Society of Great Britain can display a logo on their website.
  • Security. Don’t supply any credit card numbers unless you are sure the website has policies in place to protect your information and has a secure online payment system.
  • Promises. Statements such as ‘no risk’ and ‘money-back guarantees’ can be key giveaways of a counterfeit website.

In short, if the way you're getting your medicine seems just too good to be true--then it very likely is, and the dangers of buying your medicine that way are manifold. It is in your own greatest interest to make sure that the drugs you are buying are indeed what they advertise themselves to be--and are not chemicals that create even more problems than they claim to address.

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