Health Care Crime: Phony medications in your medicine cabinet

For example, those Americans demanding the US government to allow citizen's access to foreign prescription drugs should heed the concerns of the world's foremost health organization. According to the World Health Organization's definition a counterfeit medicine "is 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 active ingredients or with fake packaging."

It is estimated that one in 20 pharmaceutical products on the market is counterfeit, with the number rising to one in three in some developing countries.

Counterfeit pharmaceuticals are manufactured and distributed by criminals, companies or individuals who have the desire to make money unlawfully. They may contain too much, too little or no active ingredient, the wrong ingredients or high levels of impurities, contaminants and even toxic substances. They could be reject or out-of-date formulations withdrawn from the market which are obtained by counterfeiters, relabeled as bona fide product and introduced back into circulation. They have killed and injured thousands around the world.

The consequences of such counterfeits can vary. They can either fail to treat the illness or condition for which they are being taken (resulting in prolonged illness or death and wastage of valuable healthcare resources) or they can be the direct cause of death by containing lethal ingredients. Whether they fail to promote or restore health, or are the direct cause of death, they are fast becoming a global menace — both to their unwitting consumers and to the pharmaceutical industry as a whole.

Participants at the Global Forum on Pharmaceutical Anti-counterfeiting in Paris recently demanded increased cooperation at all levels and a framework convention to fight counterfeiting of medicines. Combating counterfeit drugs requires the involvement of all parties in the healthcare and pharmaceutical delivery system, placing the onus on manufacturers, all supply chain stakeholders, patients and health professionals as well as regulators and law enforcement to mobilize against fake medicines. Counterfeit drugs penetrate health systems throughout the world, both in industrialized and in developing countries.

The problem is compounded in Europe, where free trade in pharmaceutical products exists. Governments can and do set different pricing, leading to hugely divergent prices between countries such as Greece and Sweden. This encourages parallel imports, which in turn allows counterfeit products to be introduced.

Julian Mount, Senior Director European Trade, Pfizer Inc. said "there is a need for stakeholder accountability, uniform systems and regulation leading to accountable supply chain management by all players delivering medicines to patients in Europe. This means pan-European legislation, regulatory coordination, appropriate technologies and the need to better enforce the repackaging of medicines to ensure patient safety and medicine integrity."

The same could apply to other regions of the world, notably Africa, according to participants from Nigeria and Ghana.

With increasing access to potentially lethal medicines at cheap prices over the Internet, Jim Thomson, CEO of the Centre for Mental Health in the United Kingdom, warned of the "loaded gun" that fake drugs represent:

"Potent substances are freely available on the Internet and can be ordered easily without any prescription and any authentication of sources, making the public vulnerable to health hazards and public health vulnerable to growing anti-microbial and drug resistance. Because technology has advanced so quickly, it is possible to imagine a diagnostic kit that is sold or preferably supplied at the manufacturer's expense with a prescription drug so that patients can test the drug for authenticity before they take it."

"As long as the fight against counterfeits is not a concerted effort, criminals will be able to exploit the loopholes in the system," says Ian Lancaster, Director of Reconnaissance International, specialists in anti-counterfeiting strategies and organizers of the Global Forum. "The fight includes prevention measures by manufacturers, communication and effective education of professionals and patients, and ensuring that punishments are appropriate to this deadly crime."