Caveat Emptor: Counterfeit Drugs ‘Pop Up’ In The United States

(AP photo/Daniel Roland)

(AP photo/Daniel Roland)

If I believed in hell, I’d reserve a special suite there for the people who sell counterfeit cancer and malaria drugs. And nearby, a slightly cooler inferno for the vendors of phony Viagra, ADHD drugs and the like.

I’d long thought of counterfeit drugs as mainly a Third World problem, but a sharp new Nova report by Boston-based science journalist Barbara Moran finds that the estimated $75-billion global problem extends into the United States as well — and the cast of bad guys getting in on the counterfeiting act includes the Russian mafia, Colombian drug cartels, Mexican drug gangs, and al Qaeda:

Fueled by easy internet sales, global supply routes, and minimal punishments, counterfeit prescription drugs have become an exploding industry, with an estimated market worth $75 billion a year worldwide. Long the scourge of developing countries, fake drugs are now popping up in the United States. In 2012, a counterfeit version of the cancer drug Avastin was widely distributed in the U.S., and a fake version of the ADHD drug Adderall, in high demand because of a shortage, arrived in the U.S. through internet pharmacies.

In early 2013, the U.S. Food and Drug Administration (FDA) warned doctors that a fake version of another cancer drug, Altuzan, containing no active ingredient, was being distributed in the United States. An estimated 80% of counterfeit drugs come from overseas, and most of them are manufactured in India and China. In this era of globalization, the supply chain for genuine pharmaceuticals has grown longer, and every link offers an opportunity for counterfeiters.

Telltale signs of phoniness? This one made me smile: It’s a dead giveaway when the word “contains” is spelled “contaihs” on the box. But in many cases, you’d need an expert like Pfizer’s Amy Callanan, who examines some phony Viagra in this excerpt:

She points out the telltale signs of the fake: the blue stripe is too dark, the word “contains” is spelled incorrectly (“contaihs”), and the box sports a hologram that Pfizer no longer uses. But the giveaway is the lot number: 314833021, which Callanan rattles off from memory. Once a lot has been distributed to patients, Pfizer permanently retires its number. But thanks to counterfeiters, this lot number still lives on in knockoffs. It’s proven so popular among criminals that Callanan now sees knockoffs of the knockoffs. “It’s interesting how these same mistakes get perpetuated,” she says.

Read the full Nova piece for more on the problem and the ramped up attempts to fight it. Final note: It’s a serious problem, to be sure, but it does extend down to trivial — these nefarious criminals have even been known to counterfeit Chapstick….

Readers, have you encountered counterfeit drugs? Any tips to share?

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  • Can’t Believe It

    I bet there is more to this story than high school chemistry teachers making counterfeit Lipitor in a back bedroom. It all sounds somewhat improbable, how does a $75 billion industry fly under the radar like this? And who believes these giant German and Swiss drug companies with their limitless resources would allow small-time operators to steal their profits without looking into it? Is it perhaps a situation where the companies are diverting their excess or outdated inventory through legitimate intermediaries who then put it into the black market?

    Like always, everyone’s first instinct is to blame China and India, but how do we know that’s where these drugs are really coming from?

  • Pain NP

    There is always a demand for opioids on the street, of course. Some of my patients have been active in the street drug trade in the past, and have shared stories about it with me – some are likely apocryphal, others probably true. One I liked was about 2 college students who bought a pill press online and funded their college education by making and selling “pills” for recreational purposes. Apparently, one way of telling that some of these pills were fake was by breaking them in half. The real deal had been spray-coated to appear blue and were white inside, while the fakes were blue throughout. I do not vouch for the veracity of this tale!