Fake Medications Are a Growing Threat
There's lots of profit in counterfeit drugs, so consumers should be on guard
A few minutes' Web surfing turns up examples of surprisingly cheap online medications, including Zyprexa, an antipsychotic used to treat schizophrenia and bipolar disorder, for 43 cents a pill, compared with $10.77 at a certified pharmacy site. The pills are marketed as generics made in India; those generics aren't approved for sale in the United States.
Pharmaceutical companies are increasingly concerned about counterfeiting, not only because bogus drugs cut into sales but because patients could be harmed by drugs they think are legit. They increasingly deploy their own security teams and third-party investigators to detect bogus products in the marketplace. "Wherever a buck can be made, you're going to be seeing counterfeiting," says Bryant Haskins, a spokesman for Pfizer. Lipitor and Pfizer's other blockbuster drug, Viagra, are frequent targets of counterfeiters, but Haskins says that even drugs that sell for a few pennies a pill are counterfeited.
Tracking counterfeits to the source is difficult, because of the convoluted and little-monitored production and distribution systems. Pharmaceutical companies often purchase ingredients and assemble medications in different countries. Drugs then move through a variety of repackagers and distributors, some of which are little more than storefronts, before they reach pharmacy shelves.
The FDA is well aware of the problem; the agency's criminal investigations of counterfeiting have more than doubled in the past five years, from 21 in 2001 to 54 in 2006. Ilisa Bernstein, a pharmacist who is director of pharmacy affairs for the FDA, says the increase is due to more drugs being sold on the Internet and higher drug prices. "The counterfeiters have more incentives." Increasingly, drugs being counterfeited are not just "lifestyle" drugs like Viagra, which people often buy on the Internet, but widely used drugs like Lipitor, or high-ticket items, like some cancer and AIDS treatments. In June 2006, the FDA said it would require distributors to maintain documents attesting to the "pedigree" of their products. The agency had hoped to roll out an electronic system for tracking drugs through distribution, but such a system is nowhere near completion. Still, Bernstein says, "We are fairly confident that the domestic U.S. drug supply is safe."
Customers are at a disadvantage when it comes to figuring out if medications purchased at a pharmacy are fakes. In many cases, counterfeiters imitate packaging of the legitimate company (as in the case of the fake OneTouch test strips) or mix real pills with fake (as in the case of the counterfeit Lipitor). Pharmaceutical industry experts suggest taking a few steps to avoid using counterfeit medications:
Take note if pills look or taste different than they did before. Photographs of prescription drugs are available in the Physicians Desk Reference, at local libraries. Sometimes pills will look different because the pharmacist switched from one generic to another. When in doubt, ask the pharmacist.
Note any differences in reactions to medications compared with previous experiences, and report them to your doctor.
When purchasing drugs on the Internet, be sure the site is certified as a Verified Internet Pharmacy Practice Site (VIPPS) by the National Association of Boards of Pharmacy or by a state pharmacy board.
If you are suspicious about a medication or its packaging, contact the pharmacy that filled the prescription. The FDA's MedWatch program gathers consumer reports on medications at 800-332-1088, or fda.gov/medwatch.