Counterfeit pills on the rise

The Telegraph recently ran a fairly harrowing piece on the rise of counterfeit pharmaceuticals. We've known for a while that buying meds off the Interweb is not necessarily the safest thing in the world. But the production of fake pills has been scaling up in some fairly dangerous ways, killing as many as half a million people worldwide each year:

The trade extends far beyond Viagra and other 'lifestyle' drugs. Virtually all medicines have been counterfeited - increasingly, criminal gangs have moved into lifesaving medicines including antibiotics, antiretroviral drugs for Aids, and expensive cancer and infertility drugs. At the height of the bird-flu scare, fake doses of the antiviral drug Tamiflu were unleashed on to the world market that contained just vitamin C and lactose.

Bogus pharmaceuticals come in all combinations - some with no active ingredient, some with too little active ingredient, others with too much, some with toxic constituents. One seized consignment of phoney Ponstan, a non-steroidal anti-inflammatory, had no active ingredients at all; but it did contain boric acid, a pesticide that can cause renal failure. (The pills' colour came from leaded road paint.) Fake antibiotics have been intercepted that are made of talcum powder, as well as birth-control pills made of rice flour. Other ingredients have ranged from floor polish to rat poison.

The developing world still records the majority of deaths. In China, between 200,000 and 300,000 people are estimated to die each year because of counterfeit or substandard medicines. The WHO estimates that 200,000 of the one million malaria deaths a year would be prevented if all the drugs were genuine.

Don't assume you'll be immune forever, just because you don't live in the developing world:

The temptation for counterfeiters to attack the legitimate chain in preference to selling direct to the public is huge. 'Why sell a single packet to John Smith when I can sell 400,000 to John Smith and Company?' Graham Satchwell asks.

Production is not difficult. 'You really don't need a huge amount of skill,' one pharmaceutical company investigator says. Most counterfeiting takes place in south Asia and the Far East, with China the biggest source. The scale varies from small-time entrepreneurs turning out 100 tablets a day to vast factories. Both producers and distributors have become more expert. 'It's a cat-and-mouse game, permanently escalating,' Thomas Thorp, the manager of government affairs for Eli Lilly, says.

'Ten years ago it might take a counterfeiter six months to copy your product once it had come on the market, and the quality of that counterfeit would probably be very poor. We're now seeing counterfeit product in some markets where we haven't even launched the legitimate one. They are getting more and more sophisticated.' Manufacturers of the anti-malarial drug Atesunate added a hologram to the blister foil to differentiate it from fakes: the counterfeiters followed suit in less than a month.

It's gotten to the point where pharmaceutical companies like Pfizer keep their own anti-counterfeit divisions, employing detectives and security specialists to try to stop the flow of counterfeit drugs - not simply for altruistic reasons, but to avoid any hits to their brands that might come from being associated with fakes.

It's an exciting world out there, and the article closes with an understated yet brutal summary:

The public in this country seems largely ignorant to the scale of this threat. But as the Global Piracy & Counterfeiting Consultants, an organisation launched by the consumer advocacy group Americas Watchdog, warns, 'Perhaps no one cares about people dying from counterfeit pharmaceuticals in Africa, but this will change when individuals start dying in large numbers in Los Angeles, New York, London or Tokyo.'