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Identify counterfeit drugs
Imitation tablets and capsules can contain anything: there can be too much, too little or no active ingredient at all. In the worst case, the drug copies contain toxic ingredients that make you sick and do not heal.
The effects can be dramatic: an underdosed contraceptive pill can lead to pregnancy, the overly potent sexual enhancer can lead to cardiac arrhythmias and the inactive cancer drug can lead to early death. An example from China from 2009 shows how carelessly criminals put the lives of patients at risk: counterfeit diabetes medication containing six times the dose of an antihypertensive agent was sold there. Two people died and nine more had to be treated in hospital.
What fakes are there?
In the case of a counterfeit drug, experts speak of one Total counterfeit. But there are also still other types of scamsthat are no less dangerous:
- It can put the right medicine in the wrong package (or vice versa). For example, drugs for high blood pressure can be in a pack for cholesterol-lowering drugs.
- Package inserts can be missing, incomplete or in a foreign language.
- For example, there may be fewer tablets than the original preparation.
- The amount of active ingredient may differ from the product label (e.g. only 20 mg tablets in a 50 mg pack.)
Lifestyle products such as potency and hair growth drugs, antibiotics, pain relievers, growth hormones, anti-cancer drugs, high blood pressure or increased cholesterol levels and sleeping pills are counterfeited. The counterfeiters do not limit themselves to patent-protected drugs - generics also find their way onto the market from their illegal production facilities. As a rule, the wrong preparations are offered on the Internet - from dubious providers and bypassing the prescription requirement.
More lucrative than drug trafficking
Experts from the World Health Organization (WHO) assume that in the industrialized nations (European Union, USA, Australia, Canada, Japan, etc.) less than one percent of drugs are counterfeit. It is completely different in less industrialized countries in Africa, Asia and Latin America: Here the proportion of counterfeit drugs is estimated to be between 10 and 30 percent.
Counterfeiting medicines is extremely lucrative. One kilogram of counterfeit blue potency pills on the black market brings an average of 90,000 euros. For comparison: one kilogram of cocaine costs around 65,000 euros, heroin 50,000 euros and marijuana 8,000 euros. No wonder criminal gangs rush into the drug market. In 2007, the European customs authorities recorded a 51 percent increase in imports of counterfeit medicines compared to the previous year. Worldwide, drug counterfeiters generate more than 32 billion US dollars annually, the WHO estimates.
cat and mouse
Governments, and especially pharmaceutical companies, have an interest in curbing the trade in bogus drugs. The WHO set up its own working group, the International Medical Products Anti-Counterfeiting Taskforce (IMPACT). Authorities are now imposing severe penalties - even for people who ordered the counterfeits, whether knowingly or not.
The pharmaceutical companies, for their part, are designing new security features for their products: holograms, watermarks, color-changing inks, micro-characters, fluorescent pigments, microfibers or DNA labels are supposed to make the packaging forgery-proof - with modest success. So far, the counterfeiters have always managed to overcome the technical hurdles. In one case, customs discovered security features on a counterfeit that the original product did not even have.
How patients can protect themselves
The World Health Organization concludes that patients themselves have practically no chance of recognizing a well-made imitation. Even proven experts could not do this reliably.
Nevertheless, consumers should pay attention to a few features:
- The packaging should have a serial number (possibly as a machine-readable barcode) and an expiry date.
- Under no circumstances should you use loosely packed medicines or blisters without outer packaging.
- A detailed leaflet should be available, it should not look like a copy.
Particular care should be taken when ordering medicines over the Internet. According to a random sample by the WHO, more than half of the products that are sent via unchecked Internet pharmacies are counterfeits. In Germany, the German Institute for Medical Documentation and Information (DIMDI *) keeps a list in which all approved mail-order pharmacies are listed.
Pharmacies in other EU countries, Iceland, Norway and Liechtenstein should be checked by the local supervisory authorities, offer detailed advice and not sell prescription drugs without a prescription. The import of medicinal products from non-EU countries is only permitted in exceptional cases.
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