The Dangerous World of Counterfeit Prescription Drugs
What do the counterfeit drug labs look like?
Illicit Drug Labs
Drug manufacturers in the U.S. are required to follow Good Manufacturing Practices (GMP)
under the Federal Food, Drug and Cosmetic Act, which goes a long way in ensuring the safety and reliability of prescription drugs in the country.
Industry experts believe most counterfeit medicines are produced in non-GMP conditions by uncontrolled or street laboratories. One of the companies directly combating these clandestine drug labs is Pfizer, which provided the images on this page. The images were taken during raids of known drug labs in coordination with local authorities. The photos were taken during a drug raid in China, and Pfizer provided a number of additional images to CNBC taken around the world. The conditions in these labs have been described by Pfizer as “deplorable,” citing mold on the walls and “dirt all over the place.”
Below are several examples, provided by Pfizer's global security team, examples of drug labs that have been raided by local enforcement officials. All photos are reproduced with permission.
What Do They Look Like?
One reason it is so difficult to detect counterfeit medicines is that they appear strikingly similar to the genuine products. In the photo to the left, authentic Lipitor tablets appear on the left,
while the counterfeit is on the right. Zucker, formerly of the WHO, is now a practicing physician and agrees it is often difficult for patients to recognize counterfeit pharmaceuticals by sight. “If the right authorities with the proper tools look at them closely, you’d be able to identify a counterfeit product, ” he says, “but if you didn’t have a genuine pill next to you, you wouldn’t really know.”
In some cases, however, “the differences are so apparent — different color, different shape, different taste or smell — that a patient may be able to easily spot a fake from a real drug,” according to Carmen Catizone, executive director of the NABP. “But in most of the cases, the actual product and packaging are so similar that even pharmacists who manage these medications all the time have difficulty distinguishing between the fake and real drugs.”
Are There Ways to Combat Counterfeits?
Howard Zucker, former assistant director general of the WHO and former head of IMPACT, says there are five areas that must be addressed in order to combat counterfeits:
- Drug companies must be able to use technology to counter fake medicines, and more innovation to stay ahead of the counterfeiters.
- Strong legislation is important — punishment for producing counterfeit drugs is a mere slap on the wrist.
- Officials must demonstrate that the proper authorities are enforcing these laws.
- International regulatory groups must develop standards to combat counterfeit medications.
- The public must be informed about the dangers of counterfeit drugs.
There is international disagreement even with what constitutes a counterfeit drug, however. In the West, the issue is wrapped up in public health and intellectual property rights; but some countries interpret Western concerns as an attempt to stifle their generic drug industries, and others see no distinction between counterfeit and substandard drugs.
What Companies Are Doing
Pharmaceutical companies are at the center of the effort against counterfeit drugs, with the largest American companies dedicating resources to contain the problem. Technologies such as Radio Frequency Identification (RFID), holographic labels, infrared inks, supply-chain tracking, digital serial number identification chromatography, and even chemical “fingerprints” are being employed as anti-counterfeiting measures, although with varying degrees of success.
Many companies have taken enforcement a step further, with security officials from major drug companies confirming that they actively build cases against counterfeiters in other countries and present them to local law enforcement. Pfizer confirms that it has hundreds of cases in different stages of development, and reports having confiscated 65 million tablets since 2004.
Jackson of Novartis says that “in many cases the industry does most of the work themselves, identifying companies who are involved and literally taking law enforcement by the hand.... doing classic investigative intelligence work at a high evidential standard.” This work has resulted in raids and seizure of high-valued property and assets purchased with profits from these illicit businesses.
The difficulty that many drug companies face is raising public awareness in a non-alarming way. Zucker, former assistant director general of the WHO and former head of IMPACT, says drug company CEOs initially were worried that sales could drop when the WHO’s IMPACT project began. Recently, Pfizer and the NABP launched a public awareness initiative to inform the public about counterfeit pharmaceuticals, which includes a website and a series of YouTube videos addressing the subject in detail.
What Can You Do to Protect Yourself?
Buy drugs only from trusted retailers and avoid non-regulated online pharmacies. Experts including Zucker, former assistant director general of the WHO and former head of IMPACT, encourage Americans traveling abroad to take their medications with them and avoid purchasing drugs abroad. “Try to keep your eyes open in developing countries,” he says.
One of the best things you can do, experts say, is to educate yourself about the drugs you take. Below you’ll find links and resources on the subject:
The World Health Organization:
Counterfeit SFFC Medications
International Medical Products Anti-Counterfeiting Taskforce (IMPACT)
The U.S. FDA:
Counterfeit Pharmaceuticals Information
Initiative to Combat Counterfeit Drugs
Report Suspicious Websites
The National Association of Boards of Pharmacists (NABP)
VIPPS Online Pharmacy Accreditation