Counterfeit medicines: the current situation and the main ways to distinguish a fake

Going to the pharmacy, patients hope to get a medicine that can improve their condition, relieve pain and unpleasant symptoms. But sometimes drugs do not work even with strict adherence to the doctor’s recommendations and instructions for use. In such cases, the question arises: is it not a fake. Alas, counterfeit medicines, biological supplements, vitamin complexes are found in pharmacies around the world. And this problem remains a key one, both in developed countries and in the so-called “third world countries”, which are only going through the process of formation. Of course, in the latter case, the situation is much more critical, because the pharmaceutical and medical industries are less controlled, but so far no one has managed to completely get rid of drug counterfeiting schemes.

How is the situation with counterfeit medicines in the world?

The demand for medicines makes them vulnerable to falsification. This is what criminals take advantage of, making medicines that have little in common with high-quality and effective drugs. According to the latest data from the World Health Organization, counterfeit medicines account for about 10% of the entire pharmaceutical trade. The following are considered fakes:

• preparations that contain an underestimated level or no active pharmaceutical ingredient (API) at all;
• products containing low-quality components;
• medicines with the wrong API;
• contaminated, damaged drug packaging;
• expired medicines. ^[1]

For the sale of counterfeit medicines in most countries of the world, criminal liability is provided, but this does not significantly reduce the level of pharmaceutical crime.

What is important, counterfeiting can be “met” in both rich and poor countries. The difference is only in the number of counterfeit drugs. A study of the situation in the world by WHO showed that most of the reports of counterfeit products come from African countries (about 42% of all cases). In the countries of the Americas and the European region, the number of cases of counterfeit medicines is equal – 21% each. But the data may be inaccurate, as not all claims are officially confirmed, and this is proven by information from East and Southeast Asia, where only 2% of applications come from. ^[2]. The situation in these countries is somewhat different than what is presented to the public.

A particular surge in the smuggling of counterfeit drugs occurred in 2020 after the announcement of the coronavirus pandemic. At that time, demand exceeded supply, so counterfeit medicines began to appear in different countries of the world. The closure of India and China, which are considered key producers of affordable generic medicines, also contributed to this. To stop the wave of counterfeiting, Interpol conducted the international operation “Pangaea”. And in just seven days of its implementation, more than 120 people were arrested in 90 countries. And the amount of counterfeit products amounted to about 14 million dollars ^[3].

The situation with counterfeiting in the CIS countries

The situation with falsification of medicines in the CIS countries, Ukraine is not much better. For example, in Russia in 2021, approximately seven million packages of drugs were seized that were recognized by Roszdravnadzor as substandard or falsified.

In Ukraine, according to various sources, fakes among medicines range from 10 to 30%. Every year, the police uncover schemes for the manufacture and sale of counterfeit drugs. In Belarus, according to officials, there are no counterfeit medicines. And such a situation is, in principle, possible, since the online trade in pharmaceuticals and sending them by mail is prohibited there. The only option is to order medicines in the pharmacy chain, and it will be delivered to the pharmacy closest to the client. The same applies to biological additives and vitamin complexes. Their sale is possible only in pharmacies and special outlets. In such conditions, the risk of falsification of medicines is really reduced. ^[4].

In Kazakhstan, Armenia, Azerbaijan and other CIS countries, the situation with the falsification of medicines is quite critical. Such pharmaceutical crimes bring multimillion-dollar profits to their organizers, and patients are deprived of the chance to recover or a normal life with the support of drugs, because life-saving drugs are most often faked.

What drugs can be in the group of counterfeits

It is unprofitable to counterfeit medicines that are not in wide demand. That is why the list of funds that are most often identified among counterfeits is presented:

• antibiotics;
• painkillers;
• means for the treatment of erectile dysfunction;
• cardio drugs;
• vitamins and probiotics;
• contraceptives;
• antitumor agents. ^[5]

Counterfeit medicines are seasonal. For example, in winter, antibiotics, immunomodulators, and antiviral agents come out of unclean production. In the spring, antiallergic drugs can become a victim of falsification. And this is only part of the funds that criminals can “lay their eyes on”. For maximum profit, they can save on the active substance or even replace it with chalk, talc, starch. And in order to prevent the tablets from disintegrating, cement and building compounds similar in action are added to the mixture for their manufacture. I don’t even want to imagine how such remedies can harm the patient, not to mention recovery.

Is it possible to independently distinguish a counterfeit medicine

The problem of counterfeit drugs is more serious than it seems. This is not only wasted money, but also the possible occurrence of antibiotic resistance, worsening of the patient’s condition and even death. For example, in Nigeria, more than 60 children were treated with a fake vaccine against deadly malaria. Fortunately, the fake was detected in time, and the little patients were saved. ^[1]

In order to protect themselves as much as possible from falsified drugs, patients themselves must be vigilant. Buying medicines exclusively in pharmacies can significantly reduce the likelihood of acquiring a fake. Such medical institutions officially sell drugs, so they have all the necessary documentation for them. Of course, there are cases when a pharmacy deliberately sells fakes, but such phenomena are quite rare. You should not order medicines in online pharmacies, because this will not be a guarantee of their quality. The price is too low compared to offline pharmacies, especially. Mostly wholesale distributors and drug manufacturers offer the same prices (+-10%), so the price difference cannot be significant.

Having received the drug on hand or bought it at a pharmacy, you need to visually inspect the package, paying attention to:

• color scheme, which must match the original. And you can always find the packaging on the official website of the manufacturer;
• production date, expiration date, serial and registration number. They should be clear, located in the place intended for this, not erased if you run your finger over them;
• integrity, because any abrasions, dents can also attribute the medicine to low-quality or even counterfeit.

The packaging of the medicinal product must indicate the storage conditions, the dose of the active substance in each unit and its quantity in the package. Also, many drugs have a hologram and a blister to prevent opening of the package. ^[6].

An uncharacteristic color, texture, or even the smell of the contents of the medicine package can also inform about a fake. But to understand this, you need to constantly take the medicine. The first time you buy cough syrup, you may not notice that it does not smell like thyme or does not have that orange flavor that it should be.

If after all the manipulations there is no complete evidence of the falsification of the medicine, but suspicions still remain, you can use Internet technologies. For example, in Ukraine, a mobile application “Drugs-control” has been developed. It is easy to check all drugs purchased in the country. Using the application is very simple, and most importantly, it is easy to check even before purchase, simply by indicating the series from the package. The database contains all prohibited drugs, so this method will work 100% ^[7].

Russia has its own portal for drug testing. The website of Roszdravnadzor has a catalog of quality control of medicines ^[8]. There you can enter data and find out if a particular drug is approved for use. Nothing complicated, but how much you can save: money, nerves, wasted time, and most importantly – health.

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