The Fake Medication Market is Growing in Size: How to Watch Out
The size of the market for counterfeit drugs throughout the world is considerable. Many cases of health impairment due to counterfeits have been reported. The market share of counterfeits in drug circles in developing countries is smaller than in countries that are more established. However, the size of the market for counterfeits are ever on the rise due mostly because of the price of the authentic ones.
Substandard medicines have become a sizeable problem. Either it is poor quality due to inadequate quality control during manufacturing or even worse by deliberate fraudulent practice has no active ingredients in them at all.
Recent recalls of medication made in India and Valsartan made in the US have people concerned about the medication they are taking. Both the name brand and generic drugs can be counterfeit. Either through incorrect additives, wrong amounts of active ingredients or none in it at all. The majority of medications tested in this study were produced overseas in places like Africa and India. Mislabeling from such places are also of concern. Examples of that are a batch of antibiotics (rifampicin) was actually mislabeled and contained an anticonvulsant clonazepam (Klonopin). One lot of minocycline was mislabeled as amlodipine (heart medicine), one lot of bottles containing finasteride was labeled as citalopram (Celexa).
Watch out about the possible dangers of buying medicine online.
Another problem found with these fraudulent medications is the presence of contamination with substances that can alter the properties of the medication or make them toxic. In fact, it was a mass poisoning with diethylene glycol used as a diluent, that led to the establishment of the 1938 Federal Drug and Cosmetic Act. This evolved into our present-day FDA.
Other cases of contaminates include particulate matter in injectable Claforan and glass particles in bottles of generic Lipitor. And unfortunately, it isn't limited to prescription drugs alone. In 2010, batches of Tylenol (acetaminophen), Motrin (Ibuprofen), and Benadryl (diphenhydramine) were recalled due to tribromoanisole a fungicide, found in these medications (Johnson & Holt, 2013).
Substandard or counterfeit antimicrobial drugs are a growing global issue. The three most commonly found as counterfeit include beta-lactams and antimalarials chloroquine and artemisinin. The majority of these fraudulent medications are produced in Southeast Asia and Africa. And these counterfeit drugs have led to an increase in mortality and pose a danger to patients. Counterfeit drugs have been reported ten times more often within the last five years in the US.
According to the review, part of what is driving this trend is the fact for many people the authentic medications are often too expensive to those who need them and are forced to turn to the less expensive, possible counterfeit medications. Example one prescription for Abilify (antischizophrenic medication) 30 pills was $935.00 without insurance. The cash price of a Ventolin asthma inhaler is $200. Small wonder people go to less than reputable places for their medications.
This is becoming a worldwide problem as the prevalence of malaria and the drugs that treat it are often targets. This review found in Africa and Southeast Asia with 90% of fake medications found in Africa alone (Kelesidis & Falagas, 2015).
Medications most commonly counterfeited are oral forms; pills, syrups, capsules (77%). While injectables are significantly less (17%), but that is felt to be related to the lack of equipment needed to produce them. This study found there has been a 400% increase in the numbers of counterfeit drugs between 2005-2010. This trade is said to be twenty-five more lucrative than that of heroin; puts this problem into proper perspective.
Acquired resistance to first-line antibiotics in developing countries is of great concern. These are often the only ones they can afford. Countries in sub-Sahara Africa are greatly affected by the infectious disease. Due to economic, corruption and lack of regulation and control, they are an obvious target for counterfeiters.
The outcome of these fraudulent medications accounts for 50% of deaths due to infectious diseases. And in countries that have a prevalence of malaria, two-thirds of available medications were reported to be fraudulent. Over 82% of the population have acquired the fraudulent medications due to availability and cost.
Another issue reported is the impact fraudulent drugs the potential to escalate toward a pandemic of some diseases becoming resistant to treatment such as tuberculosis and viruses such as HIV/AIDS. In the Democratic Republic of Congo alone, 5% to 15% of the population with many of those diseases depend on the flatulent medications.
One of the countries has been attempting to get better oversight on the medications but their efforts have been mired in politics. There are challenges worldwide. There need to be laws to pursue and punish those who make fraudulent medications, and some kind of fake drug treaty between countries.
Counterfeiters are expanding into all therapeutic fields including expensive cancer medications. In addition, governments need to step up and take a more proactive position with manufacturing labeling and quality assurances (Glass, 2014).
A new study from the University of North Carolina at Chapel Hill concluded that the issue of substandard or falsified, including those that treat malaria, are a serious problem. This is especially seen in low and middle-income countries with more than 13% of essential medicines needed for priority health care of the population fall in this category. When focusing on African countries, this portion of substandard and falsified medications rises to almost 19%.
Researchers found that antimalarials and antibiotics were the medicines most commonly sold in substandard or falsified conditions. In low and middle-income countries it was 19% antimalarials and 12% of antibiotics were substandard or falsified.
The research was led by Sachiko Ozawa and has been published in JAMA Network Open. The prevalence of these substandard and falsified medicines is substantial because these medicines can be ineffective, harmful, or can prolog illness or lead to poisoning. It is found that more global collaboration to implement laws on drug quality and an increase in quality control is a must. Unfortunately, for many, it comes down to who has the most money and/or political clout (University of NC, 2018).
- Glass, B. (2014). Counterfeit Drugs and Medical Devices in Developing Countries. Research and Reports in Tropical Medicine. http://dx.doi.org/10.2147/RRTM.S39354
- Johnston, A. & Holt, D.W. (2013). Substantial Drugs: A Potential Crisis for Public Health. British Journal of Clinical Pharmacology, 78(2). Doi: 10.1111/bcp.12298
- Kelesidis, T. & Falagas, M.E.(2015). Clinical Microbiology Reviews, 28(2). Doi:10.1128/CMR.00072-14
- Sachiko, O., Evens, D.R., Bessias, S., Haynie, D.G., Yemeke, T.T., Laing, S.. Herrington, J.E. (2018). Prevalence and Estimated & Economic Burden of Substandard and Falsified Medications in Low and Middle-Income Countries. JAMA Network Open, 1(4). Doi:10.1001/jamanetworkopen.2018.1662
- University of North Carolina at Chapel Hill. (2018). New Study Finds Fake, Low-quality Medicines Prevalent in the Developing World. Science Daily. https://www.sciencedaily.com/releases/2018/08/180810120019.htm