Pfizer Inc. and the National Association of Boards of Pharmacy (NABP) are launching a new effort to draw attention to the risks associated with counterfeit prescription medicines and help patients learn how to safely buy medicines online. Prescription medicines are among the most counterfeited consumer goods. Worldwide sales of counterfeit medicines were estimated to exceed $75 billion last year – an increase of 90 per cent since 2005. Last year, one in six Americans purchased medicines on the Internet, potentially exposing them to harmful counterfeits.

Exposure to counterfeit medicines can have serious consequences, either because they include dangerous substances such as rat poison and lead paint or because they do not include the correct, US Food and Drug Administration (FDA)-approved amount of active pharmaceutical ingredient, which means patients may not get the intended therapeutic benefit.

“Authentic prescription medicines are manufactured with pure ingredients in clean facilities, under a highly-regulated, quality-controlled process, but counterfeit medicines are often produced in unsanitary conditions by people without any medical or scientific background,” said Patrick Ford, senior director global security, Americas region, Pfizer. “Law-enforcement officials have found fake medicines being made in bathrooms and outdoors in the vicinity of farm animals.”

In 2010, US Department of Homeland Security Customs and Border Protection seized 170 per cent more illegal pharmaceutical products ($5.6 million) than in 2005 ($2.1 million). Despite diligent work by US law enforcement, it is unknown how many more millions of dollars of counterfeit medicines are circulating online. A recent review by NABP of more than 8,000 websites selling prescription medicines found that 96 percent appeared to be operating in conflict with pharmacy laws and practice standards, putting patients at risk of receiving counterfeit or adulterated medicines.

“Counterfeiters who sell fake medicines online prey on ingrained online buying behavior, in which consumers disregard warning signs, and prioritize price and convenience,” said Carmen Catizone, M.S., R.Ph., D.Ph., executive director, NABP. “As a result, counterfeiters sell fake medicines through deceptive practices and typically don’t insist that patients provide a valid prescription, which is required by law.”

Adding to the danger, patients who buy medicines from illegitimate online pharmacies are at risk of financial fraud and identity theft when they share their credit card and other personal information with criminal counterfeiting networks.

Consumers Find It Difficult to Detect Real vs. Fake Medicines Online

All types of medicines – brand-name, over-the-counter and generic – can be and have been counterfeited, including medicines for cancer, high cholesterol, hypertension, allergies, infections and pain management. Pfizer has confirmed the presence of counterfeit Pfizer medicines in at least 101 countries. Pfizer’s Viagra (sildenafil citrate) tablets are among the most commonly counterfeited medicines. In addition to counterfeits, patients who order Viagra online may receive a product labelled “generic Viagra” that is not manufactured by Pfizer and has not been approved by the FDA.

In a new Harris Interactive survey conducted by Pfizer, men with erectile dysfunction (ED) were confused about whether ED medicines sold online were authentic and whether the websites selling medicines online were legitimate pharmacies.

Even though only a very small percentage (six percent) of men surveyed considered themselves extremely or very knowledgeable about determining the legitimacy of an online pharmacy, many men were still likely to engage in risky online buying behaviours, such as buying ED medicines from online pharmacies advertised by spam (27 per cent) or based on an online search (36 per cent). The survey also found that nearly half of men (49 per cent) accurately believe that not all online pharmacies are regulated by the government. State boards of pharmacy, not the federal government, regulate legitimate online pharmacies; fake online pharmacies are not regulated at all.

In a separate analysis, Pfizer purchased and tested Viagra from 26 pharmacy websites that appeared in the top results for “buy Viagra” on two major search engines. Pfizer found that all analyzed pharmacies claiming to sell Viagra were operating illegally and 81 per cent were selling counterfeit Viagra.

Another common tactic that counterfeiters use to mislead US-based consumers is to represent themselves as being based in Canada. In the Harris Interactive survey, men were more likely to trust websites claiming to be based in Canada that sell ED medicines (46 per cent) than websites based in countries other than the US or Canada (23 per cent). However, the analysis conducted by Pfizer showed that none of the four sites promoting themselves as “Canadian pharmacies” actually shipped their products from Canada; instead, products were shipped from Hong Kong, India and the US. The Harris Interactive survey also found that even though one in four men (23 per cent) did not believe that online pharmacies claiming to be based in Canada are selling real brand-name products, nearly half of men (46 per cent) would still consider buying ED medicines from them.

“Counterfeiters have good reason to fool patients into buying fake medicines online,” said Ford. “They have no consideration whatsoever for patient health and safety, and the risks of prosecution are lower than those associated with selling illegal drugs. Counterfeiters are adept at producing fake medicines that look authentic and developing websites that look like legitimate online pharmacies. Consumers, though, can outsmart counterfeiters, as long as they know what to look for.”

Consumers in the US who opt to shop online for medicine can do so safely. The FDA advises that websites with NABP’s Verified Internet Pharmacy Practice Sites (VIPPS) seal are licensed pharmacies from which patients can purchase FDA-approved medicines. A list of US-based online pharmacies with VIPPS accreditation can be found at www.VIPPSpharmacies.net.

Consumers who suspect that they have purchased a counterfeit prescription medicine should contact their physician and the FDA’s MedWatch program by phone at 1-800-332-1088 or online at www.fda.gov/MedWatch. Those who suspect they have purchased a counterfeit Pfizer product are also encouraged to call 1-800-438-1985.

Pfizer and NABP’s new educational effort will draw attention to the risks of buying counterfeit medicines and help consumers find legitimate online pharmacies. The campaign will use five channels to reach consumers online:

The NABP website, www.AWARERx.org, offers consumers easy-to-understand information about the dangers of counterfeit medicines and tips on how to select an online pharmacy from which to safely buy medicine.
The Viagra website, www.Viagra.com, includes additional patient-education resources, including the “Anatomy of a Fake Website” and the “Spot the Fake” quiz, which educate patients on the gimmicks counterfeiters use to trick them into buying fake medicines.

Online advertising will reach patients at the critical moment when they are searching for popular keywords, such as “buy Viagra” and “cheap Viagra.” When users click on Pfizer’s ads, they will be taken to the Viagra YouTube channel to view educational videos about the dangers of counterfeit medicines and how to safely buy prescription medicines online.

Takeovers of websites once used by counterfeiters to sell fake Pfizer medicines will be implemented by Pfizer Global Security. To reach potential buyers, Pfizer will repopulate these sites with facts about the dangers of counterfeit medicines and ways to determine if online pharmacies are legitimate.

“We believe this joint effort with Pfizer will inform consumers about the dangers of counterfeit medicines and help them find legitimate websites and pharmacies licensed by the state boards of pharmacy that provide medicines approved by the FDA,” said Catizone of the NABP. “Together, we hope to lessen the dangers related to purchasing medicines online.”

NABP is the independent, international, and impartial Association that assists its member boards and jurisdictions in developing, implementing, and enforcing uniform standards for the purpose of protecting the public health.

A national survey of men with erectile dysfunction (ED) was conducted to better understand men’s online purchase patterns of ED medicines and knowledge about counterfeit medicines sold by online pharmacies.