Global collaborative efforts among wholesalers, manufacturers, government agencies, and consumers are required to combat the counterfeiting of medicines which is becoming a global threat to the safe drugs being manufactured and sold for the people of the world, said Margarita Taburyanskaya, Pharmacy Practice Resident at the South Carolina College of Pharmacy, USA.

These counterfeits are created in illegal laboratories with lack of governmental control and sold under a product name without valid approval, she said in a discussion with the research fellows of the Raghavendra Institute of Pharmaceutical Education and Research in Anantapur in Andhra Pradesh.

People who take medicines for health problems have to be proactive and educate themselves about the risks of taking fake medications which are rampant everywhere including in the US. The support of regulating agencies is badly needed to fight against this growing illegal trade.

Regarding what is happening in the west, she said, in spite of strict safety measures are undertaken by the FDA with the support of distributors and manufacturers, counterfeit medications are being sold on the US market. The FDA imposes stringent rules and regulations for pharmaceutical companies to ensure that the best quality of medications are produced and sold in the country. Nevertheless, some manufacturers manage to find ways to adulterate or misbrand medications, Margarita said.

There are several types of counterfeit medications. Registered medications without active ingredients or incorrect quantity of  ingredients as stated on the label for the purpose of quality assurance or profit margin are on the increase. Unregistered medications that are labelled as a generic product without active ingredients or correct quantum of these ingredients as stated on a label are other examples.

Fake copies of recognized generic drugs that contain no active ingredient, smaller doses of active ingredient, or a different active ingredient are also counterfeits. Likewise, there are counterfeit copies of popular international brands that contain smaller doses of the active ingredient or different active ingredient, the pharmacy practitioner said.

According to them, expensive and widely used medications, such as antibiotics, antimalarials, hormones, and steroids are the most commonly counterfeited. This forgery is not limited to only brand and generic products. Medical devices have also been counterfeited. Internet pharmacies are one of the biggest sources for counterfeit medication distribution. The advances in technology used by counterfeiters are making it almost impossible to identify the fake medical products. Recent sales of fake bevacizumab (Avastin), phentermine (Adipex-P) and atorvastatin (Lipitor) on the US market have initially eluded inspectors due to their identical packaging.

According to estimates provided in 2009 by the World Health Organization (WHO), at least 10 per cent of all the medications sold internationally are counterfeits. This proportion was expected to increase by an average of 13 per cent per year through 2010, generating a 75 billion dollar in profit, the pharma professional opined.