"We live in an economically difficult period of time, and so consumers are looking for bargains everywhere, and especially in areas where they have monthly expenditures, such as drugs," says Fred Felman, chief marketing officer of MarkMonitor, an online brand protection company that has investigated the market for online counterfeit pharmaceuticals. This demand for inexpensive drugs, combined with the sophistication of the counterfeiters, especially in using the Internet, provides the perfect environment for counterfeiters to exploit consumers.
"A simple Internet search of 'cheap' plus any medication name will yield results that include illicit pharmacies that will allow you to purchase these at a substantial discount," Felman explains.
But you can protect yourself from counterfeit drugs, and one of the first steps is understanding why these fakes pose a public health concern.
What's Really Inside?
Many counterfeit drugs are visually indistinguishable in appearance from the real things, but are nothing like them. They can be blank pills that fail to treat a condition. They can have the same active ingredients, but perhaps in a different dosage. Or they can have additional active ingredients that don't interact well together. They can even contain banned substances. All these can not only fail to treat a patient but also potentially be dangerous and lethal.
But even if the fakes are exact duplicates, Felman adds, the origins and preparation methods are unknown. They could have been prepared in dirty factories, been mishandled, shipped improperly or have become expired.
According to the World Health Organization, fake medicines are found everywhere in the world, particularly in regions where regulatory and enforcement systems are weakest, such as many African, Asian, and Latin American countries. In most industrialized nations with effective regulatory systems and market control, counterfeiting is extremely low -- less than 1% of market value.
In the U.S., the incidence of drug counterfeiting is rare, the Food and Drug Administration says. In recent years, however, the FDA has seen growing evidence of efforts to profit from drug counterfeiting around the world by increasingly well-organized counterfeiters backed by sophisticated technologies and criminal operations. Especially online. Just this past year, the FDA warned consumers about counterfeit versions of GlaxoSmithKline's (GSK) weight-loss medicine Alli and Genentech's flu treatment Tamiflu, both of which were bought online and both of which contained different active ingredients than the authentic drugs.
No. 1: Fake Viagra
Felman says companies fight this problem every day. Indeed, counterfeit medicines are a global problem requiring global solutions, Pfizer (PFE) says. The world's largest drugmaker tells DailyFinance that counterfeit versions of at least 40 Pfizer products have been detected in at least 92 countries. Not only that, 21 fake Pfizer medicines have been detected in the legitimate supply chain of at least 46 countries, including the U.S.
During 2009, authorities from 44 countries seized more than 11.1 million counterfeit doses – tablets, capsules and vials, Pfizer added. Viagra remains the company's most frequently counterfeited product, says Pfizer spokesperson Christopher Loder, with Lipitor second.
Felman gives an example of a typical counterfeit drug transaction: "We purchased an anticholesterol drug 18 months ago. The phone number was from Dallas, but the IP address from Russia. The drugs themselves were shipped from India. . .the credit card was processed in Israel." Felman adds, "This clearly is a global operation, but you have no idea. It could have been someone sitting in their attic in Iowa."
According to the WHO, in over 50% of cases, medicines purchased over the Internet from sites that conceal their physical address have been found to be counterfeit. The extreme difficulty in tracing the manufacturing and distribution channels of counterfeit medicines makes their circulation on markets difficult to stop, despite global and national task forces.
How to Protect Yourself
Given the current scale of the fake drug industry, how can consumers safeguard themselves? Mostly it comes down to the consumer knowing how to shop for drugs online. But that's not easy because the illegal pharmacies do an excellent job using search engine optimization to make sure their sites come up on top of Web search results, Felman explains.
So, before you even go online, Felman suggests contacting your health insurance company, if you have one. Often, the company can help you save money "with ways to buy the drugs in bulk, or buying more than one month's supply, or having a renewal plan that can actually reduce your cost substantially," he says. Also, some drug companies provide financial help for people who can't afford necessary medications.
If you do purchase drugs online, Felman and MarkMonitor's Communications Vice President Te Smith offer these helpful tips:
- Make sure you buy from a legitimate pharmacy. Start with a trusted source such as the National Association of Boards of Pharmacies, which lists pharmacies and veterinary pharmacies that are accredited to do business online through the VIPPS accreditation program (Verified Internet Pharmacy Practice Sites). You can check any pharmacy's VIPPS accreditation, although this is by no means an exhaustive list of legitimate pharmacies. Another source is LegitScript.
- For offshore pharmacies, Canada agencies and LegitScript also certify pharmacies.
- If the pharmacy site demands a prescription, is located in the U.S., provides a physical address and contact information for a pharmacist to consult with, it's probably legitimate, the FDA adds.
- Sites that demand no prescription, offer "doctor consultation" or a questionnaire instead of a prescription.
- Sites that sell by the pill, an illegal practice in the U.S.
- Sites that offer free pills with an order. For example, buy $50 worth of drugs and get some Viagra.
- Sites that provide no physical address or are located outside the U.S.
- Sites found in the VIPPS Not Recommended Sites list.
- Sites that offer foreign or non-FDA-approved drugs.
- Sites that offer no pharmacist consultation or require the patient to sign a waiver.
- If you got to the site through spam or e-mail solicitation.