However, the incident was considered as the tip of the iceberg of the fast-growing and underground network of counterfeit medicines. According to a study published in the anti-counterfeiting and product protection program (A-CAPPP) paper series in 2009, counterfeit medicines accounted for approximately 10% to 15% of world’s total supply. The situation in developing countries is even worse. Based on the estimates by the World Health Organization (WHO), the percentage of fake medications can go up to 30% in these poorer countries.
3,000 people die each day around the world from taking fake medications
Counterfeit drugs are medications that have been mislabelled and produced fraudulently. Their unregulated production means that these pills may contain very little of an active ingredient that it claims to have, thereby hampering patients’ treatment. What makes these medications worse is that some of them may contain dangerous drugs that pose threats to patients’ health. They may include ingredients such as starch, sugar or even printer ink, leaded paint, arsenic or pesticide.
“An estimated 3,000 people die each day around the world form taking fake medications,” said Scott Davis, the senior regional director (Asia-Pacific) in Pfizer’s Global Security section.
One of the most significant incidents happened in India 2013 when a counterfeit antibiotic was attributed to the deaths of 8,000 people over a five-year-period. The antibiotic was later found to be missing any active ingredient.
China is one of the leading producers of counterfeit medications
The WHO estimated that counterfeit medicines raked in profits of US$75 billion in 2010 – and the number was expected to grow.
China remained as one of the leading producers of counterfeit medications in the world. According to a report by the United Nations Office on Drugs and Crime (UNODC), China exported about 40 percent of its counterfeit medicines, healthcare products and medical equipment to other countries.
Based on analysis of confiscated drugs by the WHO, contraception pills and medication for treatment of sexual dysfunction and sexually transmitted infections as well were among the most counterfeited drugs, these include Viagra and HIV/AIDS medications.
The fear of receiving unsafe medication is driving the patients in Mainland China to travel across the border to visit Hong Kong.
“People are not trusting their supply chains,” said Ben Cavender, an associate principal at the Shanghai-based China Market Research Group. “They are worried that the drugs may be labelled incorrectly, or the quality is not that high, or the company decides to make it more cheaply in China than in the other countries, or they might be fake,” he added.
The sky high prices of the medications sold in Mainland China is another reason. It was found up to 90% of anti-cancer drugs that are sold under-the-counter are bought by Mainland Chinese.
“My wife needs it to survive,” said a customer named Li, who travelled from Guangzhou to purchase drugs from a pharmacy in Mong Kok. “I will save more than 8,000 yuan per bottle if I buy Herceptin here. They may charge you 24,000 yuan for this on the mainland.”
Stepping up efforts to combat counterfeit medications
Despite strict regulations, Hong Kong citizens may still be vulnerable to purchasing phony drugs. In 2011, 18 pharmacies in Hong Kong were caught selling fake products. The products contained ingredients that were inconsistent with their labels and had forged trademarks.
The fraudulent medication business in Hong Kong thrives mostly online. Products are marketed as slimming products or ‘healthy supplements’ but in fact may contain banned substances including sibutramine, fluoxetine or hydrochlorothiazide.
In 2006, WHO initiated the International Medical Products Anti-Counterfeiting Task Force (IMPACT) in efforts to clamp down on the black market. IMPACT draws its support from over 50 national medical regulatory authorities, international organizations, and international healthcare professionals, patients and pharmaceutical manufacturers associations. Nevertheless, the mission to eliminate counterfeit drugs remains extremely challenging.
“Counterfeiters are extremely flexible in the way they mimic products to avoid detection,” said Sabine Kopp, manager of WHO’s anti-counterfeiting programme. A large collaborative study investigating artesunate tablets (an anti-malarial drug) in South East Asia revealed elaborate fakes that had hologram stickers and even similar ultraviolet light marks to the original, but in the wrong spot on the box.
"The problem is simply so massive that no amount of enforcement is going to stop it," said David Fernyhough, an expert at the Hong Kong offices of Hill & Associates, a risk-management firm that foils counterfeiters. He added that these distribution networks ‘mirror heroin networks’ in their far-reaching web of influence. MIMS
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