Inside the World of Counterfeit Drugs
Part 1: Your critical role in safe medicines — In recent blog entries, the Partnership for Safe Medicines’ (PSM) experts have warned consumers and pharmacists of the dangers that counterfeit drugs pose, recapped legislation surrounding these issues and highlighting incidents of counterfeit drugs from across the world. However, this month we have invited guest blogger Gregory Zec to share his thoughts on some current drug safety issues. This week, Gregory uses a fictional consumer’s experiences (which he based on real patients’ stories) to explore the confusion many patients encounter from when they receive repackaged, imported prescription drugs from a legitimate pharmacy.
Part 1: Your critical role in safe medicines
In recent blog entries, the Partnership for Safe Medicines’ (PSM) experts have warned consumers and pharmacists of the dangers that counterfeit drugs pose, recapped legislation surrounding these issues and highlighting incidents of counterfeit drugs from across the world. However, this month we have invited guest blogger Gregory N. Zec to share his thoughts on some current drug safety issues. This week, Gregory uses a fictional consumer’s experiences (which he based on real patients’ stories) to explore the confusion many patients encounter from when they receive repackaged, imported prescription drugs from a legitimate pharmacy.
It was an overcast, Thursday afternoon in May that found Jan walking down the narrow street in Haarlem, the Netherlands. Jan’s family physician had just given him his usual prescription refill for his high blood pressure. Jan handed the refill form to the pharmacist’s assistant. He hoped he would not be told they were out of stock, as that sometimes happened, since this would mean he would have to wait or come back to the shop. But this time he was in luck, the tablets were in stock. The smiling assistant handed Jan a plain, white paper bag.
Jan opened the bag. Inside was a plain, white carton. He opened that too and found a printed leaflet explaining what was in the tablets as well as how and when to take them. He had seen this many times before. Also inside were the blister strips containing his tablets. But this time, the tablets looked different –they were white instead of the usual sky blue tablets, and the shape was different too. He approached the assistant who was wearing a white lab coat. “Are these my usual pills?” he asked.
“Jan,” the assistant reassured him, “this is the same blood pressure medicine you usually receive, but these tablets are manufactured in Spain. There’s no difference in the actual medicine”.
Although the assistant had reassured him, they just didn’t look right. Jan had a problem with the idea of a substitute for his usual medicine. He knew that pharmacists often dispensed repackaged products from other European countries in plain white boxes, and figured that middlemen made higher margins on these substituted products. “But,” he reasoned, “there certainly isn’t any benefit to me.”
“Oh well,” he mused, “I suppose there is nothing I can do. But it is confusing for an older person on a lot of medicines trying to navigate his way around all these different shapes and colors.”
Jan’s experience is a classic example of the difficulties a consumer face as a result of drug importation and repackaging practices. While not illegal under current European Union (EU) law, the repackaging of medicines for resale in retail pharmacy or over the Internet exposes patients to serious public health risks. In addition to confusing patients, repackaging prescription medicines is closely linked with the introduction of counterfeit drugs into the supply chain. Particularly worrisome is the proliferation of rogue Internet sites selling prescription drugs. Last spring, the European Alliance for Access to Safe Medicines (EAASM) found that more than 90 percent of Internet pharmacies were not licensed, did not require a prescription before dispensing medicines and had no pharmacists on site. Not surprising, then, was their finding that nearly two-thirds of prescription medicines ordered over the Internet were counterfeit.
Double-checking the appearance and feel of your prescription drugs is an important part of drug safety since discrepancies in a drug’s appearance can be a sign that it is counterfeit. Yet, generics and imported drugs may differ in shape or color from the brand name medication available in one country, and still be a safe and effective product. In this case, Jan did the right thing when he asked the pharmacists if he received the right medication.
Next week, hear more from guest blogger Gregory N. Zec in part 2 of Inside the World of Counterfeit Drugs.