A review of the client database recovered during a recent raid at a call center in Bengaluru, India has shown that the U.S. is a major market for illegal online prescription drug sales.

According to the Times of India, the April 19, 2017 bust produced evidence of the call center selling drugs and prescription pharmaceuticals to customers in the U.S., Australia, and other countries. Approximately 5,355 psychotropic substances were seized, including some that are legal in India but banned in other countries. Employees of the call center would contact potential clients abroad using VoIP calls and sell them counterfeit drugs. A senior official from the India’s Department of Revenue Intelligence stated that defendants created authentic-looking websites to trick potential customers into believing that the drugs were procured locally, but only the call center was abroad.

Lyndsay Meyer, a spokesperson for the U.S. Food and Drug Administration, stated in an email interview that, “The global anonymity of the internet can provide a safe haven for illicit prescription drug sales. It continues to be a major source for counterfeit and unapproved prescription drugs. Many websites seem like legitimate pharmacies, leading unsuspecting customers in the US to believe the dispensing pharmacy is in the US or Canada… The majority of counterfeits that we have seen have been manufactured outside the US, particularly in China and India.”

A 2016 report issued by the Office of U.S. Trade Representative noted that 97% of all counterfeit pharmaceuticals seized at the U.S. border in FY 2015 came from four economies: China, Hong Kong, India, and Singapore.

Narcotics Control Bureau zonal director Sunil Kumar Sinha said that similar cases have come to light in Hyderabad, Chennai, Ahmedabad, Delhi, and Mumbai. In 2016, the Indian Medical Association stated that counterfeit medicines made up 23% of the market in India.