Criminal gangs are increasingly using the internet to market life-threatening counterfeit medicines and some have even turned up in legitimate outlets such as pharmacies, according to a review led by Dr Graham Jackson, editor of IJCP, the International Journal of Clinical Practice, and published in the March edition.
Latest estimates suggest that global sales of counterfeit medicines are worth more than $75 billion, having doubled in just five years between 2005 and 2010. Numerous studies have also reported large numbers of websites supplying prescription only drugs without a prescription and people buying internet drugs despite being aware of the dangers.
"Counterfeit medicines pose an every-increasing threat to public health, including death and inadequate healthcare as a result of self medication" says Dr Jackson. "Particularly worrying examples include counterfeit cancer and heart drugs and fake vaccines sold during the bird and swine flu scares.
"The majority of medicines people buy from unverified internet sites are counterfeit and often lack the active ingredients they claim. Others have variable concentrations of active ingredients or even contain dangerous toxins, such as arsenic, boric acid, leaded road paint, floor and shoe polish, talcum powder, chalk and brick dust and nickel.
Counterfeit medicines are a major concern to the authorities and significant European Union legislation is being developed, including stronger penalties. As outgoing European Commissioner for Enterprise and Industry Gunter Verheugen said in 2010: "Every faked drug is a potential massacre. Even when a medicine only contains an ineffective substance, this can lead to people dying because they think they are fighting their illness with a real drug."
Facts and figures highlighted in Dr Jackson's review include:
"Counterfeiters produce medicines with no regard for the health consequences of those using them, with cancer and heart drugs being increasingly targeted, along with opportunist drugs like flu vaccines" says Dr Jackson.
"We even found reports that a 13-year-old had bought the psychostimulant drug Ritalin online, that underweight, underage patients were able to buy diet drugs and that men were able to buy impotence drugs despite clear indications that taking them could have serious health consequences.
"There have also been reports of deaths from internet drugs and some investigators suspect that many more have been overlooked or wrongly attributed to other causes.
"It is vital that healthcare professionals play a proactive role in fighting the rise in counterfeit medicines by reporting all suspected cases to the relevant health authorities. And patients should be advised to avoid unregulated internet pharmacies and to be suspicious of sites offering prescription only medication without a prescription or at substantial discounts."
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