Time for action on fake medicine

The Standard (Hong Kong)
By Cheng Huan
November 19, 2007

A recent newspaper headline caught my eye. It said that in some poor countries a staggering 60 percent of medicines are fake.

Thankfully, the World Health Organization, now led by our own very able Mrs Margaret Chan (she was previously Hong Kong's Director of Health), is trying hard to control the scandalous trade in counterfeit medicines.

A few months back we heard about the scam across in Guangdong where drug pirates were collecting old, unwanted and expired medicines from people's homes, repackaging them with fresh expiry dates, and re-selling them as new.

The thought that the tablets which I have been prescribed by my doctor, and which I have obtained from a licensed dispensary or pharmacist, might be fake - well, it makes feel both sick and angry.

You have to ask yourself, how low will these criminals stoop in their crazed quest for quick profits?

Pirated DVDs and Louis Vuitton handbags are the kind of fake items that most of us can stomach. They are not life-threatening. A Rolex "copy watch" or a HK$50 Hermes purse may be commercial headaches for their copyright owners but counterfeit drugs represent a different level of criminality.

I spent about an hour researching the problem of fake drugs. It left me even more terrified. The problem seems to be out of control in many countries and I think we need to know more about the situation in Hong Kong.

The biggest problem by far is the sale of so-called "copycat" medicines on the internet. Such fakes may be either too strong or too weak, contain dangerous ingredients, be beyond their expiry dates, have not been made using safe standards, may not be safe to use with other medicine, and are not labelled, stored or shipped correctly.

Although law enforcement agencies in many countries are catching more of the drug pirates, the criminals are reaping gigantic profits. The difference between the manufacturing cost of a fake tablet and the retail value of the genuine article can be over 1,000 percent. Indeed the sky is the limit.

A recent case saw a man arrested at a European airport (he had flown from India) with 300,000 fake tablets of a popular prescription drug in his luggage. You have to ask yourself how many similar traffickers are not detected.

A worse scare in North America concerned a huge quantity of counterfeit drugs which were found to be circulating in the legal distribution system. They were filgrastim (Neupogen), an anticancer drug sold by Amgen, two versions of the human growth hormone somatropin, Serostim, made by Serono, and Nutropin, which is sold by Genentech. The cost of these drugs, when genuine, gives an idea of the vast profits the fakers can make. A 12-week course of Serostim costs US$21,000, or HK$163,800.

A European country has also found nine fake drugs circulating in the legal distribution chain. Adding to the problem is that governments and drug makers do not want to spread panic or undermine the public's perception of drug quality.

Now for the good news. There are, strangely, hardly any reports of the fakes harming anyone, but this may be partly because of the other danger - that they simply do not work. And many of the fakes, it seems, do contain small amounts of the correct "active ingredient" in order to ensure repeat business and reduce the risk of detection.

Given the dangers posed by these fakes, and the huge potential profits, surely all nations need to agree on standardised severe penalties to bring an end to this frightening trade. The pharmaceutical companies are evidently about to introduce expensive packaging which will make it possible to identify each packet to verify if it is genuine.

Of course, the biggest problem is the internet, where it is easy to purchase medicines, which must be fakes if they are cheap. Why cannot governments warn people never to buy medicine on the internet?

Sadly, I guess it will take a series of deaths before people wake up to the risks of the fakes.

I hope I haven't spoilt your daily pill-taking session. You can always look on the funny side. As a policeman, whose job it is to catch the fakers, joked: "With a drug like Viagra, you can tell reasonably quickly if it's working."

Cheng Huan is a senior counsel and member of the Hong Kong Press Council

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