Falsified Medicines; the Role of the Pharmacist in Raising Patient Awareness
There is a rising tide of criminal activity to manufacture and distribute falsified, substandard, or fake medicines. The two patient safety organisations that I work for, the Alliance for Safe Online Pharmacy in the EU and the European Alliance for Access to Safe Medicines focus on making the internet a safer place to buy medicines.
We find that it is almost impossible to determine the exact size of the problem but there are approximately 40,000 – 50,000 active online medical product sellers worldwide, and 93-96% of them are operating illegally. It is worrying that evidence shows that the issue is growing.
Given the World Health Organisation’s (WHO) recent reports on substandard and falsified medical products, published in November 2017, it is clear that a collaborative government backed approach is needed to tackle this threat to public health. Governments, businesses, and all stakeholders have a fundamental part to play in raising awareness in this area. Fondation Chirac calls for “a global and permanent mobilization” and states “the scourge of falsified medicines is rarely featured in the media and is little understood by the general public and political authorities. Becoming aware of the problem is the first, essential step to effectively battle the scourge and to better protect Public Health”.
The illegitimate supply chain is extremely difficult to police. To combat this, WHO began an initiative to educate regulators on how to detect and report falsified medicines; since 2013 they have trained 600 regulatory personnel in 141 Countries on the prevention, detection and response to Substandard and falsified medical products. This has resulted in a growing number of reported cases.
Case study: INTERPOL’s Operation Pangea X (12-19 September 2017)
A global initiative, involving 197 authorities in 123 countries, which targeted the online market of falsified medicines. It resulted in:
- The seizure of 25 million fake and illicit medicines, worth more than US$51 million
- The launch of 1,058 investigations
- 3,584 websites taken offline and the suspension of more than 3,000 online advertisements
- 400 suspects arrested and/or investigated
- 297 search warrants issued
Another global initiative, run by INTERPOL, highlights the extent of criminal activity in falsified medicines.
It could be argued that the best defence is to take an active role in providing consumers with the knowledge to realise the risks involved in buying medicines online and distinguish between those legal and illegal online sellers. With 18% of Europeans saying that they have bought medicines online it is clear that consumers are becoming increasingly reliant on and trusting of the internet to buy medicines. There are several reasons that the public would turn to the internet for medicine; convenience, time-saving, remote access to products, price and discreet purchasing.
A number of organisations are working to raise public awareness such as: Fight the Fakes, Fondation Chirac, CSIP, ASOPGlobal, EAASM, Fakeshare and IRACM. It is also clear that hospital pharmacists can play a crucial role in the fight against falsified medicines. As they operate at the point of care, they are in a unique position to inform patients about the dangers of buying medicines online.
There are many approaches that pharmacists within Europe can adopt to help inform patients about falsified medicines. Top tips on the subject could be summarised by the following:
Do not buy from an online website that:
- Doesn’t require a valid prescription for prescription medicines
- Sells medicines that are not approved by The European Medicines Agenc
- Doesn’t have a physical address and phone number
- Doesn’t have a licensed pharmacist
- Offers ‘bulk discounts’, ‘sample packs’, ‘new cures’ or ‘amazing results’
- Doesn’t include the EU Common logo.
This logo was introduced by a European Directive to help protect patients from fake medicines (see logo below). The EU Common logo will include your country’s national flag and link you to the website of the national competent authority, listing all legally operating sellers of medicines.
We need to encourage pharmacists, as pillars in the public health system, to enhance their role in the fight against falsified medicines. Alongside that, we need to work collectively with all stakeholders to drive awareness and action to restrict this illegal and potentially fatal trade.