Counterfeit drugs

1
Counterfeit drugs

• Substandard drugs the amount of active
  substance is lower than as stated
• Fake drugs contain no active substance
• Falsified drugs active substance is
  changed/replaced with other substance
• Cheating traditional (herbal) medicine
  contains chemical/synthetic active substance but
  not declared

2
Counterfeit drugs

• The most counterfeited drugs in the developed
  countries (e.g. USA) high volume and expensive
  drugs, like antiretroviral, anti impotency, and
  psychiatric medicines.
• The most counterfeited drugs in developing
  countries high volume but not necessarily
  expensive, such as paracetamol, anti malarial
  drugs, vaccines.

3
Medicines that could kill millions(New
Scientist, 08 September 2005)

• In 1995 in Niger 60.000 people inoculated with
  fake meningitis vaccine
• In 2001 in China 192.000 patients died after
  taking counterfeit drugs
• In Africa active substances of ART drugs are
  replaced with tranquilizers
• In Mekong Region 40 of artesunate (anti
  malarial drug) are fake.

4
Indonesia

• Sales of counterfeit drugs Rp.21 billion/year
  (Parulian Simandjuntak)
• Chemical substance is added to traditional
  medicines sold freely ? hazardous to health
• Chemically active substance sold as traditional
  medicine or food supplements through MLM
  (BPOM/Depkes are not aware?)
• Cheating or misleading information, like
  tolak angin and obat panas dalam

5
The professionals

• Many doctors are not aware of the existence of
  counterfeit drugs
• Many doctors and pharmacists cannot distinguish
  the counterfeit drugs from the original
• No information, education and training on this
  problem

6
The patients and the government

• The patients are the one who bear the risks and
  costs of counterfeit dugs
• Total cost of treatment, both economically and
  socially is high
• The government bear the economic lost, in term of
  people productivity, investments, and health care
  cost
• Government lack of or weak in control
• Harsh competition and small market share provoke
  counterfeiting by legal pharmaceutical companies
  ? need reform

7
The health hazards

• Prolonged and uncured sickness
• Drug resistance pathogenes ? will spread to wider
  population
• Prevention failure (in case of fake vaccines)
• Unwanted effects
• Unnecessary death

8
Crime

• Drug counterfeiting is a serious crime ? causes
  bigger health and economic problems and even
  death
• India is considering death penalty to
  counterfeiters
• Indonesia weak law enforcement and inconsistency
  in law enforcement
• Penalty does not bring deterrent effect
• Considered (only) as unlawful trading?