While we often associate counterfeiting with luxury items, maybe the industry where counterfeiting is the most troublesome is the pharmaceutical industry.
Scary Extent of Counterfeiting of Pharmaceuticals
Already in 2017, WHO estimated that, globally, more than 1 in 10 pharmaceuticals was counterfeit at a value of at least USD 200 billion. We've seen numbers quoted as high as over 400 billion USD, but haven't found the source.
In some regions in Africa and Southeast Asia, it is estimated that only 1 in 2 is legitimate, for specific drugs. A 50/50 chance of getting the medicine you need.
Dramatic Growth of Counterfeiting in Pharma
The growth of counterfeiting of pharmaceuticals has skyrocketed since the turn of the millennium. The number of incidents in 2002 was a mere 196 cases. In 2023 it had ballooned to 6,900!
North America dominates the statistics for detected incidents with 3,000. If that is due to better detection or more cases, we don't know.
Types of Treatments Impacted by Counterfeiting
We're not talking your regular painkiller either. The drugs affected include treatments for life-threatening conditions: HIV/AIDS, diabetes, malaria, cancer. Recently, counterfeit Ozempic has attracted great attention, the new diabetes treatment that has become a favourite treatment also of obesity.
Vast Economic Impact by Counterfeit Medicine
Naturally, counterfeiting has a substantial impact on the finances of pharmaceuticals producing drugs legally, but also much broader.
Direct Costs for Pharmaceutical Companies
The 200 billion USD mentioned above is an estimate of the loss of sales globally by the legitimate pharmaceutical companies. A 2016 report by EUIPO states that the lost revenue in the UE alone is 10 billion € annually... and approximately 38,000 lost jobs!
Counterfeits Hamper Innovation Needed for the Long Term
Naturally, the sales revenue lost by legitimate pharmaceutical companies could have been used to invest in research for new treatments. In addition, knowing counterfeiters are just waiting to steal your next innovation discourages investing energy and resources into innovation and research.
Counterfeit Pharmaceuticals Are Expensive Also for Society at Large
On top of the 200 billion USD lost by the legitimate manufacturers, it is estimated that healthcare expenses increases due to prolonged and additional treatments by some 75 billion USD, globally.
Add to that the costs of authorities to monitor, enforce and increase public awareness of the risks and extent of counterfeit pharmaceuticals.
Societal Impact of Counterfeit Drugs
Proliferation of counterfeit drugs erodes public trust in healthcare systems and legitimate medications, reducing adherence to prescribed treatments. As people believe their medications to be genuine, originating from established pharmaceutical companies, the lack of results or adverse reactions due to counterfeits being contaminated or outright dangerous, may fuel conspiracy theories against institutions, healthcare providers and pharmaceutical companies.
As much of counterfeiting is done by international crime syndicates, it also fuels their growth and power, risking to destabilise economies, particularly small or with weak public systems.
Counterfeit Pharmaceuticals – Great Risks for Patients
Obviously, counterfeiters only purpose is to make as much money as possible and therefore cut every corner they can find. This creates great risks for patients.
Counterfeit Drugs May be Ineffective
Probably the most probable effect of counterfeit drugs is a lack of effectiveness. In some cases it's the least of your worries - it will prolong your time to recover as well as suffering, but it won't add new problems.
But for other, life-threatening illnesses, it can be serious indeed. Like for malaria, cancer or HIV/AIDS.
For contagious conditions, the absence of treatment may cause spreading of diseases to continue.
Ineffective Drugs May Contribute to Drug Resistance
Especially if we're talking antibiotics, counterfeit drugs with too low doses may contribute to bacteria developing resistance, making once-treatable infections more difficult or impossible to cure. Contributing to this risk is, of course, the prevalence of over-prescribing antibiotics, even if they are genuine, but that's another issue.
Counterfeit Drugs May be TOO Effective
Why would counterfeiters adhere to strict quality control standards? It's not unusual to find that the quantity of active ingredients vary in counterfeit medicines - if they contain it at all, that is. But, it's not unheard of that they contain too much of the active ingredient, creating risks of overdosing.
Counterfeit Drugs May Contain the Wrong Substances; Other Active Ingredients, Toxins or Infectious Agents
As counterfeiting operations cut costs with little risk of being held responsible for the outcome, there are substantial risks of your medicine containing other ingredients than intended:
Infectious Agents - Read bacteria and virus. Counterfeit drugs have been found containing faeces, urine of both human and animal origin or bacteria typical for such origins
Other Active Ingredients - A case in point: Ozempic, which we mentioned earlier, has revolutionised the treatment of diabetes by introducing semaglutide as the active ingredient instead of insulin. Fake Ozempic has been found to contain insulin instead, leading to insulin shock and several fatalities.
Toxic Ingredients - Counterfeit medicines have been found to contain substances like lead, arsenic, boric acid and - maybe the least harmful - brick dust. How about that; instead of being cured from your illness you get lead poisoning instead!
Counterfeit Pharmaceuticals Summed Up
Counterfeit pharmaceuticals create problems on multiple levels:
Financial impact on producers of legitimate pharmaceuticals
Discourage development of innovative treatments for illnesses
Increased healthcare costs due to prolonged illnesses and additional treatment
Erodes public trust in healthcare and legitimate pharmaceuticals
Boost the power of crime syndicates, creating risks for system critical influence
Creating additional suffering and additional risks for patients, even causing fatalities
Counterfeiting is not a luxury problem primarily for the luxury market, it's a problem that permeates industries and society in general
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