The current methods for detecting counterfeit medicine are varied in nature and span from laboratory-based methods through to SMS texting. 13 High profile cases of counterfeit medicines include anticancer agents such as Avastin (Bevacizumab USA), 6 Herceptin (Trastuzumab UK, Finland and Germany) 8 and epidemic cases such as those seen in Bangladesh, where unsafe levels of ethylene glycol found in paracetamol elixir, which were responsible for the renal failure and death of over 50 patients (mostly children), 10 and represents an international medicines safety issue.
5 – 12 The indirect effects of drug counterfeiting include a loss in government tax revenue and the funding of illegal activity which may include terrorist organisations. 3 This upward trend can also be seen in the UK supply chain, where 11 cases of falsified medicines were detected over an 11-year period (2001–2011) 4 The direct result of medicine counterfeiting includes deterioration of medicine quality and therefore patient health, unnecessary drug side effects and death in some of the most vulnerable patient groups. 2 The pharmaceutical security institute report that between 20 the global incidence of drug counterfeiting has increased by 51%, with 2015 seeing the highest levels of counterfeiting to date, a 38% increase when compared with 2014. 1 According to the European Medicines Agency, falsified medicines are fake medicines that pass themselves off as real, authorised medicines. They could have the right active ingredient but at the wrong dose. It may be contaminated or contain the wrong or no active ingredient. According to the Food and Drug Administration (FDA), a counterfeit medicine is fake medicine. The terms counterfeit and falsified are often used interchangeably.