May 17, 2020

The financial pull of counterfeit drugs

Counterfeit drugs
medication
WHO
developed world
Admin
4 min
10 percent of all medications are counterfeit
According to estimations from the World Health Organisation (WHO), 10 percent of all medications in the world are counterfeit. The manufacturing and su...

According to estimations from the World Health Organisation (WHO), 10 percent of all medications in the world are counterfeit. The manufacturing and supply of counterfeit drugs is a growing problem and the trend has now even stretched into the world of counterfeit medical devices. The rise in popularity of online shopping has seen the eruption of ‘fake online pharmacies’ and it is these internet sales that is fuelling the counterfeit drug movement and facilitating the inclusion of counterfeit medical products in the supply chain.

The issue of counterfeit drugs differs across the world and breaking down the WHOs estimation reveals that only one percent of counterfeit drugs are found in the developed world; the problem is much more severe in poor economic climates where medical regulations and enforcement systems are lacking. On that basis, incidences of counterfeit drugs in richer and more industrialised countries like the U.S, Australia, and the majority of the European Union are fairly rare. It is the poorer countries in Africa and Asia where the problem is particularly prevalent and suggestions indicate that in some developing countries up to a third of medication and drugs could be counterfeit. 

The demand for counterfeit drugs can be largely attributed to finances. The WHO says: “Paying for medicines can consume a significant proportion of an individual or family income.” This explains why people are shopping around for cheaper prices. However, rather than through choice, consumers may be forced to go to non-regulated vendors and expose themselves to counterfeit drugs. Again, this is often the result of a limited economy and restricted healthcare resources: “It is often the case in the rural areas of developing countries that medicine supplies at regular health facilities do not meet demand,” explains the WHO.

As with any health scam, the drive behind these illegal operations is money-related. “Counterfeiting medicines can be very lucrative,” claims the WHO. “Since many countries have not yet enacted deterrent legislation, counterfeiters often do not fear prosecution.” To ensure they maximise the potential of such a financially rich market, one of the things that counterfeiters focus on is reflecting the most popular healthcare and lifestyle medications. “Counterfeiters target the most lucrative markets, copying high value, high turnover, high demand medicines,” says the Medicines and Healthcare products Regulatory Agency (MHRA). This includes drugs like Prozac, Viagra, Tamiflu and the weight loss supplement Alli. By replicating well-known, branded drugs, counterfeiters benefit from genuine brand power and by promising to deliver genuine products at a discounted price, they have the ability to spark a huge amount of interest from interested consumers. 

Aside from the potential harmful effects that counterfeit drugs may have on the user’s health, they also contribute to a financial burden on economies across the world. Estimated figures suggest that the market of counterfeit drugs is worth US$32 billion on an annual level and there are estimates that in five years this figure could grow to $62 billion a year. Transactions of counterfeit drugs on this level support international crime activities and they also contribute to financial losses in the pharmaceutical industry. In addition, they are responsible for a burden on public health and law enforcement services, as well as being a significant cost to the health delivery system; if counterfeit drugs are filtered through to the patient and pharmacy level, trust is lost in the public health system.

A combined human and financial cost has seen efforts to eliminate the counterfeit drug industry intensify over recent years. In 2006 the WHO played a part in forming IMPACT, the International Medical Products Anti-Counterfeiting Taskforce. According to the WHO, the aim of IMPACT is to “protect people from buying and taking counterfeit medicines,” and also to “prevent the manufacture and distribution of counterfeit medicines.” Aside from being a key IMPACT player, the WHO also provides “direct country and regional support for strengthening medicines regulation.”

Counterfeit drugs are a growing global issue and as the internet trend shows no signs of fading it is hard to see how fake online pharmacies will cease trade. Although the issue is presently being seen in the developing world, there have been incidences where counterfeit drugs have reached a patient level in developed countries. Although preventative methods can tackle the criminal aspect of counterfeit drugs, consumers need to be educated in the dangers of these medications to halt the alarming growth in the counterfeit drug industry. 

Examples of counterfeit medications:

 

What

Where

Why

Anti-diabetic medicine

Used to lower blood sugar

China, 2009

Contained six times the normal dose of ‘glibenclamide’. Two people diedandnine people were hospitalised

Metakelfin

An antimalarial medication

United Republic of Tanzania, 2009

Discovered in 40 pharmacies; it lacked sufficient active ingredient

Viagra andCialis

Used to treat erectile dysfunction

Thailand, 2008

Smuggled into Thailand from an unknown source in an unknown country

Xenical

Anti-obesity pill

United States of America, 2007

Contained no active ingredient and sold via Internet sites that were operated outside the USA

Zyprexa

Used to treat bipolar disorder and schizophrenia

United Kingdom, 2007

Detected in the legal supply chain; it lacked sufficient active ingredients

Lipitor

Used to lower cholesterol

United Kingdom, 2006

Detected in the legal supply chain; it lacked sufficient active ingredients

Source: WHO

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Jun 15, 2021

 NHS trials test that predicts sepsis 3 days in advance 

sepsis
MachineLearning
clinicaltrial
blooddisorder
2 min
Queen Alexandra Hospital is trialling a new sepsis test by Presymptom Health that uses machine learning to detect the onset of the disease

A new test that can predict sepsis before the patient develops symptoms is being trialled at a National Health Service (NHS) hospital in the south of England. 

Clinicians at Portsmouth’s Queen Alexandra Hospital are leading medical trials of the blood test, which they hope will help them save thousands of lives a year. 

The test is being developed by government spin-out company Presymptom Health, but the research began over 10 years ago at the Defence Science and Technology Laboratory (Dstl). This included a study of 4,385 patients and more than 70,000 samples, the largest study of its kind at the time. 

From the samples taken, a clinical biobank and database were generated and then mined using machine learning to identify biomarker signatures that could predict the onset of sepsis. The researchers found they were able to provide an early warning of sepsis up to three days ahead of illness with an accuracy of up to 90%.

Unlike most other tests, Presymptom Health identifies the patient’s response to the disease as opposed to detecting the pathogen. This is an important differentiator, as sepsis occurs as a result of the patient's immune system’s overreaction to an infection or injury, which can then cause life-threatening organ dysfunction. 

Worldwide, an estimated 49 million people a year contract sepsis, while in the UK almost two million patients admitted to hospital each year are thought to be at risk of developing the condition. If Presymptom's test is effective, it could save billions of pounds globally and improve clinical outcomes for millions of sepsis patients.

The initial trials at Queen Alexandra Hospital will last 12 months, with two other sites planned to go live this summer. Up to 600 patients admitted to hospital with respiratory tract infections will be given the option to participate in the trial. The data collected will be independently assessed and used to refine and validate the test, which could be available for broader NHS use within two years. 

If successful, this test could also identify sepsis arising from other infections before symptoms appear, which could potentially include future waves of COVID-19 and other pandemics.

Dr Roman Lukaszewski, the lead Dstl scientist behind the innovation, said: “It is incredible to see this test, which we had originally begun to develop to help service personnel survive injury and infection on the front line, is now being used for the wider UK population, including those fighting COVID-19.”

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