Is it the law that allows the success of counterfeit drugs?
According to Nature Medicine 16, 348 (2010) the law is responsible.
Why the law is poor
Nature Medicine proposes that the reporting o f counterfeit drugs is not mandatory and therefore is underreported. This may be true for the USA where pharmaceuticals are bought online, which is a major distribution source of counterfeit drugs; however, in countries like Australia, this is not a major source of counterfeit drugs.
But where is the problem most endemic? In countries such as India, it is a huge problem since the recipients of counterfeit drugs cannot generally buy legitimate drugs through legitimate means.
In my mind, the first question arises is how does one know that a drug is counterfeit and therefore know to report? This is the first step. The problem with counterfeit drugs is that they do not contain the pharmaceutical required for its action, or may contain a poison.
More laws do not remove the problem
There are many laws already available to stop the sale of counterfeit drugs; however, we are not seeing these laws being used. Why? The main problem is detection. How is an individual or even a practitioner to know if a drug is not working? Is it because of the patient’s own response, the profile of the drug (many drugs are not 100% effective in all patients at all times) or because a drug is counterfeit?
Increasing the policing of counterfeit drugs by putting a mandatory obligation onto reporting of counterfeit drugs will not address the above problems. This really in turn is making a recipient of a counterfeit drug a criminal if they do not report it. Further increasing policing of reporting has a huge cost with little return.
Use reward, not the stick!
I believe that increased reporting is necessary, but not by imposing penalties. A reward for reporting counterfeits would have a much more positive outcome for all concerned. This will help stop counterfeit drug trafficking, because it:
1. will not cause criminalisation the innocent recipients, thus further expanding the black market; and
2. will help the recipients of counterfeit drugs, who are the most vulnerable due, afford the legitimate channels for legitimate drugs.
Further, industry should support the development of readily available objective tools for proper screening of drugs to allow recipients to determine the legitimacy of drugs they have received, thereby facilitating the reporting of counterfeits.