{"id":4603,"date":"2013-02-13T19:05:29","date_gmt":"2013-02-14T00:05:29","guid":{"rendered":"https:\/\/blogs.nature.com\/spoonful\/?p=4603"},"modified":"2013-02-13T19:05:29","modified_gmt":"2013-02-14T00:05:29","slug":"us-report-calls-for-international-action-in-the-fight-against-counterfeit-drugs","status":"publish","type":"post","link":"https:\/\/blogs.nature.com\/spoonful\/2013\/02\/us-report-calls-for-international-action-in-the-fight-against-counterfeit-drugs.html","title":{"rendered":"US report calls for international action in the fight against counterfeit drugs"},"content":{"rendered":"<div id=\"attachment_4604\" style=\"width: 210px\" class=\"wp-caption alignright\"><a class=\"wpn-image-link\" href=\"https:\/\/blogs.nature.com\/spoonful\/files\/2013\/02\/CBP_with_bag_of_seized_counterfeit_Viagra.jpg\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-4604\" class=\"size-medium wp-image-4604 wpn-image \" src=\"https:\/\/blogs.nature.com\/spoonful\/files\/2013\/02\/CBP_with_bag_of_seized_counterfeit_Viagra-200x300.jpg\" alt=\"\" width=\"200\" height=\"300\" srcset=\"https:\/\/blogs.nature.com\/spoonful\/files\/2013\/02\/CBP_with_bag_of_seized_counterfeit_Viagra-200x300.jpg 200w, https:\/\/blogs.nature.com\/spoonful\/files\/2013\/02\/CBP_with_bag_of_seized_counterfeit_Viagra-682x1024.jpg 682w\" sizes=\"auto, (max-width: 200px) 100vw, 200px\" \/><\/a><p id=\"caption-attachment-4604\" class=\"wp-caption-text\">Seized counterfeit Viagra {credit}Wikimedia Commons{\/credit}<\/p><\/div>\n<p>The distribution of counterfeit drugs represents a significant and ever increasing public health concern. Estimated to generate <a href=\"https:\/\/www.stimson.org\/images\/uploads\/research-pdfs\/Full_-_Counterfeit_Drugs_and_National_Security.pdf\">$70 billion in annual sales<\/a> worldwide, fake or ineffective medications can harm or kill patients, increase legitimate medicine costs, fund criminal activity and even fuel <a href=\"https:\/\/europepmc.org\/abstract\/MED\/16931411\/reload=0;jsessionid=3X6LhKqhNJK3LDn8VC1a.4\">drug-resistance<\/a> in diseases such as tuberculosis and malaria.<\/p>\n<p>Developing countries are disproportionately affected\u2014researchers <a href=\"https:\/\/www.thelancet.com\/journals\/laninf\/article\/PIIS1473-3099(12)70064-6\/abstract\">reported<\/a>\u00a0in <em>The Lancet<\/em> that more than a third of antimalarial drugs are falsified in sub-Saharan Africa, for example\u2014but no country is immune. As recently as last Tuesday, the US Food and Drug Administration (FDA) issued yet <a href=\"https:\/\/www.fda.gov\/Drugs\/ResourcesForYou\/Consumers\/BuyingUsingMedicineSafely\/CounterfeitMedicine\/ucm338283.htm\">another warning<\/a> to healthcare providers in the country over batches of counterfeit Avastin (bevacizumab), the blockbuster cancer medication marketed by South San Francisco\u2019s Genentech. This was the third such alert for Avastin in a year.<\/p>\n<p>Although internationally acknowledged as a major public health problem, the fight against counterfeiting<strong> <\/strong>has been marred by issues of inconsistent regulatory responses, unclear solutions and even the ambiguity over definition of the term \u2018counterfeit\u2019. In response, the US Institute of Medicine, with funding from the FDA, released a <a href=\"https:\/\/www.iom.edu\/Reports\/2013\/Countering-the-Problem-of-Falsified-and-Substandard-Drugs.aspx\">report<\/a> today detailing the scope of the problem and offering recommendations for solutions.<\/p>\n<p>The committee emphasized the need for cooperation between international governments, big pharma companies and civil society groups, such as academia, non-governmental organizations and non-profits\u2014all of which have had <a href=\"https:\/\/in.reuters.com\/article\/2012\/11\/14\/pharmaceuticals-fake-who-india-idINDEE8AC0AK20121114\">contentious<\/a> relationships of late when it comes to combating counterfeits.\u00a0(See our\u00a0<a href=\"https:\/\/www.nature.com\/nm\/journal\/v16\/n4\/index.html#subcatxt\">April 2010 \u2018focus on counterfeit drugs\u2019<\/a>\u00a0for more.)<\/p>\n<p>For example, some member states of the World Health Organization (WHO), including India and Brazil, have accused Western governments of being influenced by major pharmaceutical companies and attempting to use anti-counterfeit measures to stifle unpatented, unregistered or generic drug competition. Versions of these drugs with legitimate formulations represent the only affordable sources of medication in many low-income communities, and some are labeled as counterfeit even if they are neither fake nor ineffective.<\/p>\n<p>\u201cI was shocked in talking with all the stakeholders how deep the suspicion was, and how it caused really a harmful dynamic and lack of cooperation,\u201d committee chair <a href=\"https:\/\/www.law.georgetown.edu\/faculty\/gostin-lawrence-o.cfm\">Lawrence Gostin<\/a>, a global health legal scholar at the Georgetown University Law Center in Washington, DC, told <em>Nature Medicine<\/em>.<\/p>\n<p><!--more-->To mitigate some of the issues of trust and re-direct the focus to public health, Gostin and his fellow committee members recommended using the term \u2018counterfeit\u2019 only when trademarks have been violated. Instead, the label \u2018falsified\u2019 should be used for drugs that misrepresent identity or source, or \u2018substandard\u2019 for those that do not meet accepted pharmacopeial benchmarks. They urged the WHO adopt these clearer terms, which they hope will help shift the debate toward efforts to implement or improve detection and surveillance, instead of rancor over intellectual property. The panel also stressed that governments in low- and middle-income countries must be more proactive in regulation, inspection and enforcement efforts.<\/p>\n<p>Domestically, the US-based committee found the need to implement a universal track-and-trace system that can follow the specific locations of pharmaceuticals after manufacturing. This would, the panel claimed, reduce concerns over falsified or substandard medicines entering secondary wholesaler inventories, especially foreign ones that service online pharmacies. Counterfeit Avastin entered the US, for example, though a Canadian internet pharmacy in this manner. California plans to implement a strict pharmaceutical <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC3086119\/\">track-and-trace program<\/a> by 2017, but the panel emphasizes the need for a mandatory national system, similar to the rule proposed last year by the FDA to require medical devices to carry <a href=\"https:\/\/www.nature.com\/nm\/journal\/v18\/n8\/full\/nm0812-1160.html\">unique identifying tags<\/a> for tracking.<\/p>\n<p>While the cost and difficulty of implementing the recommendations issued by the report are sure to be high, Gostin hopes that stakeholders will realize the urgent need to invest, and to coordinate their efforts. \u201cOur key hope is [they will focus on] the public health problem,\u201d he says<em>.<\/em><\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>The distribution of counterfeit drugs represents a significant and ever increasing public health concern. Estimated to generate $70 billion in annual sales worldwide, fake or ineffective medications can harm or kill patients, increase legitimate medicine costs, fund criminal activity and even fuel drug-resistance in diseases such as tuberculosis and malaria.&nbsp; <a href=\"https:\/\/blogs.nature.com\/spoonful\/2013\/02\/us-report-calls-for-international-action-in-the-fight-against-counterfeit-drugs.html#wpn-more-4603\" class=\"more-link\">Read more<\/a> <a href=\"https:\/\/blogs.nature.com\/spoonful\/2013\/02\/us-report-calls-for-international-action-in-the-fight-against-counterfeit-drugs.html\">Continue reading <span class=\"meta-nav\">&rarr;<\/span><\/a><\/p>\n","protected":false},"author":21736,"featured_media":4604,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[7,5],"tags":[197,198,200,199,201],"class_list":["post-4603","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-drugs-drugs-and-more-drugs","category-policy","tag-counterfeit","tag-fake","tag-falsified","tag-ineffective-medications","tag-substandard"],"_links":{"self":[{"href":"https:\/\/blogs.nature.com\/spoonful\/wp-json\/wp\/v2\/posts\/4603","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.nature.com\/spoonful\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.nature.com\/spoonful\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.nature.com\/spoonful\/wp-json\/wp\/v2\/users\/21736"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.nature.com\/spoonful\/wp-json\/wp\/v2\/comments?post=4603"}],"version-history":[{"count":0,"href":"https:\/\/blogs.nature.com\/spoonful\/wp-json\/wp\/v2\/posts\/4603\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/blogs.nature.com\/spoonful\/wp-json\/wp\/v2\/media\/4604"}],"wp:attachment":[{"href":"https:\/\/blogs.nature.com\/spoonful\/wp-json\/wp\/v2\/media?parent=4603"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.nature.com\/spoonful\/wp-json\/wp\/v2\/categories?post=4603"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.nature.com\/spoonful\/wp-json\/wp\/v2\/tags?post=4603"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}