A lot of media coverage about counterfeit drug threats in the U.S. are spurred by the media relations efforts of organizations funded by pharmaceutical companies, such as the Alliance for Safe Online Pharmacies and Partnership for Safe Medicines. As I see it, their public education efforts conflate safe online sales of medicines imported by consumers in the U.S. with counterfeit drug sales and other forms of drug sales, ones that clearly harm patients. One such article that did not fall prey to the propaganda was published in Kaiser Health News’ California Healthline detailing street market sales of prescription drugs, including cases that involve counterfeit drugs and the dangers they pose. Journalists who are looking closely, checking the funding of organizations disseminating information about prescription drug importation, can help stop the propaganda of the pharmaceutical industry.
The Kaiser story, written by John M. Glionna, focuses on
Latino immigrant communities in which people can’t afford medication or, due to
their immigration status, are fearful of deportation if they go to federally-funded
clinics for medical treatments. Eight people were arrested and charged with
illegal street sales of prescription drugs, including injectables and
controlled drugs. Glionna describes the LA County authorities report:
“Dispense as Written” are the words found on prescriptions in the U.S. when the prescriber wants the patient to take the brand drug, not the generic. Many who read Katherine Eban’s new book – Bottle of Lies: The Inside Story of the Generic Drug Boom – will conclude that they would like to see “DAW” on their prescriptions.
Bottle of Lies teaches its readers that generic drugs are not as good as the FDA claims. It shows that poor manufacturing practices, mostly in India and China, but also in the U.S., are the leading cause of substandard drugs being sold in U.S. pharmacies and throughout the world. More ominously, India and China intentionally ship even lower quality and, in some cases, worthless drugs to poor countries in Africa and Southeast Asia where regulations are weak or non-existent.
Over 700,000 people died in the U.S. from a drug overdose between 1999 to 2017. That’s about 130 American deaths daily. At PharmacyChecker, we are dedicated to helping fight this epidemic by learning more about the crisis and spreading awareness. I recently obtained certification for The Opioid Crisis in America course offered by Harvard University.
According to a report published by the Substance Abuse and Mental Health Services Administration (SAMHSA), the main channels that people obtain opioid drugs illegally are from a friend or relative for free; buying from a friend or relative; or buying from a drug dealer or stranger.
As our main focus is often online pharmacy and importation, it’s notable that Harvard did not identify online pharmacy or importation as contributors to the opioid epidemic.
In their opposition to drug importation legislation, the myriad “non-profit” groups funded by drug companies often cynically invoke the evils of counterfeit drugs. We’ve seen this as recently as this week, when an importation bill triumphantly passed in Florida (Prescription Drug Importation Programs HB19). One such group, the Partnership for Safe Medicines, was called out by PolitiFact for essentially lying that the new state law would “allow” imports from China “without FDA inspection,” tacking on that “too many have already died from counterfeit drugs.”
The Florida drug importation bill builds in so many
regulatory checks that it may in fact make importation from Canada into Florida
safer than our “regular” drug supply chain, but that’s for another post. As it
happens, no one has ever been reported killed by a non-controlled prescription
drug imported from a pharmacy that required a valid prescription.
PolitiFact is right to call out PSM, but I’m sad to report
that, yes, there is a very real counterfeit drug problem in the United States.
But, unlike the fake counterfeit drug facts propagated by groups like PSM to
scare people away from buying lower-cost medicines online, it comes in the form
of illegal fentanyl ingredients used
to make counterfeit prescription narcotics.
According to the FDA, in 2017, 80% of the active pharmaceutical ingredients used to make our medicines are imported. I can’t remember how many times I’ve read (and written) that over the past decade or so. Almost every time I read that particular statistic in the news, it’s often a story about drug quality problems, in which foreign APIs are reported as a growing problem. Flashback to the FDA in 1998: as reported by the U.S. Government Accountability Office, the percent of active pharmaceutical ingredients used to make medicines for sale in the U.S. is about 80%.
This week Purdue Pharma settled with the state of Oklahoma for $270 million to avoid a trial charging the company with what I call opioid drug dealing. Purdue Pharma and members of the Sackler family–founders and managers of the company–are enmeshed in 1,600 cases throughout the U.S. They are accused of illegal marketing activities that led to over-prescribing and rampant distribution of Oxycontin, which paved the way for millions to the addiction of opioids, with hundreds of thousands dying over the last decade.
It was not just Purdue but many drug companies—and the entire
drug supply chain—that fueled the opioid death spiral. As drug companies and
their allies in the drug supply chain continue to use the opioid crisis as a
means to oppose prescription drug importation to lower drug prices in the U.S.,
we can only look on with amazement at their audacity.