As I have discussed before, the issue of counterfeit prescription drugs continues to be a major problem in the United States. The counterfeiting of the actual drug is certainly one issue, but so is the replication of the drug packaging and the label placed on the pill vial or injectable bottle.
I just returned from the annual conference of the National Association of Drug Diversion Investigators (NADDI), where I had the pleasure of briefly meeting the author of a book that I think is a mustread for all pharmacists.
The author is Katherine Eban, the book is entitled Dangerous Doses, and it is the result of an almost 3-year investigation by the author into a largescale counterfeiting prescription drug operation based in southern Florida. In the book, she follows an ongoing investigation into this problem where the criminals primarily live in the Miami, Fla, area, but have a devastating effect on patients across the country.
Eban writes about a breast cancer patient, Maxine, who lives in Missouri, and was experiencing excellent results through her injections for her anemia. It was such a boost to Maxine's energy and well-being that she looked forward to her weekly injections of the expensive drug.
Then one day, the usual burning sensation that Maxine experienced when it was injected by the nurse had disappeared, and she felt she was actually getting used to the drug. Her energized self began to deteriorate again, however, and she had no clue as to why.
The reason was that the medication she was receiving had 5% of the potency listed on the label. Maxine's medication was actually 2000 U/mL, when the label indicated it was 40,000 U/mL. Counterfeiters had obtained the less potent, cheaper product, and then produced a label for the much more expensive Procrit, which caused Maxine's sudden decline in her treatment.
This example of the results of counterfeiting drugs, labels, and packaging material and several others are detailed in the book. It once again shows what some criminals will do to make huge profits at the expense of innocent people. In this case, the innocent victims could be your patients, where life and death may be a very valid concern.
Counterfeiting pharmaceuticals in all forms continues to represent an understandable concern for regulators, law enforcement, and health professionals. It is essential that we all continue to pursue this problem in order to safeguard the prescription and OTC drug supply in America.
Katherine Eban's book may scare you a little, but its importance in making you aware of the problem may reap benefits in your own corner of the world as you strive to protect your patients while providing quality pharmacy care.
John Burke, commander of the Warren County, Ohio, drug task force and retired commander of the Cincinnati Police Pharmaceutical Diversion Squad, is a 38-year veteran of law enforcement. Cmdr Burke also is the current president of the National Association of Drug Diversion Investigators. For information, he can be reached by e-mail at firstname.lastname@example.org, via the Web site www.rxdiversion.com, or by phone at 513-336-0070.
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