fake drugs

Beware of fake drugs

Your Health DR GITA MATHAI

India has the largest "fake drug" industry in the world. The government estimates fake drugs to be four per cent of the total industry while media and the drug industry itself claims its closer to 30 per cent. Drugs that are counterfeit, spurious, mislabelled, uplabelled (showing a higher concentration on the package) or illegal can be called fake. A drug is counterfeit if it is produced in a shoddy and unhygienic way. It may contain minuscule quantities or none of the genuine ingredient. The rest, (if you are fortunate) may be ingredients such as milk or starch powder or (if you are unlucky) rat poison or powdered glass. If a spurious drug is injected, it can produce abscess or fatal reactions. The black market for fake drugs is very lucrative. They are manufactured for a fraction of the cost of the real medication, often in unhygienic factories but are sold at the same price. Obviously, spurious medication does not work. The blame usually falls on the medical professional. Dissatisfied, the patient may begin to doctor shop. Expensive investigations -- often invasive -- follow as medical professionals attempt to arrive at a diagnosis. If the fake drugs were taken for an infection, the bug that caused the disease soon becomes resistant to the antibiotics. Expensive potent drugs are then given in an attempt to tackle the problem. The patient may succumb to the infection. Sometimes the patient recovers, but antibiotic resistant bacteria are released into the environment to attack other unsuspecting individuals. Drug resistant TB is a major public health problem worldwide. Initially, it was blamed on the fact that patients did not continue with the treatment or finish the long time frame for which the medicine needs to be taken. Now, however, it has been found that fake and substandard medication for tuberculosis (TB) is in the market. Almost 10 per cent of the prescribed medication was faulty. It was apparently labelled correctly, but close inspection revealed faulty packaging, the drugs were pass the expiry date or "fake", with spelling mistakes. Many batches were found to have been uplabelled. The most lucrative market for spurious medication is in the treatment of infections, cancer, sexually transmitted diseases, impotency, glucose strips for the testing of diabetes and psychiatric medication. Generic medication is much cheaper than branded products. They are stocked and used in government hospitals to provide effective but inexpensive treatment to the underprivileged. For the first four years after companies obtain a license to supply institutions, the products are checked by a central agency. After that it is the individual state's responsibility. The testing agencies are underfunded, inadequately staffed and overworked. It leaves many loopholes, which can be exploited and also provides scope for bribery and corruption. In developed countries, the bulk of spurious drugs are sold through an unregulated Internet market, directly to customer. No prescription is required. We have not reached that stage in India yet. However, many friendly neighbourhood pharmacies do sell spurious and substandard drugs at rates lower than the MRP to unsuspecting customers. They often lure the customer with the argument that "this brand is cheaper!" Stay safe • Do not buy medication without a prescription and a bill. You might pay more as VAT (tax) is added. On the other hand, bills require that the batch number year of manufacture etc. be clearly recorded minimizing chances of fraud. • Do not buy or use a medicine that has been substituted. If your physician has prescribed a medication take only that and not something "which is the same but is cheaper!" • Check the expiry date and packaging. If it looks corroded, smashed or discoloured do not buy it. Other danger signals are spelling mistakes on the labels, with "e " instead of "i" etc. • Vaccines should preferably be supplied and injected by the doctor. They may be fake or of reduced potency if bought from a pharmacy and then carried to the doctor's premises. The cold chain may not be maintained.