Dr. Miller reviews what we know about the global trade in counterfeit drugs, and what can be done to protect the U.S. drug supply in an increasingly global market.
What can be done to protect the integrity of pharmaceuticals dispensed in the United States?
First, Congress must increase the penalties for drug counterfeiting, and the FDA must more aggressively enforce regulations that require documentation of the "pedigree," or history, of a drug as it moves through distribution channels.
Second, we need to apply new trackandtrace technologies to uniquely identify and track the distribution of drugs. (And similar to our confrontations with dealers of illicit drugs, in order to keep ahead of the bad guys we will have to innovate constantly.)
Third, new authentication technologies, such as holograms and ultraviolet and forensic tags, must be developed to make it more difficult for counterfeiters to imitate legitimate drugs. A promising new technology would attach mixtures of pHsensitive fluorescent dyes to drug molecules and measure changes in fluorescence in the presence of solutions of different compositions.
Fourth, when making Internet purchases, consumers should patronize only pharmacies on the National Board of Pharmacy's recommended list (www.nabp.net/vipps/consumer/listall.asp).
Finally, consumers should be vigilant for anything amiss in any prescription drug obtained anywhereunusual color, texture, markings or packaging and, when feasible, for any differences in effectiveness or side effects.
The miracles of modern medicines do us no good if we're getting the wrong drugs, the wrong dosages, or inactive sugar pills. Individually and collectively, we must assign a high priority to combating fraud in drug distribution and sale.