pharmaceutical crime

The main purpose of this study is to describe the frequency of falsely misrepresented counterfeit Anabolic Androgenic Steroids and some Performance-enhancing drugs, among counterfeit and unlicensed products, processed by the Division of Enforcement and Inspection of the Israel Health Ministry between 2014-2017.

In Europe, the use of falsified medical products (Medicrime products) is increasing. The unreliable quality of these products is expected to cause health damage. The nature and extent of this damage is difficult to determine because the expected symptoms are not sufficiently specific to be recognized in everyday practice. It is also unclear to health care professionals where and how they can report their suspicions about usage. This is shown in an exploratory study by RIVM. Medicrime products are rarely found at (family) doctors and official pharmacies. However, consumers receive these products when they purchase medical products from unreliable suppliers, mainly over the internet. Through this source they are increasingly exposed to Medicrime products. This study assesses Medicrime products that are seized throughout Europe and the associated health complaints expected. Six categories of Medicrime products are seized most: erectile dysfunction agents, psychoactive drugs (such as stimulants, and designer drugs), drugs (especially steroids), slimming agents, strong painkillers and medicines for heart disease. These categories represent about 40 per cent of the seized Medicrime products. The remaining 60 per cent comprises a large variety of drugs, including anti-cancer agents, antibiotics, and anti-retroviral drugs. Even though these are seized in smaller numbers, the health threat is not to be underestimated due to their nature. With respect to epidemics and the development of resistance, it is undesirable that unreliable anti-infective medicines are used. It is recommended to raise awareness among physicians of the phenomenon of Medicrime products through, for example publications in medical journals. It is also recommended to create an information exchange platform on suspect products and complaints. Finally, it is important to devise a simple registration procedure for suspected medical products to set, for example, by adding a tickbox to the international adverse events reporting form by WHO. The recommendations have been incorporated into a pilot study in several European countries that is currently being tested.

A counterfeit drug is one which is deliberately and fraudulently mislabeled with respect to identity and/or source. Counterfeit drugs can be found worldwide, both in deveLoped and developing countries, and their dissemination is a major threat to public health and safety, and has major economic effects on the consumers, the pharmaceutical industry, and society at Large. One of the first measures in confronting this problem is bringing it to the awareness of medical staff and public. This review aims to describe the extent of the problem, to discuss its negative effect, and to present actual and possible consequences.

Counterfeit drugs are a major threat to public health and safety around the world. This review describes the various distribution methods and channels of counterfeit drugs, including the growing use of the internet. National, regional and international efforts to confront this problem are presented, as well as a wide range of technologies that may assist in detection and enforcement. Finally, the Israeli perspective and actions are illustrated.

Detection of phosphodiesterase type 5 inhibitors and their analogues in "100% natural" or "herbal" supplements have been described in numerous reports. However, few reports have been published in relation to actual harm caused by counterfeit erectile dysfunction herbal supplements .We describe a case of a 65-year old male admitted to a tertiary hospital with acute liver toxicity, possibly induced by adulterated "Chinese herbal" supplement "Tiger King" for sexual enhancement. Chemical analysis of the tablets discovered the presence of therapeutic doses of sildenafil with no other herbal components. Other medications were excluded as potential causes of the hepatic impairment. According to the Naranjo adverse drug reaction scale and the Roussel Uclaf Causality Assessment Method (RUCAM) the probability of association of Hepatotoxicity with Sildenafil was "possible" and "probable" respectively (Naranjo score of 4, RUCAM score of 7). Within three days of admission, the patient's clinical status and liver function improved without any specific treatment . His liver function tests normalized 30 days post discharge. Further pharmacovigilance actions should be taken by regulatory authorities and pharmaceutical companies in order to determine the relation between sildenafil and hepatotoxicity. This case emphasizes the importance of raising public awareness on the potential dangers of "Tiger king" in particular, and other counterfeit medications or herbal supplements of unknown origin.