FEBRUARY 4, WORLD CANCER DAY
Today, 4 February is World Cancer Day. A day set aside by the international community to raise awareness about cancer. It is led by the Union of International Cancer Control (UICC) under the theme “I am, I will” reminding everyone to make a personal commitment in the fight against cancer. As I was running through worldwide events to mark the day on the UICC website, I stumbled across another item on counterfeit medicines and this time it was related to a fake anticancer medicine. The World Health Organization (WHO) released the alert on the issue last year but then the dimensions are still relevant in the era of online marketing. I will try to reproduce the alert as I released by the WHO.
A global alert has been issued by the World Health Organization, warning patients, doctors and pharmacies of a fake cancer drug circulating in Europe and the Americas.The fake medicine is packaged to look like the cancer drug Iclusig, which contains the active ingredient ponatinib to treat adults with chronic myeloid leukaemia and acute lymphoblastic leukaemia. The labels are in English, as if destined for use in the National Health Service (NHS). The boxes of 15mg and 45mg pills contain only paracetamol.“There’s no active ingredient so it is a really high value product,” said Michael Deats, who leads the vigilance group on fake medicines at WHO in Geneva. “It is dangerous. We are concerned about this one.”
The medicine was “slightly unusual” because it was made solely of paracetamol. Deats said although it was more common to see fake antibiotics and antimalarials, there have been reports of fake cancer medicines.
Deatsadded, “We see breast cancer, prostate cancer, leukaemia products being reported with some regularity, unfortunately, from all regions.”
The report noted that the fake medicines in packs of 30 x 45mg tablets and 60 x 15mg tablets aroused the suspicions of a wholesaler in Switzerland. The Swiss health authorities then informed the WHO and lab analysis confirmed that the pills were fake. Sadly, Deats noted that the market would be people with cancer and their families in countries where this particular cancer medicine was not made available free or where persons did not have enough health insurance to pay for it.Deatssaid, “If you are involved in the manufacture and distribution of this counterfeit medicine, you are going to be making it available on the internet to people in countries that do not have an NHS or not subsidized”. The fake anticancer medicine would be picked up by patients in other parts of the world and usually by people desperate to get a medicine to treat their disease (or relation) when all they would be getting is paracetamol.”
The drug is expensive, priced at around £5,000 a pack in the UK in 2017 and currently around $13,500 per pack or $450 a pill in the US. The counterfeit version even though initially noticed in Switzerland had also been detected in Turkey and Argentina. It is being sold at a fraction of the real price. Deats said there was a risk, although very slight, that it could get into the NHS. Medicines are sometimes legally bought by UK pharmacies for NHS use from other countries where they are on sale at a cheaper price; a practice called parallel trading and called for everyone to be alert. Deats added that the mere fact that this counterfeit cancer medicine was circulating should be of concern to everyone (“I am, I will”).The fact is no one knew how much was availableand sometimes people act will act unscrupulously and get it into into the system. Deats advised everyone to be on their guard since the counterfeit version was in circulation.
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Counterfeit pharmaceuticals are a big business, estimated to be about $200 billion dollars per year. In sub-Saharan Africa, for example, where the bulk of the fakes are sold, the WHO estimates that as many as 116,000 people die every year due to counterfeit antimalarials. Fake medicines are adding hundreds of millions to health care costs, due to the treatment and hospitalization of people.
An Interpol coordinated action in 116 countries led to the seizure of 500 tonnes of fake pharmaceuticals worth an estimated $14 million US. The haul included anti-inflammatory medication, birth control pills, and counterfeit treatments for HIV, Parkinson’s and diabetes. There were also more than 110,000 fake medical devices like hearing aids, contact lens and syringes. The seizures resulted in 859 arrests and the closure of 3,671 weblinks. In recent years, Health Canada has been waging a battle against counterfeit Viagra, Cialis and Levitra- widely available online at a steep discount. Authorities in Scotland and Northern Ireland are currently dealing with a spate of overdose deaths linked to fake Valium and Xanax. The fake medicinesbeing pressed in the U.K. from materials made in Far East drug labs, differ dramatically in strength with every batch, and contain entirely different sedatives.
There is a general concern on how best to tackle the global fake drug crisis.West African nations are talking about creating their own pharmaceutical firms to ensure that quality products make it to local markets. Kenyan authorities plan to roll out a system of country-specific codes that pharmacists and consumers can track via a smartphone app ensuring that they are selling and buying real, government-approved medicine. Others believe that block chain systems might provide the answer, documenting every step of a medicine’s journey from the manufacturer to the consumer. The European launched its own continent-wide system to fight and track fake medicines, which has been more than four years in the making.
I will end with the advice by the WHO expert, Deats, vigilance at all times.
DR. EDWARD O. AMPORFUL
CHIEF PHARMACIST
COCOA CLINIC
