Spurious drugs — consumers' health at stake

Distinguishing a spurious drug from a genuine one is difficult. Only a proactive consumer and a vigilant Government imposing stiff penality to those indulging in the crime can strangle the industry.

Buying medicines only from reputed, well-established chemists is one way to strangle the spurious drug industry. -- Pic by: M. Moorthy

SHALINI HAD a long history of epilepsy. She was free of seizures for the last four years during which she was under medication but got one after taking medicines bought in Lucknow.

Jagmohan was very sick and was asked to take some antibiotics. His condition did not improve even after a week's medication. All kinds of antibiotics were tried out. Nothing worked. He died soon after.

Richa, a high BP patient was highly dependent on tablets. Suddenly her BP became erratic and she required immediate hospitalisation. This despite her taking the prescribed tablets dutifully. Doctors could control her BP but could not figure out why she developed complications.

Shalini, Jagmohan and Richa are not some isolated cases. Incidents such as these are becoming commonplace and would soon become a norm rather than an exception. And the reason — spurious medicines. "One out of five strips sold in North India is a spurious one," pointed out Ranjit Sahane, President of Organisation of Pharmaceutical Producers of India (OPPI) and also the Vice Chairman of Novartis India Ltd. "It's a perfect crime with little evidence left behind in many cases."

The spurious drug industry is becoming well established in India. According to World Health Organisation's (WHO) 2001 statistics, 35 per cent of the world's spurious drugs are produced in India, followed by Nigeria at 23 per cent. By all accounts the magnitude of this problem would have only increased in the last two years.

North India already shows signs of this industry doing brisk business at the consumers' cost. And its tentacles are spreading far and wide. Unfortunately, consuming a spurious drug unlike buying a counterfeit designer shoes or apparel has mind-boggling ramifications. "There is no safe counterfeit. Spurious drugs are life threatening and not life saving drugs," said Mr. Sahane succinctly.

Even when spurious drugs do not endanger life, they can leave the patient seriously ill and those with inadequate potency do bigger harm to the society in general. Drug resistance develops when patients consume drugs with inadequate potency forcing them to look for costlier new generation drugs. And these patients could put the entire society at risk by spreading drug resistance.

Unlike other cases where the consumer knows his intent, the spurious drug industry thrives on consumers' ignorance, lack of stiff penalty for indulging in such activity and finally on lax regulatory system. Packaging is so nearly perfect that distinguishing a spurious drug from a genuine one is almost impossible. "They spend nearly 5-15 per cent of their investment in packaging. They even have the batch numbers right," Mr. Sahane noted.

Reusage of drugs past their expiry date is yet another menace. Or take the case of state governments settling for tenders quoting the lowest bid. "Nearly seven out of ten drugs have been found to be of less potency," recalled Harinder S. Sikka, Senior President, Corporate Affairs, Nicholas Piramal India Ltd. Is price or quality more important? It is time state Governments come to grips with reality.

Filling spurious drugs in used medicine bottles is another modus operandi. "We at Nicholas Pirmal face this peculiar problem with phensidyl cough syrup. People in north-eastern states get empty bottles from Bangladesh and refill them with a higher content of narcotics and sell them," said Mr. Sikka.

Cheaper substitutes for biotech drugs are another area of concern. "Neupogen for instance is available for nearly half the price. These spurious drugs are made available from across the border," pointed out Swati Piramal, Marketing Manager at Nicholas Piramal India Ltd. Nicholas Piramal is trying to beat these people using advanced technology and distribution system. Alu-alu packaging, patented sugar coating on certain medicines and having its own clearing and forwarding (C&F) in all states have made it difficult for the counterfeiters.

Incidentally, the consequences are not restricted to consumers alone. With a market share of nearly 20 per cent of the total drug market in India (it is worth nearly Rs. 4000 crores) the spurious drug industry's thirst for more is clear to see. It has already set its eye on the export market and succeeded in taking spurious drugs beyond our shores.

For instance, Africa and Latin America have taken cognizance of the increased export of spurious/sub-standard drugs from India and have started complaining about it. And worse, nearly 3-5 per cent of the drugs landing in the U.S. are spurious. The U.S. has already put India in the 301 watch list threat some months ago. If implemented it would totally ban export of drugs from India and sound the death knell for the Indian drug industry.

The low-risk, high-return spurious drug industry is bound to grow. Though belatedly, the Government is slowly waking up to reality. It plans to advocate death penalty for spurious drug racketing. Plans are afloat to reward anyone providing evidence of spurious drug manufacturing or selling, and finally to educate the public about the ills of spurious drugs through the electronic media.

In the meanwhile the consumers can become more proactive by buying medicines only from reputed and well-established chemists.

So the next time before you pop a pill or take a jab spare a moment. Do you want to consume chalk powder, sub-standard drugs or medicines past their expiry date? It's your health and the nation's future at stake. Chemists are a part of the chain and shunning the bad guys is one sure way to kill the spurious drug industry. Are the consumers game for it?

R. Prasad
in Chennai

© Copyright 2000 - 2009 The Hindu