Are you worried about counterfeit drugs? According to the American Council on Science and Health, you certainly should be:
Counterfeit drugs, including fake, substandard, adulterated or falsely labeled (“misbranded”) medicines, have become a real and growing threat to global health…
Even the U.S. drug supply, among the most secure in the world, is increasingly threatened by counterfeit or substandard drugs. The last few years have seen a rising number of cases of counterfeits turning up in neighborhood pharmacies, including fake versions of some of the nation’s most popular drugs.
This isn’t mere hyperbole, they’ll have you know: they’ve published a 35-page pamphlet — complete with 101 footnotes, five pages of bibliography, and a 2009 addendum peer-reviewed by no fewer than six experts — dedicated to this subject. The title of the pamphlet is "Counterfeit Drugs:
Coming to a Pharmacy Near You". So, yes, be worried. Unless, of course, you start actually following those footnotes to their source.
A lot of the footnotes I can’t track down at all, possibly because most of the pamphlet is a couple of years old; many of the rest of the footnotes refer only to news reports rather than actual primary sources. They generally circle back to a WHO report which was not — and never purported to be — a remotely scientific study of the prevalence of counterfeit drugs; instead, it included a fair amount of anecdote, and cited a mysterious September 2005 report from the US-based Centre for Medicines in the Public Interest which predicted "that counterfeit drug sales will reach $75 billion globally in 2010, an increase of more than 90% from 2005."
I haven’t been able to find a copy of the CMPI report; if anybody can point me to it, I’d be much obliged. But that CMPI report — which, remember, was a prediction, not a survey of any kind — seems to be the only source backing up the claim from the ACSH that the counterfeit drug problem is growing. (Oh, and the author of the CMPI report is one of the experts peer-reviewing the update to the pamphlet.)
As for the claims that counterfeit drugs are increasingly being found in the US drug supply and in neighborhood pharmacies, I can’t even find a single footnote to that effect; I can’t even find the claim about neighborhood pharmacies in the pamphlet’s text.
In general, whenever a claim is footnoted in the text, that footnote doesn’t support the claim itself, but cites some other primary source — and so on, ad infinitum. And sometimes, the ACSH seems happy to make claims which aren’t even in the text of its pamphlet at all.
At the end of this exercise, the skeptical reader naturally wonders whether there’s really anything to all the hyperbole at all. Counterfeit drugs may or may not be a problem in the US, but if substantially all the claims about them turn out to be bogus or unsupported, one has to wonder why the likes of the ACSH aren’t being fully honest with us.
(Thanks to Jesse Eisinger, who pointed me to the ACSH press release.)