The Dangers of Counterfeit Medications: A Growing Concern

Imagine this common scenario: You are 50 years old, diagnosed with Type 2 diabetes and obesity and prescribed Ozempic by your health care provider. You have a high prescription co-pay at your pharmacy, and you struggle with the cost of filling the prescriptions.

Your friend then tells you about a great deal from an online pharmacy for high blood pressure medications. You go to the authentic-appearing website which sells Ozempic for a fraction of the cost that you are paying at your neighborhood pharmacy. It arrives in similar packaging, and you begin taking it.

Several weeks later, you are found unresponsive at your desk at work. In the emergency department, you are found to have a massive increase in your blood sugar and severe dehydration that could have been fatal. You spend several days in the Intensive Care Unit (ICU) where the hospital pharmacist identifies the medications your family brought in as fake or counterfeit. This type of adverse medical event is becoming much more common and being identified by health care providers in our nation’s Emergency Departments.

With the excessive cost of many popular medications, there is an ever-growing issue of counterfeit medications. Criminal organizations see massive profits with very little legal risk in the sale and distribution of counterfeit drugs. Notices on both the FBI and FDA websites over the last few months warn of fraudulent drugs purporting to be Ozempic and several other weight loss medications. These illicit formulations have been found to contain unapproved drugs, chemicals and additives and do not contain semaglutide, the active ingredient in Ozempic. Due to costs and the reality of tariffs, many Americans have been searching for lower cost options to obtain their medications.

This has led to an explosion in the availability of counterfeit drugs in the United States and abroad. Commonly counterfeited medications include all classes of medications from prescription to over-the-counter medications. Reports of fake or counterfeit medications include erectile dysfunction medications, weight loss medications, opioids, cancer drugs, Botox, stimulants and HIV therapeutics. Counterfeit medications are medications that have been manufactured by non-regulated manufacturers and contain no active pharmaceutical ingredients (APIs), improper APIs, or may contain the proper ingredients in the incorrect quantity.

The deadliest versions of such counterfeit drugs may also contain fentanyl, methamphetamine or other dangerous drugs such as Xylazine that may lead to overdose and death. These counterfeit pills are made to look like prescription opioids or stimulants but contain fentanyl or even methamphetamine. There are numerous reports on the epidemic of deaths caused by this class of counterfeit medications. Many teens and even older persons have been impacted, resulting in needless suffering and death.

As Americans have increasingly turned to online pharmacies for cost and convenience, the problem is growing more concerning every year. The DEA has tracked an increase in illegal on-line foreign-based websites that deceptively target American consumers looking to save money on legal medications or gain access to controlled substances. Many of these websites are being operated in India and the Dominican Republic. Such online stores purport to be legitimate, U.S.-based FDA approved pharmacies. Such websites invest large sums of money to make the website look like legitimate online pharmacies. They often have highly professional graphics, offer 24-hour customer service, post online reviews and safety facts, and offer deep discounts to deceive the customers into believing they are buying from a reputable pharmacy or vendor.

Such counterfeit medications originate and are produced in countries such as China, Mexico and India, entering a web of international criminal distribution before they appear in our medicine cabinet. They are often packaged and labeled to look like legitimate medications. These medication counterfeiters and distributors often work closely with packaging counterfeiters. Some are very sophisticated and may have holograms and other forged security barcodes that closely resemble pharmaceutical grade medications. Sophisticated cloning technology has made no system completely secure.

What can you do to protect yourself and your family from counterfeit medications? The key is vigilance and common sense. First and foremost, be sure to exercise extreme caution when purchasing medications on-line.

There are several basic red flags to look for that may suggest a website or the medication it offers is counterfeit.

1. It sells prescription drugs without requiring a valid prescription from a health care provider.

2. It does not have a valid pharmacy state license or DEA registration.

3. It offers much cheaper prices than typically seen on other pharmacy websites.

4. It sells medications that appear different from what you received from your trusted pharmacy.

5. It sells medications that do not have an expiration date or have already expired.

6. It may display prices in a foreign currency.

7. It has no brick-and-mortar address listed.

Exercising caution, in this regard, may be lifesaving for you, your family and friends. It’s vital to educate your family on the massive and possibly life-altering or life-ending consequences of purchasing medications from online pharmacies that advertise prices that are much lower than you would typically expect to pay. Long lasting damage or death could result from taking counterfeit medications, especially opioids and stimulants.

Visiting the Be Safe Rx campaign on the FDA’s website provides information on how to safely buy prescription medications online and to locate official state-licensed online pharmacies.

It’s imperative that federal law enforcement agencies continue to work with international partners to shut down suspicious websites and manufacturers of counterfeit medications. Our national leaders also need to pressure foreign governments to stop manufacturing at the source. Such counterfeit medications affect not only us—but individuals worldwide.

Dr. Peter J, Papadakos, Professor of Anesthesiology and Critical Care Medicine and Director of Critical Care at University of Rochester Medical Center, contributed to this article.