Marv Shepherd

Beef up international cooperation on counterfeits.

Counterfeit drugs are a menacing and deadly problem worldwide. The proliferation of fake drugs is astounding, with over 100 countries reporting incidents of fake drugs, according to a 2008 report from the Pharmaceutical Security Institute. And incidents of drug counterfeiting show no evidence of declining: some industry insiders suggest that the number of counterfeit medicines on the market has increased as much as 25% each year over the past several years.

Role of the pharmacist in preventing distribution of counterfeit medications

OBJECTIVE To provide an overview of the counterfeit medication problem and recommendations of a joint American Pharmacists Association (APhA) Academy of Pharmaceutical Research and Science and APhA Academy of Pharmacy Practice and Management taskforce. DATE SOURCES SciFinder and PubMed were searched from 1980 to March 2011 using the following keywords: counterfeit drug product, counterfeit medications, drug product authentication, drug product verification, and track-and-trace. Publications, presentations, and websites of organizations that research the counterfeit medication problem in the United States and other countries were reviewed. A representative from the security division of a pharmaceutical manufacturer and a representative from a supplier of anticounterfeiting technologies gave presentations to the taskforce. SUMMARY The taskforce recommends that pharmacists (1) purchase medications from known, reliable sources; (2) warn patients of the dangers of purchasing medications over the Internet; (3) confirm with distributors that products were purchased from manufacturers or other reliable sources; (4) monitor counterfeit product alerts; (5) examine products for suspicious appearance; (6) work with the pharmaceutical industry, distributors, and the Food and Drug Administration (FDA) to close gaps in the supply chain, especially for drugs in short supply; (7) use scanning technology in the pharmacy as part of a prescription verification process; (8) educate themselves, coworkers, and patients about the risks of counterfeit medications; and (9) report suspicious medications to FDA, the distributor, and the manufacturer. CONCLUSION The consequence of a patient receiving a counterfeit medication in the United States could be catastrophic, and pharmacists must play an active role in preventing such an event from occurring.

Examination of the Relationship between Direct-to-Consumer Advertising Expenditure and Price

Objective: Examine the relationship between direct-to-consumer advertising (DTCA) expenditure and prescription drug price from 1997 to 2000 for the top 20 advertised drugs of 1998. Method: The 20 prescription drugs were selected based on DTCA expenditure for 1998 as published in Med AD News. Drug prices were determined using the average wholesale price. Trend graphs were plotted between DTCA expenditure and unit price. The correlation coefficient was calculated between percent change in DTCA expenditure and unit price between 1998 and 2000. Results: There was a negative nonsignificant correlation between the percent change in DTCA expenditure and unit price between 1998 and 2000. All drugs had an increase in price but only half of the drugs showed an increase in percent change in DTCA expenditure whereas, the other half had a decrease in DTCA expenditure. Conclusion: Even though every year the industry spends millions of dollars on DTCA of prescription drugs we cannot conclude that it influences drug prices.

The Effect of US Pharmaceutical Drug Importation on the Canadian Pharmaceutical Supply

Background and objectives: For over a decade, many US politicians have advocated that the US allow personal and commercial drug importation. Currently, the only entities that can legally import a pharmaceutical in the US are pharmaceutical manufacturers. Our objective was to compare the number of prescriptions dispensed in Canada with the US and estimate the effect US drug importation from Canada will have on the Canadian drug supply. Methods: A model was created to measure the potential effect on the Canadian drug supply. The model uses the number of US prescriptions being sourced from Canada and the number of prescriptions dispensed in Canada in 2007 as the baseline. The number of days to exhaust the 2007 Canadian drug supply was calculated. Results: The model found that if 10% of the US prescriptions were filled from Canadian sources (manufacturer, wholesale or retail), Canadas 2007 drug supply would be exhausted in 224 days. If the demand from the US reached 20%, the 2007 supply would be exhausted in 155 days. The model was redone focusing on brand name drugs, with generic drugs removed. It was found that with a US demand of 10% and 20%, the 2007 Canadian supply for brand name drugs would be exhausted in 268 and 201 days, respectively. Conclusion: US drug importation is a threat to Canadas drug supply. Even if the US demand were 10%, Canada would need to dramatically increase manufacturing, triple drug importation, or most likely control or halt pharmaceutical shipments to the US.

Drug importation into the United States: impact on Canada

I write in support of the recent commentary by Nigel Rawson and Louise Binder.[1][1] My recent research examining the effect of US drug importation on Canada supports this commentary. The focus of the proposed bill in the US (i.e., the Affordable and Safe Prescription Drug Importation Act) is on