Watchdog demands research into Irish online drug problem

PATIENT safety watchdogs have called for urgent research into the extent of the country’s addiction to buying medicine off the internet.

The Irish Patients’ Association (IPA) says counterfeit medicines pose a threat to Ireland on two fronts:

* To public health and safety;

* To the country’s €34 billion pharmaceutical industry, which makes six of the world’s 10 top-selling drugs.

Earlier this year an IPA report into counterfeit and internet medicine made 15 recommendations to Government, drugs companies and public health authorities to combat the menace of rogue drugs.

Among these was a call for more money for gardaí and customs to allow officials to work with international crime fighters Interpol.

The report also called for research into the extent of the counterfeit drugs problem in the Republic and how much is getting in through the postal and parcels industry.

It also outlined for need for more information on the popularity of the internet the purchase of drugs and the quality of online medicines.

The report said: “Irish people, like those around the developed world, are increasingly using the internet to seek information and make purchases.

“Although studies were not based in Ireland, various estimates find that between 36% and 55% of those using the internet are seeking medical information.”

Anecdotal evidence in Britain, for instance, reveals the country’s love affair with the internet: health information is one of the biggest reasons for people logging on.

But the internet also poses a danger in the form of “spam” or unwanted emails advertising medicines for sale.

The report said: “Internet and email users are continually exposed to advertisements offering drugs and other medicinal products.

“Some of these offer prescription drugs at much reduced rates. They offer prescription drugs without the expense or inconvenience of having to obtain prescriptions.”

Research has shown that one in five websites offers prescription-only medicine without demanding to see a prescription first.

Only 12% of online pharmacy websites has any form of quality accreditation, said the report.

The authors said: “The internet offers herbal remedies and dietary supplements that claim to be as effective as prescription drugs, like the infamous herbal viagra.

“While all types of medicines are available, the identity and quality of many products are unknown. The extent to which people in Ireland use the internet to purchase drugs and supplements is not known. Research is needed into this phenomenon to gain a clearer understanding of any problems.”

Patients who buy off the internet are unable to tell if the medicines they get are real unless they order through one of the few reputable names.

The IPA report also highlights another sinister side to the €28bn counterfeit drugs market: the role played by criminals and terrorists.

“The global problem of counterfeit products like films, software, clothes and CDs have been seen by some as “victimless” crimes; large corporations lose some profit, but the ordinary person in the street can better afford a counterfeit item than the authentic one. The claim is that no-one really gets hurt.

“The reality is very different. It is increasingly apparent that counterfeit products are part of the income-generating and laundering sides of organisations devoted to crime and terrorism.

“Ireland was represented at meetings organised by Interpol in which counterfeit products, including drugs, were reported to account for much of the money the international terrorist network depends on.

“But the harm from counterfeit drugs is even greater. A counterfeit CD or T-shirt will not cause direct harm to the purchaser. The direct harm to those purchasing counterfeit drugs is of the most serious kind. Little wonder headlines introduce the issue with terms like ‘Murder by fake drugs’.”

According to figures from the Industrial Development Agency (IDA), Ireland is one of the world’s largest exporters of medicines, with sales abroad of €34bn in 2002.

Anecdotal evidence suggests, however, that the global trade in counterfeit drugs is almost as big. It is worth e28bn annually.

The report said: “Of the world’s top-selling drugs, six out of 10 are produced in Ireland. These include Lipitor and Viagra, two of the most widely-counterfeited drugs. The potential impact of counterfeit drugs on the Irish economy is therefore substantial.”

Counterfeit medicines are not only costing Irish jobs but they are also killing people in poor countries where genuine drugs are out of the reach of the needy.

Fake drugs - which contain no active ingredients or which contain lethal additives - have caused a considerable toll of deaths, said the report.

Authors Dónal Ó Mathúna and Adam McAuley, of Dublin City University, gave four examples of the grim effect of fake medicines:

* Drugs donated to fight a meningitis epidemic in Niger, west Africa, in 1995 turned out to be fake, costing the lives of 2,500 people.

* A 1999 survey in Cambodia found that 60% of drugs purporting to be the anti-malarial medicine Mefloquine were ineffective or contained no drug at all.

* Hundreds of children have died in Haiti, Nigeria, Bangladesh, India and Argentina due to anti-freeze being added to give fake paracetamol syrup the right consistency.

* Fears are mounting of fake products being sold as anti-AIDS drugs in Africa, which may set back the treatment of the disease.

The authors concluded their report by saying: “Counterfeit drugs are a major problem - but they are part of an even larger problem.

“The search for cheaper medicines arises in part as a consequence of poverty and disparity.

“Addressing the problem of counterfeit drugs has to be seen as part of a strategy to bring social justice around the world. At the same time, greater resolve is needed to tackle the problem.

“Only coordinated action will achieve success here: governments, the pharmaceutical industry, healthcare professionals, police, customs, distributors, patients’ organisations, and those concerned about people’s rights must unite against the scourge of counterfeit drugs. Many different strategies will be needed to combat this problem.”