Counterfeit pills are not placebos

It should not come as a surprise to anyone who has visited a doctor for even the most minor of medical complaints and been presented with a prescription for a vast array of colorful pills that the call for Western pharmaceuticals in Taiwan is huge.

The populace's reliance on modern Western medicine as a cure for everything from erectile dysfunction to the common cold means that Taiwan's pharmaceutical expenditure cashes in at a hefty NT$100 billion per year.

Patients don't, however, always get what they pay for.

According to recent figures from the Department of Health (DOH), every year around NT$10 billion of the populace's pharmaceutical outlay goes towards lining the pockets of the organized criminal gangs that smuggle, manufacture and sell counterfeit pharmaceutical products to an unsuspecting public.

The problem is now so great that those who purchase any one of over a dozen popular name-brand pharmaceuticals from pharmacies and private clinics run the risk of inadvertently ingesting worthless and, or dangerous counterfeit medications.

"It is a huge problem. Nobody knows whether anyone has died as a direct result of taking counterfeit drugs, but taking these products certainly poses great risks," said Carol Cheng (程馨) of the International Research-Based Pharmaceutical Manufacturers Association (IRPMA). "It can prolong disease, can make people sick and quite often they can have absolutely no effect."

There are several ways in which counterfeit medications are classified, but the most commonly used are those employed by the WHO. The list includes any pharmaceutical product that is deliberately mislabeled in respect to identity or source; any product that contains incorrect quantities of or does not contain active ingredients; one that contains the wrong ingredients and any product that comes in fake packaging.

While the use of counterfeit medicines stands at 10 percent of Taiwan's annual consumption -- a number similar to the US FDA's estimates for the saturation of counterfeit medication on a global scale per-nation -- the penetration rate for some brand-name products in Taiwan is well above the norm.

The infiltration rates for counterfeit impotency medications Cialis and Viagra, the hypnotic Stilnox, Reductil slimming pills, the osteoarthritis drug Glucosamine, Centrum multi-vitamin tablets and the anti-diarrhea medication Seirogan are estimated to stand at a staggering 20 percent to 30 percent.

"In developing countries we see more medicinal pharmaceuticals counterfeited. Anti-malaria pills and so on, but in developed countries it tends to be what we refer to as `lifestyle' drugs and those aimed at curing chronic diseases," Cheng said. "People purchase a lot of these types of pharmaceuticals here and the counterfeiters are well aware of this."

"The fakes are sometimes easy to spot. If the packaging is not in Chinese, then it is a fake, as the Law states that all pharmaceuticals sold in Taiwan have to be printed in Chinese," said pharmacist Hsu Chao-lun (許眧倫). "But I've seen copies that are so good that unless you really know what to look for they appear genuine. Quite literally anyone could purchase counterfeit drugs by mistake."

The raw ingredients for the counterfeit medications produced in Taiwan are smuggled from China and, on average cost as little as NT$1,000 per kilogram. A large amount of the packaging used by counterfeiters is illegally imported from Singapore. Counterfeit medication can be produced, packaged and sent to market for between NT$1 and NT$20 per tablet.