When you take medicine, there's a good chance you're getting a dose of modern global business practices as well. Eighty percent of the active ingredients in the medications that Americans use are produced overseas. In a single drug, it's quite possible that the individual components came from several countries and were assembled in yet another before arriving on U.S. shores.
This diffuse manufacturing operation increases the opportunities for chicanery, which can include too-low amounts of active ingredients or substitution of different ingredients as well as adulterated ones. In some countries, 30% to 50% of medications are counterfeit — unlicensed knockoffs or imitations of real drugs. A new study published in the June 2012 edition of the Lancet found that about a third of the anti-malaria drugs administered in Southeast Asia and sub-Saharan Africa were either counterfeit or so poorly made that they were ineffective.
In the United States, the problem of counterfeit drugs is still relatively rare, but growing. In February, a counterfeit version of the cancer drug Avastin that contained none of the active ingredient was purchased online by various medical groups that were ignorant of the fakery. On Tuesday, the U.S. Food and Drug Administration posted a warning about a counterfeit version of Adderall that contains painkilling ingredients instead of those for attention deficit hyperactivity disorder. During the last year there also have been cases of counterfeit weight-loss drugs, anti-flu medications, Viagra, Vicodin and morning-after pills. Most counterfeits are purchased online.