The Pharmaceutical Journal
Vol 273 No 7316 p334
11 September 2004

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Keep supply chain intact more
Chinese medicine is a risky business more

Keep supply chain intact

Nearly a year ago The Journal carried a leading article pointing out the potential dangers to the public of buying counterfeit medicines, particularly over the internet (4 October 2003, p436). We wrote: “Although they are not a significant problem in the United Kingdom at present, they may become so in future.” More worrying, counterfeit versions of Cialis and Reductil have now been found in the legitimate supply chain (PJ, 28 August, p277 and, this issue, pp335 and 341).

It could be argued that the fact that so few counterfeit products have emerged in this way is a credit to the checks and procedures in the UK system that ensure health care professionals and patients can be confident that medicines obtained legitimately are what they say they are.

However, how long will this last? The chilling description of what is going on in the US (Broad spectrum, p344), where the majority of prescription medicines are obtained by the internet and/or mail order, is a timely reminder. Cracks can appear in any system when business imperatives seem to be given greater priority than quality issues. This is not to suggest that the UK system is likely to become more like the US model. But, with all the changes expected in the next few years to the delivery of medicines and the system of reimbursement for dispensing, unscrupulous operators will exploit any weaknesses they find.

There are some suggestions that pharmacy businesses will become divided into dispensing factories and service providers. Those dispensing factories will look at any way to improve their profitability and might offer an opportunity for counterfeiters to join in. Internet pharmacies — whose development the Government is encouraging — must be maintained under the most strict controls, so that there is no possibility that patients could inadvertently use a cowboy outfit by mistake when their medicines are dispensed in a virtual pharmacy. These scenarios may not be likely but they are examples of the way the legitimate supply chain may become more fractured. The Government needs to be sure that, as the NHS changes, patients can be assured that if they do take risks with medicines it is a risk of their own making.

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Chinese medicine is a risky business

Every day thousands of people buy a traditional Chinese medicine (TCM) thinking it will do them good. However, as the latest warning from the Medicines and Healthcare products Regulatory Agency points out (pp335 and 342) it may just as easily do harm. Pharmacists and patients need to be vigilant that products that they stock and sell are genuine TCMs and herbal medicines and not contaminated or inactive. Unfortunately, legislation, which will come into force in a year’s time, will not have any real teeth on the quality front until 2011, so patients need to be aware that the risks they are taking with TCMs and herbal preparations are of their own making.

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