A technique once considered for explosives detection might save more lives if used to verify the integrity of medicines

By Swarup Bhunia and Soumyajit Mandal

When you purchase medicine at the drugstore, you assume that it’s what you think it is and that the active ingredient in the drug is present in the specified concentration. Unfortunately, your assumption might be all wrong. Counterfeit and substandard medicines have become widespread, particularly in low- and middle-income countries with weak regulatory systems. Indeed, according to the World Health Organization (WHO), one out of 10 medicines sold in developing countries should be considered “substandard.” Your drug could even be an outright fake.

“But I live in the United States,” you may say. “The medicines at my pharmacy are regulated by the U.S. Food and Drug Administration, so it must be the genuine article.” Unfortunately, even the United States and other higher-income countries aren’t immune to this scourge. Since 2012, smugglers have been caught selling fake drugs to more than 3,000 doctors, clinics, and hospitals across the United States.

In one notorious case, two lots of the cancer drug Avastin were discovered to contain none of that medicine’s active ingredient. After a recall and lengthy investigation, the FDA concluded that the fake Avastin had traveled through a network of overseas suppliers, passing through Canada before reaching the United States.

And even if your drugs aren’t counterfeit, what assurance do you have that the pharmaceutical ingredients have not degraded? Many drugs are sensitive to heat, and neither you nor your pharmacist has any way of telling whether the pills you’ve just picked up experienced problematically high temperatures—say, in the back of the truck that delivered them.

The growing use of online pharmacies is only making these problems worse. In the United States, tens of millions of people (about 8 percent of the adult population) buy medicines outside the formal drug supply chain, typically from foreign online pharmacies or other unlicensed sources. A quarter of the people in the United Kingdom say they’re likely to use an online pharmacy in the near future. [READ MORE]