In our hospital, only the patient is prescribed the medicine by the consultants and the hospital has no role in this. Our own effort is to keep in our hospital medicines that are either manufactured by multinational companies or medicines from local companies that export their own medicines Dr Shahid Khawaja, Chief Executive of National Hospital
450 on it. This counterfeit medicine is now available in our market for RS 30 to 40 while the price of real medicine is between four to five hundred rupees. Think for yourself what will be the material in counterfeit medicine for forty to fifty rupees,” he explains. The manufacturer pays Rs 5 per packet for the packaging of this medicine. Similarly, when the medicine comes in the market, the wholesaler has to pay a commission of 20 to 30 percent and the cost of transportation will also be incurred. If we look at the total cost of this medicine, then it becomes Rs 20. “Take another example, this time of these drops called Consticare, similar to Skilex,” he explains. “This medicine is used to relieve constipation and there is a huge difference in the price of real and fake medicine. If we talk about Rizek, this medicine is used by more or less every person. This medicine contains omeprazole salt which cures gastrointestinal disorders and most of the gastrointestinal problems. “The price of this packet of medicine in the wholesale market is RS 430 whereas a similar medicine is also available in the market under the name Renzk, the packaging of which is very similar to the original medicine and its packet is available at RS 30. These are just a few examples of counterfeit medicines being sold in the market for diseases such as heart disease, kidney, liver, stomach, blood pressure, diabetes and cancer. Even life-saving counterfeit medicines are sold openly in the market,” he lamented. Now, the question arises as to how these counterfeit drugs reach the market, to which Abbas answers by saying that
in most parts of the city, the counterfeiters have opened factories secretly manufacturing these drugs. “These factories are not registered anywhere. The owners or employees of these factories come to our wholesale market and offer to sell their counterfeit medicines to many shopkeepers in the lure of higher profits.” “These drugs are brought to the market in various shoppers and bags. However, such drugs are not displayed in the shops. Because of the small means used for the transportation of these drugs, these drugs reach the market from these unregistered factories without any checking,” he said. Abbas believed that when it comes to the sale of drugs or medicines, the wholesale market sells 40 to 60 million daily, of which 50 percent is counterfeit drugs.
Who is buying these counterfeit drugs?
A
pparently, counterfeit medicines are being sold openly in the wholesale markets, but the answer to how these medicines travel from the wholesale market to the general market is given by Hassan Malik, the owner of a medical store in Lahore. “We visit the wholesale market daily because we have to buy some new medicine on a daily basis. When it comes to the wholesale market, many well-known shopkeepers also come to shop in this market and these shopkeepers are the ones whose medical stores are located around various government hospitals and streets in the city. When the wholesaler is asked for the required medicine, most of them [wholesalers] recommend buying
When medicine returns, it is counted and remains in DRAP’s custody. Any pharmaceutical company in Pakistan needs to get a license for the manufacture of any medicine. We take full action against counterfeit and substandard drugs sold in the market Dr Ghazzanfar, senior DRAP official
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cheap medicine,” he explains. “Apparently this [fake] medicine looks real and the price is very low so many shopkeepers buy this medicine. In buying it, the medical store owner has the advantage that the price of the counterfeit medicine is written on the packet of the original medicine while the shopkeeper buys the counterfeit medicine for between Rs 30 and Rs 40. Many medical store owners buy counterfeit medicines from this market instead of buying real ones. Now that these medical stores are open on streets or around government and small private hospitals, most people who visit them do not pay attention when buying medicine. When someone asks these shopkeepers for Risek, they say that we have run out of Risek, but the same medicine is available under another name which is also cheaper by ten or twenty rupees. The common man does not pay attention and buys counterfeit medicine. On the other hand, these shopkeepers do not even tell the naive people and sell them counterfeit medicine instead of the real medicine. Obviously this is counterfeiting and there is a lot of profit in it,” Malik said. Clearly the issue here is one of collusion. Wholesalers are producing these medicines, and medical store owners are buying them and selling them to patients. The patients, who are getting the short end of the stick, do not buy these medicines because they are cheap they still pay what they would pay for the real thing. The reason is that medical store owners allow their greed to get ahead of them and play with people’s lives. However, on the other hand, Abbas also believes that the wholesale market supplies medicines to the whole of Pakistan, so it is not only medical stores that come to this market. “Medical stores, private clinics and private hospitals from every small and big city come to our market to buy counterfeit medicines. Since there are no large medical stores in small cities, these counterfeit medicines are easily sold there, while many quacks and qualified doctors keep these medicines in their clinics and make patients use these medicines and charge the full bill of medicines,” he says.