PHARMACEUTICAL ROULETTE | The Shadow Market and Counterfeit Drugs

Lax System Allows Criminals To Invade the Supply Chain

By Mary Pat Flaherty and Gilbert M. Gaul
Washington Post Staff Writers
Wednesday, October 22, 2003

Fourth of five articles

She had made peace with the indignities of chemotherapy: the baldness and the vomiting. And she had learned to brace for the pain that broke in waves during the end stages of her breast cancer. But the bone-deep fatigue that settled over Maxine Blount was different and troubling.

"I couldn't get out of bed. I was really tired, worn out, exhausted," she said.

Even the costly injections she relied on to rejuvenate her did not help.

"The girls at the cancer suite," as Blount called her nurses, figured it out first, remembering a recent warning about counterfeit medicines in circulation. They checked a remaining vial from the set of four Blount, of St. Charles, Mo., had bought in March 2002 at her drugstore.

She had bad medicine.

Already weak herself, Blount was taking a weakened version of Procrit, which fights fatigue and anemia. Testing confirmed her dose was one-twentieth the strength listed on the packaging -- packaging that was so authentic-looking that it fooled health inspectors.

Blount died last October at age 61, knowing that when she needed the most from her Procrit she had received the least.

"You're very angry," she said in an interview a month before her death. "You have faith in your pharmacy and faith in the medicine, faith in the packaging and the people doing the buying that they know what they're doing. Now, whenever I get my medication I wonder where it's coming from. But what can I do?

"I need it. I have to have it. And I'm scared of it, every time."

At a time when more Americans are relying on medication, their chances of receiving a drug that is fake, diluted or mislabeled have never been so great.

Last summer, a drug wholesaler was forced to recall nearly 200,000 counterfeit and mislabeled Lipitor tablets after patients complained that their medication tasted bitter. In May 2002, investigators discovered that nearly 110,000 bottles of cut-strength Epogen had passed undetected into the open market. In the past three years, counterfeit, adulterated or diluted medications have been found in drug wholesaler warehouses in Maryland, Kentucky and California. Some of the drugs were distributed in Hawaii, Texas, Washington, Arkansas, Tennessee, Louisiana, Mississippi and Alabama.

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