World Report

Rise in online pharmacies sees counterfeit drugs go global

The problem with substandard and falsified (SF) medical products may grow in high-income countries when e-commerce of medicines increases. Unauthorized websites offer medicines of insufficient quality. This underscores the importance of evaluating how the problem with SF medical products can be prevented from escalating. However, little is known about what knowledge and experience professionals working primarily with medicines have about the phenomenon.

This study was conducted to explore purposively selected pharmacists' experience and knowledge about SF medical products.

Twelve individual interviews were conducted with purposively selected pharmacists between May 2021 and September 2021. An interview guide was used with specific questions about e-commerce, which focused on exploring pharmacists' experience and knowledge about SF medical products. The interviews lasted, on average, 49 min and were analyzed using inductive qualitative content analysis.

A main theme ‘Pharmacists as guardians of safe medicines’ emerged. This theme consisted of three categories pinpointing ‘risk factors’, ‘protective factors’, and ‘opportunities for improvement’ regarding SF medical products. Findings suggest that pharmacists can play a role in preventing the problem with SF medical products from escalating. Participants emphasized they were in this line of work to help patients and increase patient safety.

Pharmacists have the opportunity to empower the public with knowledge about SF medical products since they discuss medicines with many people every day. Awareness of risk factors for SF medical products enables pharmacists to guide patients to avoid risky purchases from unauthorized websites. To do this, better communication, and cooperation with patients and other healthcare professionals are needed.

Non-genuine medical products, including diagnostic devices, have become a lucrative business for fraudsters, causing significant damage to revenues and reputation of companies, as well as posing a significant risk to the health of people and societies. Along a “digital twin” representing centrifugal microfluidic flow control on exemplary “Lab-on-a-Disc” (LoaD) systems, a novel, two-pronged strategy to safeguard miniaturized point-of-care devices by means of secret features and manufacturing challenges is outlined; such “hardware encryption” is flexibly programmed for each chip during production, and deciphered from a secure, local or online database at the time of use. This way, unlicensed copying can be efficiently deterred by an unfavorable economy-of-scale, even in absence of legal prosecution.

For many years, pharmaceutical organizations have battled to trace products across the supply chain. This shortcoming has made it easier for counterfeiters to introduce counterfeit pharmaceuticals onto the market. To solve the challenge, a new method for tracking and tracing medications is needed. Researchers believe blockchain can provide the technological underpinning for such a system because it can track legal pharmaceuticals and assist prevent the circulation of counterfeit ones. Counterfeited pharmaceuticals and unapproved medicines are dangerous and cause harm to patient life, owing to several causes such as its ineffectiveness, contamination, and inappropriate dose. The major challenge in handling this is the identification of the counterfeited product due to their similarity to the authentic drugs. Counterfeiting of drugs has become high-volume, high-profit business to the counterfeiters in the 21st century. Blockchain is an electronic cryptographic ledger that has a decentralized network model, here the information is not stored in one database, but the information is distributed and synchronized throughout the supply chain. Since counterfeiting of drugs is increasing globally, pharmaceutical companies are adapting blockchain technology to prevent counterfeiting. The supply of medicines is from manufactures to wholesalers, distributors, and pharmacy stores before it is purchased by customers; the counterfeiters come in between this supply chain and thus fake medicines get supplied and distributed. In this chapter, we are introducing blockchain-based solution “Drug-chain” to improve on the end the end transparency of the drug in supply chain using quick response (QR) code. The authentication of the stakeholders using private and public key is proposed to avoid the misuse of QR code in drug counterfeit. The proposed solution resolves the issues of drug supply chain by bringing the transparency, traceability, security, and authenticity of the data.

Counterfeit drugs are one of the most severe threats to the pharmaceutical industry. World Health Organization (WHO) highlights that nearly 1035% of the drugs, i.e., one out of ten medicines produced in the least developing countries, are counterfeit and have serious side effects on human lives. The upsurge in online and Internet-based pharmacies has made the safety and security of the drug supply chain process more intricate and complicated. This research proposes a new and novel track and trace blockchain-enabled Medledger system that leverages the Hyperledger Fabric blockchain platform using chaincodes (smart contracts). The proposed Medledger system helps to efficiently and securely execute drug supply chain transactions in a fabric enabled private permissioned distributed network of different pharmaceutical stakeholders. Our proposed traceability solution diminishes the need for a trusted centralized authority, intermediaries and provides transaction records, enhancing efficiency and safety with high integrity, reliability, and security that reduces the likelihood of meddling with stored data on the Medledger. Chaincodes are designed, coded, and implemented using sequence diagrams to govern and control the interaction amongst the participating stakeholders in the drug supply chain ecosystem. The proposed system perpetually stores and records all activities, events, and transactions on the blockchain's immutable Medledger linked with peer-to-peer decentralized file systems such as IPFS, Swarm, filecoin, etc. for storing and providing maximum transparency and traceability. We provide an insight into some of the ongoing implementation challenges for the hyperledger fabric platform. Finally, we discuss open challenges that serve as future research directions to improve the drug traceability solutions further.