Bogus medicines targeted at low-income consumers

By Arif Suryobuwono

JAKARTA (JP): Bogus pharmaceuticals are there for those who cannot afford to buy the expensive real ones. The stuff is also there because there the low-budget consumer's problem is an opportunity to make money.

"What I mean with 'bogus' stuff is medicine which is illegally imported, produced, are substandard or mere placebos," said Aman (not his real name), a former medical representative who helped his company trace drugs pirates many years ago. "Hence they are cheaper," he added.

Aman said it is usually quite easy to distinguish them from the real ones. "First, they are cheap. Second, they are not professionally packaged. Third, they look different." Aman did not describe these differences in any detail.

Another medical representative, Amir (not his real name), said that illegally-imported drugs are easily detectable because they are not registered with the Directorate General of Food and Drugs Supervision (Ditjen POM). They also lack the code and lot number of the distributor officially appointed to sell them.

Spotting substandard drugs can be as tricky as spotting the differences between two identical pictures, especially if their prices do not differ much.

But there are uglier tricks. A man who once witnessed how bogus medicine was made said that scrapped medicines -- discarded or expired ones which have been thrown away in garbage dumps -- were "reconstituted in such a way that they look as if they were fresh from the factory, and then resold."

Scavengers and hospitals' cleaners supply dumped drugs to junk men and traders who sell them to drugstores after "revamping" them, the man, who requested anonymity, said. A relative of his did this dirty job.

Placebos

There are also placebos sold as antibiotics, he said. "The vendor, of course, has to employ a hit and run strategy," he said.

Another relative of his who managed to steal hundreds of empty capsules before losing his job in a pharmaceutical company used to sell "antibiotics" which were actually encapsulated wheat flour.

Amir said that a subtler way of playing trick is using near- quality materials. For instance, using cultivated medicinal herbs instead of those which grow wild as required.

Another, still subtler way is illegally procuring special low- priced drugs designated for hospitals, relief or charity organizations or government agencies instead of legally purchasing drugs designated for the common market. That way it is possible to offer them at a much reduced price. Those special low-priced drugs differ from normal ones in that they are loose in a can instead of being packed in air-tight foil strips.

Thus not all bogus drugs are really bogus and not all cheap drugs are fake.

The surest way of determining whether they are fake or not is to have them tested in a laboratory. But this is rare.

Aman said that when he gets reports of his company's products being sold below the market price in a given marketing area, the first thing he does is investigate the distributor responsible for the area. He recounted a specific case.

"Once I found a slightly different version of the drugs. But my manager said that our company used to produce that version some time ago. So there was no need to have them tested in the lab," he said.

"We changed our mind, however, when we found that the cover of the can containing the drugs was a bit too loose. The can was ours but the cover was not. Laboratory tests showed that the drugs were substandard."

A stock-take was then performed on drugstores in the area to investigate, and an insider was eventually found guilty of illegally producing the drugs.

This happened more than 10 years ago, but such things are still happening. Amir, whose company imports liquid drugs, confirmed this.

"Oh, yes, I know very well that our products also enter Indonesia in a rather informal way. But our company has decided not to take legal action because we know it would be useless".

"We deal with this problem by explaining to pharmacists and physicians the differences between legal and illegal products and asking them not to accept the illegal ones. That's all we can do," he said.

"I always wonder how these products can get into this country illegally," he added, "Is there nobody at the door?"