Dangerous doses

The worldwide counterfeit drug market is huge and growing. The Center for Medicine in the Public Interest estimates that in 2010 the trade reaped around $75 billion, a 90 percent increase since 2005. Over the same period, the Pharmaceutical Security Institute (PSI), of which one of us is president, documented a huge increase in discoveries of counterfeit pharmaceutical products. In 2005, it recorded over 1,000 incidents; in 2010, it recorded more than twice that. The World Health Organization previously estimated that as much as 15 percent of the medicine in circulation around the world could be fake. These drugs occupy a wide spectrum of medications, and their quality is suspect; they can be mislabeled, tainted, adulterated, ineffective, or, in the worst cases, all of the above.