Fake drugs, real problems

The racking coughs on the subway are getting louder, the masks are out in full force and common colds and flu are growing from infancy into full blown epidemic. With every degree that the temperature drops, the dollar sign in the eyes of Beijing's pharmacists grows a little bigger. Sadly getting treatment can sometimes be just as risky as getting ill. A recent three month nationwide investigation into counterfeit medicines came to an end on November 17, exposing more than a thousand counterfeiting dens for medication and claiming 315 million U.S. dollars in fake drugs. The whole affair had been sparked by a taxi passenger in Zhejiang province, who had been carrying hundreds of empty medicine packets. It turns out that hospital cleaners had been saving the packages for resale to counterfeiters. Then, the latest counterfeit bust caught a range of Western medicines up for sale, including high end cancer treatment drugs like Herceptin. "Actually any medicine that you go out to buy could be fake, Western or Chinese medicines alike," says Chen Jing, who works for the JinLong pharmacy group. "We have to check all the certifications and serial numbers on the packets that come in to our store to see whether they come from a source that is licensed to produce that kind of medication, and check that it has certification by the state administration too." Chen suggests that if you're shopping at small back alley pharmacies or markets, it's possible that you'll get caught out with a few less-than-trustworthy pills, especially since serial numbers and certificates are preposterously easy to forge. "As a customer there's really not much you can do. Shop at reputable places, and if you're in doubt of the quality of medicine after you've opened the packet, take it to a professional pharmacy to get it checked out," she advises. "We can normally spot a counterfeit by the color and marking of a medicine. But just from the packaging it can be difficult." Difficult indeed, especially given the sheer variety in the average Chinese pharmacy. Not so traditional Traditional Chinese Medicine (TCM) also has its own problems. Without specialist training, it can be difficult to spot the difference in raw form. "Compared to other cities, Beijing has relatively few fake medicine outlets and the market is better controlled and supervised," claims one TCM doctor at the General Hospital of Armed Police Forces, surnamed Li. He suggested that it is possible to be given completely counterfeit medicinal cures from open markets. But small low budget herbalists also tend to offer lower quality goods in exchange for the real deal. While not necessarily counterfeit, the impurity of the herbs renders them relatively ineffective. "One of the most problematic ingredients for TCM are Cordyceps," says Zhang Ke, a pharmacist with Jianguo TCM hospital. Cordyceps are used in a huge variety of traditional medication for everything from boosting the immune system to supplementing cancer treatment. Real examples are difficult to find, but should be light yellow in color, fatter at one end, with several patterns on the stem, Zhang suggests. Fakes often lack these distinctive markings. The famous "time honored brand" of Tongrentang TCM clinics came under scrutiny in June, when tourists visiting a branch near Badaling Great Wall complained of generic diagnoses of "kidney trouble" given to massive groups of tourists, and placebo prescriptions that seemed to have no effect. The company apparently worked fast to correct the errant staff. However, when they were contacted by Global Times for an interview, they refused to talk about the practice or even how customers could avoid being stung. The same was true of Beijing Hospital of Traditional Chinese Medicine, who refused to speculate on the availability of fake medicines and would not talk to the newspaper. Locals hinted that this could be because the topic of fakes has become taboo, particularly after a senior official with the State Food and Drug Administration was executed for corruption and dereliction of duty in 2007. At the end of the day, going to smaller, independent pharmacies can pose a risk, particularly if you feel like you're getting a good deal on your prescription. Li suggests heading to an established brand. "If worried, patients can go to a licensed TCM department of a standard Chinese hospital or try professional and well respected herbalist shops like Tongrentang or Jingxiang pharmacies," he said, then warned people to just expect a lighter wallet at the end.