Council of Europe Convention on Counterfeiting of Medical Products and Similar Crimes Moscow, Russia, October 26-28, 201

1. Council of Europe Convention on Counterfeiting ofMedical Products and Similar CrimesMoscow, Russia, October 26-28, 2011 Presented by: Jeffrey Gren, Director, Office of Health and Consumer Goods, U.S. Department of Commerce Multi-regional Cooperation in the Fight to Stop Counterfeit/Falsified Medicines and Similar Crimes via the Internet

2. Presentation Outline • The Global Counterfeit/Falsified Medicines Problem and Growth of Internet Crime • APEC Anti-counterfeit Medicine Initiatives • Combating Counterfeit Medicines Internet Crime • Summary and Conclusions

3. Introduction – The Global Counterfeit Medicines Problem • Factors leading to this increase in falsified/counterfeit medicines include: • Increase in criminal activity and level of sophistication • High profit level (even higher than for narcotics) • Internet provides a marketing vehicle for counterfeiters to distribute counterfeit medicines • Lack of penalties, enforcement, and coordination in prosecution in many overseas markets have created conditions for counterfeiting to grow

4. Introduction – The Global Counterfeit Medicines Problem (cont’d) • Globalization of the pharmaceutical industry has contributed to the ready supply of APIs to counterfeiters, as manufacturing of APIs and finished dosage form medicines shifts from developed to lesser developed countries • Counterfeiting impacts all aspects of the pharmaceutical industry – patented drugs, generic drugs and OTC medications • Globalization of the pharmaceutical industry has also contributed to the growth of substandard medicines

5. Introduction – The Global Counterfeit Medicines Problem (cont’d) • Lack of vigilant oversight can lead to supply chain vulnerability • Supply chain vulnerability, in turn can lead to entry of counterfeit drugs into legitimate distribution channels • Lack of effective API regulations and the growth of counterfeit or adulterated APIs are significant global problems

6. APEC-Funded Anti-counterfeit Medicines - Past Activities • Under the APEC Life Science Innovation Forum (LSIF) there is an anti-counterfeit/falsified medicines initiative • The spread of anti-counterfeit/falsified medicines is a significant problem facing APEC economies and through joint cooperation by APEC economies we hope we can make a significant impact on this global problem • We also hope to include non-APEC economies and WHO in this APEC Initiative since stopping the spread of counterfeit medicines requires global cooperation

7. APEC Funded Anti-counterfeit Medicines Past Activities (cont’d) • During 2008 and 2009 APEC LSIF organized three Asia anti-counterfeit medical product seminars – January 2008 and March 2008 in Singapore and a February 2009 seminar in Mexico City • Attendance during three seminars (over 300) included regulators, customs, law enforcement and judicial officials, as well as industry representatives • Findings of the APEC Anti-counterfeit medical product seminars were presented to APEC Ministers and an APEC Anti-counterfeit Medicines Action Plan was developed • We are very pleased that the APEC Anti-counterfeit Medicines Action Plan has been endorsed by the APEC LSIF Planning Group during September 2010

8. Proposed APEC LSIF Anti-counterfeit Action Plan Components: • Strong cooperation among APEC economies is critical • Cooperation within each APEC economy between regulators, customs, law enforcement, judicial and industry is also critical • APEC economies should work together to collect data on counterfeit medicines • APEC economies should coordinate on legislation and penalties for prosecuting drug counterfeiters

9. Proposed APEC LSIF Anti-counterfeit Action Plan (cont’d) • Many falsified/counterfeit medicines enter APEC economies through Internet sales. Better internet prevention and education strategies are needed • Detection technologies to identify unsafe drugs are extremely important • Cooperation on the global shipment of ingredients used in the production of counterfeit medicines is also needed • APEC cooperation on counterfeit medicines public awareness is important for patients, health professions, regulators, custom officials and law enforcement officials

10. Proposed APEC LSIF Anti-counterfeit Possible Future Activities • The first activity of the Action Plan was completed several weeks ago in Beijing – a September 27-28 Drug Safety and Detection Technology Workshop • During this workshop APEC economies shared best practices and developed the first draft of a guidance document on how to use detection technologies as part of a larger strategy to ensure that counterfeit/falsified medicines are removed from the drug supply chain

11. Proposed APEC LSIF Anti-counterfeit – Possible Future Activities (cont’d) • In cooperation with other APEC economies the U.S. plans to develop an additional APEC anti-counterfeit /falsified medicines projects to take place during 2012 and beyond implementing the APEC LSIF Action Plan • One proposal being considered is a workshop to take place during 2012 with a focus on public awareness and the development of a Single Point of Contact System for counterfeit/falsified medicines investigations • Future workshops being considered include: • Internet Medicines Crime • Good Distribution Practices for Medicines • API Regulatory Practices and Counterfeit/Falsified APIs

12. Combating Counterfeit Medicines –Internet Crime - The Problem • One of the negative consequences of the growth of the Internet is that the Internet has become a significant method for the sale and distribution of counterfeit medicines • While twenty years ago most counterfeit medicines did not contain medicinal ingredients (i.e. ground up dry wall and highway paint) currently a large percent of counterfeit medicines contain APIs or excepients • What is scary is the counterfeiters are often using real pharmaceutical ingredients since they are seeking repeat business. Of course all counterfeit are unsafe and may not have the correct ingredients • In developed markets, such as the United States and Europe, the majority of counterfeit medicines are distributed through the Internet • Several studies have documented that the vast majority of medicines distributed through the Internet are counterfeit

13.   Combating Counterfeit Medicines – Internet Crime - The Problem • APIs are being sold on Internet sites promoting medicinal uses • Major pharmaceutical company security units track the production of APIs used is commonly counterfeited drugs, and they find significant amounts being produced in countries, such as China, that are in many cases sold through Internet websites • Distribution of APIs though the internet has become a much larger global problem in the past decade since the global production of APIs have been shifting to China and India and many experts predict that in the next 10 - 15 years 80 % of all APIs will be made in China and India • We are also finding more evidence of counterfeit and economically adulterated APIs

14. Combating Internet Crime – Possible Solutions • Public awareness of the dangers of counterfeit medicines. For example, a Korean study highlighted that erectile dysfunction drugs purchased on-line can have significant health risk • Enforcement and shutting down of websites selling APIs. For example, the China Ministry of Public Security has shut down numerous Chinese websites selling APIs with medicinal claims for APIs not registered with the China State Food and Drug Administration (SFDA) • Public Health Warnings – For example, USFDA issued a public health warning about a fake version of antiviral Tamiflu being sold on-line causing harmful reactions • Increased law enforcement efforts focused on shutting down on-line pharmacies selling counterfeit medicines

15. Combating Internet Crime – Possible Solutions • Cooperation within countries to monitor and shut down Internet sites selling counterfeit medicines. For example, in the United States, the USFDA, US Immigration and Boarder Enforcement and US Customs and Boarder Protection and other law enforcement agencies have participated in a number of law enforcement actions focused on counterfeit medicines and Internet sites • Multi-lateral Cooperation is also critical. For example “Operation Pengea IV” was a worldwide “week of action” September 20-27 targeting on-line sales of counterfeit and illegal medicines resulting in 2.4 million units seized, 55 arrests around the world, closure of over 13,000 websites and significant Public and Private Sector Cooperation

16. Combating Counterfeit Medicines - Internet Crime –Possible Solutions • Public and Private Sector Cooperation. For example, in the U.S. the Intellectual Property Enforcement Coordinator (IPEC) announced significant private sector coordination in the form of 11 major Internet commerce companies planning to establish a non-profit organization referred to as the Center for Safe Internet Pharmacies (CSIP); and support of Verified Internet Pharmacy Practice Sites (VIPPS) • Private Sector Initiatives. For example, the National Association of Boards of Pharmacy (NABP) announced progress in effort to fight rogue Internet drug outlets. During 2010 three major Internet search engines agreed to limit their advertising to Internet pharmacies in the U.S. that are associated with NABP’s VIPPS program

17. Combating Counterfeit Medicines -Internet Crime –Possible Solutions • Other notable examples of private sector initiatives are the Partnership for Safe Medicines (PSM) and the Pharmaceutical Security Institute (PSI) • PSM issues a weekly update and a Safe Medicines Alert and offers partnerships with specific countries such as India, China and Thailand • PSI maintains the “Counterfeiting Incident System” which is a unique incident-based reporting mechanism inaugurated in 2002 which includes pharmaceutical crime reports from open sources such as press releases, academic journals, media articles, or government warnings, as well as member company reports • Another notable public private partnership is the US Pharmacopeia Quality of Medicines Program (PQM) (a US AID supported program)

18. Summary and Conclusion • During my presentation I covered the following: • The global counterfeit/falsified medicine problem and the growth of internet crime • APEC/Anti-counterfeit/Falsified Medicine Activities • Activities to combat Internet medicines crime • Counterfeit/falsified medicines is a significant growing global problem and I am hopeful that the programs and cooperative activities I outlined during my presentation will make an impact to stop the spread of counterfeit medicines

19. Jeffrey L. GrenDirectorOffice of Health And Consumer GoodsInternational Trade AdministrationU.S. Department of Commercetel: 202/482-2470fax: 202/482-0975jeffrey.gren@trade.govhttp://www.ita.doc.gov/td/health