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How to Get Rich Selling Fake Drugs Online
1.5k Plays1 year ago
In this episode, we speak to Anne Devaud, global head of product security at one of the world’s largest pharmaceutical firms, about the threats posed by pharmacrime gangs. She has spent the last 25 years in both the private sector, and in France’s customs enforcement agency combating crimes such as smuggling and counterfeiting. Anne holds a Masters in political science from the Institute Etudes Politique in Bordeaux, and a degree in crisis management from France’s national security and justice college.
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Transcript
Introduction to the Podcast
00:00:02
Speaker
Welcome to How to Get on a Watchlist, the new podcast series from Encyclopedia Geopolitica. In each episode, we'll sit down with leading experts to discuss dangerous activities.
Dangerous Activities and Prevention
00:00:13
Speaker
From assassinations and airliner shootdowns through to kidnappings and coups, we'll examine each of these threats through the lenses of both the Dangerous Act to seek and to conduct these operations, and the agencies around the world seeking to stop them. In the interest of operational security, certain tactical details will be omitted from these discussions.
00:00:34
Speaker
However, the cases and threats which we discuss here are very real.
Host Introductions
00:01:02
Speaker
911, what's your emergency? I'm Louis H. Prisant, the founder and co-editor of Encyclopedia Geopolitica. I'm a researcher in the field of intelligence and espionage with a PhD in intelligence studies from Loughborough University. I'm an adjunct professor in intelligence at Science Pro Paris, and in my day job, I provide geopolitical analysis and security focused intelligence to private sector corporations. I'm Alexandra Shokiewicz, a co-editor of Encyclopedia Geopolitica.
00:01:31
Speaker
I'm a multilingual security and intelligence professional with a master's in international security from Sciences-Popari. I have served in both consulting and in-house roles focusing on threat monitoring, geopolitical intelligence, and security support to various public and private audiences.
Rise of Pharma Crime
00:01:45
Speaker
So today we're discussing how to get rich selling fake drugs online. With pharma crime on the rise globally, we thought it was best to sit down with an expert on the topic. So today we're joined by Anne Devode. Anne is the global head of product security at one of the world's largest pharmaceutical firms. She spent 25 years in both the private sector and in France's customs enforcement agency combating crimes such as smuggling and counterfeiting.
00:02:09
Speaker
and holds a master's in political science from the Institut de Etudes Politique in Bordeaux and a degree in crisis management from France's National Security and Justice College. So Anne, thank you very much for joining us. Thank you so much, Lewis. My pleasure to be with you today. So the question we always like to ask our guests to start with is, how did you get into your line of
Anne Devode's Career
00:02:29
Speaker
work? It's a business not many people are familiar with. People may be surprised to know that this kind of job exists. So tell us, how did you find yourself doing this work?
00:02:38
Speaker
Yeah, you're right. It's kind of a niche job. I have 25 experience in mitigating crime in both public custom enforcement and pharma industry. And I use my knowledge of law, political science, experience, but also humility. Because when you are working to fight against crime, you have really first to learn and understand the landscape.
00:03:07
Speaker
How I get on this job first, I'm really passionate about fighting against various crimes due to the severe impact for populations and states. When I joined customs as superintendent,
00:03:23
Speaker
I spent eight years at Rochelle de Gaulle Airport and my job was to manage teams in charge of detecting and disrupting narcotic importation, money laundering, counterfeit goods or smuggling. And this daily collaboration was law enforcement unit, airport, commercial operator, prosecutor was very exciting because when you start your day, you never know what will happen.
00:03:51
Speaker
So the job was to ensure efficient control at the border, but also to ensure business continuity, because what's the goal is most 52 million of passenger per year. So fighting the bad guys in this high traffic was always a challenge. So I really learned a lot and it was very exciting job. But at the end, I was a little bit frustrated because
00:04:19
Speaker
At customs, you stop illicit business mainly in transit, but I was not able to investigate at the source of the crime. And that's why I decided after 13 years within custom enforcement to consider a new carrier pass in the private sector. The question was always, okay,
00:04:42
Speaker
who may be interested by my experience and by my background. So that's why I started to look and I have identified that for my company was starting to develop anti-country fit program. And I say, okay, I will knock at the door and check if they may be interested by my background. So in comparison with other country, for example, US or UK, or it's quite common for military or
00:05:09
Speaker
ex-law enforcement to move in the private sector in France is not so many developed yet. So it's always a challenge, but I think it's very good because it helped to open the mindset. So this is part of my experience and I really would recommend to the new generation to also consider how to move from public to private sector because this is really a complimentary and very interesting approach.
00:05:38
Speaker
And if I may now share some few maybe insights from my now private carrier experience and that when you are working for the private company, you have to be solution oriented. And that's why now since 13 years, I learned a lot in working with all geography, all culture, and I have one tip.
00:06:04
Speaker
always take into consideration the geopolitical environment. Try to understand the landscape which may really facilitate criminal activity and analyze the data to find the best angle to address your case and obtain some results. That is a really fascinating background and a really, really good advice as well for everybody looking at these different spheres that we're talking about in this podcast.
Understanding Pharmaceutical Crime
00:06:29
Speaker
Digging right in, when we talk about counterfeit medicines,
00:06:33
Speaker
What do we actually mean? What are these things that we're talking about here?
00:06:37
Speaker
Alex, if you allow me, I would like maybe to start by explaining what is pharmaceutical crime, because counterfeit is one part of pharmaceutical crime. And today, the pharmaceutical crime cover different infringement and issue. And those criminal organization, they are involved in multiple infringement, putting patient at risk. So maybe start us with what is counterfeit medicine? What does it mean?
00:07:04
Speaker
counterfeit medicine are related to fake product.
00:07:09
Speaker
that are deliberately and fraudulently mislabel genuine product identity looking for genuine products. So they may contain wrong active ingredient or wrong dosage, and worst situation, they may also contain dangerous substance. And sometimes it's genuine product with fake packaging. But nevertheless, those products are counterfeit because they are fraudulently used
00:07:37
Speaker
trademark, brand name, and most important, and in many cases, no active ingredient putting patient at risk.
00:07:46
Speaker
In parallel, of counterfeit medicine, there are also kind of complex legal definitions, which is illicit diversion. And in some countries, we identify diverted medicine. What are diverted medicine? It's usually genuine medicine, which are dedicated to some market, but identify in some other market. And what is the risk?
00:08:13
Speaker
You may consider that, oh, it's a genuine product. Usually, it's dedicated for the Turkish market, but it's sold in Georgia. The issue is that it's a violation of contract, law or regulation. But most important, those products usually are not following the normal distribution channel, meaning that they may be adurated due to Colshan description, or they are not properly transport.
00:08:41
Speaker
So anyway, there is also a risk for patients. And there is a third category that we identify in some countries, for example, Latin America, with genuine but expired product, meaning that they don't have any more active ingredient. They are expected to be destroyed, but they are not. They are relabeled, or we can consider that those products are alteration, criminals really scratching.
00:09:11
Speaker
the expiring date and changing to resell the product in the pharmacy. So, counterfeit, illicit diversion, tampering and theft are part of the pharmaceutical crime and it is sometimes quite complex for patient or for authority to really identify and consider which type of infringement and what is the response according to the infringement.
00:09:38
Speaker
So what type of medicines are we thinking about when we think about these kind of problems? What types of medicines are impacted by counterfeiting? Is this just something we see in the kind of, let's call them luxury medicines field, such as things like weight loss drugs, or are we seeing other medicines impacted? I'm thinking more about the kind of essential core medicines.
00:09:58
Speaker
Unfortunately, all terra-particle area are concerned. Potentially the first type of medicine which are counterfeit are what we call prescription medicine, such as antibiotics, painkiller, or life-saving products such as diabets, oncology, and vaccines. Why they are counterfeit? Because those medicine are a high value medicine. And in a lot of countries,
00:10:28
Speaker
The health insurance system is different, meaning that part of the population has no health insurance system. So meaning that when they are suffering a disease, they have to buy their medicine. And because there is no robust health insurance system, they try to find those products on their own at a cheaper price. So this is one category of counterfeiter.
00:10:55
Speaker
But there are also some other categories, for example, contact lenses, a lot of counterfeit. Why? Because it's very easy to resell on the market.
00:11:08
Speaker
and very easy to produce. And there are also a lot of products without any prescription, which are today counterfeit. Low price medicine, such as vitamins, food supplements, but due to the large volume of consumers, it's also very profitable to counterfeit such type of medicine or product without any prescription.
00:11:33
Speaker
What is important, I think, is to highlight that this pharmaceutical crime now is a major challenge which affects, again, patient safety in every single country. And I would like just to share with you some recent data which have been collected by the Pharmaceutical Security Institute.
00:11:56
Speaker
Pharmaceutical Security Institute is an association of the main or the big 40 pharma companies in the world. And we are sharing intelligence about this pharmaceutical crime risk. And just last year, we have identified almost plus 17% of counterfeit incidents and plus 8% of diversion incidents compared to 2021.
00:12:24
Speaker
Again, it's always the emerging part of the iceberg, but it's interesting to see that counterfeit is increasing and now injectable represent almost 25% of total counterfeit pharmaceutical products identified worldwide, both by authority or by the pharma industry.
00:12:45
Speaker
So it gave us some, I think some kind of trends to consider that today, all terra particular area may be concerned by those counterfeit. And if you consider always, if you ask, why is those increasing issue? First, because it's a very profitable business, counterfeit medicine generates more revenue compared to narcotic business. And do you know why?
00:13:15
Speaker
to reason, the volume of patient or consumer eager to get product is larger than the volume of potentially drug user or narcotic user. And then they said also because pharmaceutical crime today is not really, there is no real penalty.
00:13:38
Speaker
against this crime, because usually it's in some countries, it's not criminal crime, but it's a civil crime. So as soon as this is a civil crime, the penalty are very limited. So that's why the traffickers consider that it's more interesting to involve in this business, low risk and very good profit. And Anne, you mentioned that price can drive people towards counterfeit, obviously.
00:14:07
Speaker
What does the price point look like there for these counterfeit medicines compared with legitimate products? Maybe you can share a little bit both on the production side, but then also on what the price point looks like for those buying it.
00:14:21
Speaker
It's a very good question, Alex. First, if we consider the price for the patient or for the consumer, you have two situations. There are some counterfeit products which are offered at a very low price to reach certain populations which are in a bad situation or difficulty.
00:14:42
Speaker
And I'll just give you an example. In the Baya, California region, you know that there are a lot of Mexican immigrants illegally entering and living in the US. This population has no access to US medicine. So that's why when they need, for example, contraceptive treatment, or when they need oncology, they will
00:15:09
Speaker
find or look at some doctors who are really providing those counterfeit medicines for those populations because they don't have access to the US insurance system, so very low price. And there is a second category, which is with counterfeit medicine,
00:15:29
Speaker
offer almost at the same price than the genuine one. Just to reinforce patient trust, when patients in Europe or in the US are looking for cosmetic botox or weight loss,
00:15:44
Speaker
If they see that the price is very low, they will have suspicion. Or is it really a genuine product or not? So they will prefer to order product at the same price. They don't know that this can't fit. So they are paying for a can't fit product at the same price. Again, they are comfortable and they have the trust based on those price. So it's interesting to see the two trends. And regarding your question about the price for the manufacturing side,
00:16:15
Speaker
This is also an interesting trend because some counterfeit organization, they are using some active ingredient in the counterfeit treatment because they need to provide a result for the patient.
00:16:31
Speaker
If you take the example of Viagra, if you produce counterfeit Viagra with no active ingredient, there is no result. So you will lose your consumer. So you have to put inside some active ingredient. The same for weight loss. So that's why counterfeit organizations, they are really businessmen.
00:16:51
Speaker
there is a high demand, they will fit the demand, but they will also, they have to keep their consumer. So that's why they are really, you have different situation. Again, when we are looking about population in danger or for example, migrants or so on, it's quite different because of course they don't have the capacity to complain again. So they are using a medicine because they absolutely need
00:17:17
Speaker
a medicine, whatever it's counterfeit or genuine than it is. This is a landscape of counterfeit organization today.
Starting a Counterfeit Medicine Business
00:17:27
Speaker
That's interesting. If I wanted to get into the counterfeiting business, if I wanted to become a counterfeiting cartel member or something, how would I go about doing this? What sort of equipment and supplies would I need?
00:17:41
Speaker
Very good question. I will not disclose any details, too many details. But anyway, if you are a counterfeiter and you need to start your business, first, you need to get a genuine product or a product of reference that you will copy. Is it difficult to get this genuine product? Of course, not at all. You can buy a genuine box in a pharmacy and just copy the packaging and the blister and the leaflet.
00:18:12
Speaker
Or if it's a product under prescription, you can just look at the internet and look at the different presentations and again use 3D machines or just printer to get it. So getting a product reference is not difficult. Then do you need an active ingredient for counterfeit medicine?
00:18:35
Speaker
And not necessarily, as I explained, some counterfeiter, they are using expired product and just relabel it. Or they may also put water inside of viral vaccines because as soon as it's a transparent liquid, nobody will make the difference between water and active ingredient. Or some other counterfeiter are using small active ingredient again to have minimum efficiency. So there is the two different situation.
00:19:05
Speaker
Then, do you need a machine to produce counterfeit medicine? Yes and no. If you would like to do it at a large scale, of course, you need to buy those printing machine, embossing machine.
00:19:22
Speaker
And I was very surprised when I start my career to realize that there are some websites which are offering pharmaceutical machines for buying, even to some individuals or company who have no pharma license. So it was really, really for me, impressive to see why there was so low control on it.
00:19:47
Speaker
you can bind machines. This is something that we have, for example, identified in Middle East or in China.
00:19:53
Speaker
Then what is also important that if you start your counterfeit medicine, you have to find your client. It's like a business plan. So where you will find your clients first, of course, on the internet and social media. And now a lot of people are connected to various Facebook group or marketplace, and you can use those digital channels to sell your counterfeit. But you may also use more
00:20:23
Speaker
parallel channels. In some countries, again, where there is a low regulation, there are some street markets, for example, in Africa, where you can buy a lot of medicine. There are open markets. There are also some
00:20:41
Speaker
dark net or specific group where you can buy also your medicine. So the clients potentially are everywhere. And there were situations that there are also some pharmacist chain, which may be also involved in selling at the same time genuine and counterfeit products. Again, the reason for this
00:21:06
Speaker
In some countries, there is very low regulation. I just have an experience as well. For example, in Africa, in a country where, according to the legislation, you are not obliged to be a pharmacist to open a pharmacy.
00:21:22
Speaker
So of course it may create, I think, a gap and facilitate infiltration of counterfeit. Or there are some countries which are allowing more than 150 distributors to import medicine. So if there is law regulation in the importation or in the distribution, it can also create some channel to distribute the counterfeit medicine.
00:21:50
Speaker
It's a good transition because if you would like to sell your counterfeit medicine, you need distribution channel. How to carry on those counterfeit medicine? Multiple channels are used by counterfeiter networks today. If we are looking for intelligence and based on investigations which have been performed, usually
00:22:15
Speaker
This is always the same road than used by the drug dealers or narcotic organized crime. As soon as you have your channel open, you may export your counterfeits through container, large quantity, for example, between China and Middle East. You may also use small parcel because with the internet trafficking, customs are not able to control each individual parcel. So it's a second way to ship counterfeit.
00:22:45
Speaker
And there are also some more, I think, small situations, but some organizations are also using passenger carry-on in their luggage to fit medicine in some countries. And this is also another way to carry on.
00:23:01
Speaker
And then there is also some potentially other distribution channel that we are not completely aware of. But I'm quite sure that organized crimes are very creative in developing different ways to distribute the counterfeits.
Payment Methods in Trafficking
00:23:20
Speaker
And then
00:23:21
Speaker
As soon as you have your client, your distribution channel, you have to put in place financial system to get money and to organize money laundering. What we see in the counterfeit medicine trafficking, there are different website organization using Bitcoin for payments. You are a client and you will pay by Bitcoin, or you may pay directly with cash on delivery. This is a method which is regularly used in emerging markets.
00:23:51
Speaker
and there is also a very interesting method for payment, is the AWALA system. We actually discussed this in last week's episode with a money-laundering expert, Yaya Fanuzzi, so this is very timely.
00:24:06
Speaker
It is very interesting methodology again. It's quite unusual financial system, but very efficient if counterfeiter or counterfeit smuggler, they use a wallah to pay between two countries, those counterfeit network. They are using what they call relabel partner and there is no money transfer. This is based on trust between people.
00:24:35
Speaker
According to my knowledge, this is used in the Middle East but also in India, and it really facilitates those trafficking, not only for medicine but also to finance terrorism and different topics. It's very funny to see that
00:24:56
Speaker
I heard and I was in contact with some authorities in Europe, south of Europe, and they have dismantled counterfeit human hormone growth trafficking in Greece. And this criminal organization was using a wireless system to hide
00:25:14
Speaker
the profit of the medicine trafficking. So it was interesting to see that, again, creativity and the way to develop illicit business and to organize money laundering as really international. And if you want to learn more about the How Weller system and money laundering, make sure you check out last week's episode, How to Learn the Money with Yayef Nusi.
00:25:35
Speaker
You mentioned the business acumen needed by those that operate in this space, making sure they keep their customers happy and keep their trust and having a business plan. What else do we know about these malicious actors? What do we know about these people? Do we know what their background is? Do we know if they have any scientific background or training regarding the production of legitimate pharmaceuticals?
00:25:59
Speaker
Is there any overlap between those trafficking counterfeit medicines and those trafficking other goods? Are these the same people? When I start my career in the pharma sector,
00:26:12
Speaker
Usually the individuals involved in counterfeit medicine were really like kind of classical criminals, no specific scientist background. They were just involved in those counterfeit because it was part of the organized crime business.
00:26:30
Speaker
And it was mainly kind of small manufacturing facilities, not very professional way of producing and so on. It was more like a kind of a counterfeit in a garage or in small facilities. And since a few years now, we really saw an improvement in the counterfeit manufacturing, production, capacities,
00:27:00
Speaker
some of the major counterfeit manufacturing
00:27:06
Speaker
are really impressive because now they are using high professional machine and they are using some manufacturing scientists to ensure that the product really look like the genuine one, that they have some active ingredients inside. So we definitely in the pharma sector saw this professionalism in counterfeit medicine.
00:27:31
Speaker
The reason is because it's so profitable business that they have to be professional. One of the issues with this professionalism is that even for the forensic laboratory managed by local health authority or by the pharma company, it's more and more difficult to detect the counterfeit
00:27:53
Speaker
evidence on the packaging or on the blisters because at the beginning the mistakes were obvious and now it's more and more difficult to track and trace. So we see this evolution in the criminal profile and what is also I think recently new is also that
00:28:12
Speaker
counterfeit organizations, they are also using now people who are really professional, again, in money laundering, how to attract new patients, new consumers. They have very nice websites, look completely genuine one with doctors. It was really a nice design. When you look at it,
00:28:34
Speaker
You definitely, you can trust, but unfortunately they are a work website, but the design is very, very nice. So they have developed all those, I think, areas to ensure that it's more and more difficult to track and trace. And you also spoke about always being aware of geopolitics and the introduction as a context, you know, for, for pharma crime.
00:29:00
Speaker
Are there particular geographic trends in this whole thing, both in terms of where these fake pedroks are actually manufactured and where they end up being sold? When you ask two people, do you know where the counterfeit is coming from? A lot of people say, oh, China. This is real. Everything counterfeit is coming from China. It's a little bit more complex than this today. Geopolitics is a very important element in the pharma crime context.
00:29:29
Speaker
First, because counterfeiters are really starting to develop this business due to some geopolitical situation. For example, when there is a major inflation or economic collapse. Or, for example, like in Lebanon, when there was an explosion at the port.
00:29:52
Speaker
sales situation are creating really a major description in the normal life and the normal medicine delivery. So it's a pity, but those organized crime, they are using this geopolitical instability to reach patients who need treatment and we need medicine.
00:30:14
Speaker
If we're also looking about geopolitics, the war situation, the impact on border closure or disruption, of course, has an impact, again, on medicine trafficking.
00:30:29
Speaker
Now we have identified increasing volume of counterfeit cases in Ukraine and even in Russia because patients have some difficulty to get medicine. As soon as there is a disruption, potentially organized crime will go and feed the demand by a different way. Geopoliticals may be also a good driver in the improvement of the situation. We are discussing about China.
00:30:59
Speaker
The collaboration with China government has really been a game changer in the recent years following the big scandal. Maybe you remember it with the contaminated milk for babies.
00:31:14
Speaker
it was a huge scandal in China because it really impact Chinese population. And this scandal started to raise really more attention from Chinese authorities, health authority and police. And now we get very good results in
00:31:33
Speaker
dismantling those pharmaceutical crime network because Chinese authorities are really looking at it to protect their population. And that's why geopolitical crisis or scandals may really have an impact on how we collaborate and how the pharmaceutical crime may be mitigated
00:31:55
Speaker
The growing situation is that now there are a lot of geopolitical crisis. Just to take another example, crisis in Venezuela has also really increased as a medicine trafficking. People have no access to food, no access to medicine, so again.
00:32:14
Speaker
the same issue, the same response. And in Latin America, there are a lot of patients suffering those counterfeit medicine trafficking because they have no more access. And that's why for me, geopolitics is very important. And as a pharma company or as law enforcement, it's very important always to understand the landscapes, what is changing, what is the real situation on the real time. Because if a border is closed, you have to look at it.
00:32:42
Speaker
because it may have an impact on your product delivery. Listen, can you talk about how well-designed some of these websites are? It makes me wonder what the risks people are facing when they buy fake medicines. I'm always nervous about using my credit card online, so I'd imagine that these types of transactions have risks. Could you talk a little bit about that?
00:33:06
Speaker
First, what is important to note is that what happened today online. I usually explain that online fraud is increasing and covering different situations. If we are looking about a medicine online, we have various issues.
00:33:26
Speaker
We have some websites offering products without any prescription, again, which is completely forbidden because when you are a patient suffering cancer, you cannot get an oncology medicine without prescription. But some websites are offering those products without any prescription and they are not authorized to do it.
00:33:49
Speaker
We have also some websites selling counterfeit medicine, meaning that there is, again, using trademark counterfeit product content. And there is also a lot of websites which are really scam and fraud.
00:34:08
Speaker
You connect to the website, you order your medicine, you pay with your nice credit card, and you never receive the product because they are just here to get your money without any prescription. So that's why it's also important to educate patient and people that as soon as you try to get some medicine online, potentially you have two risks.
00:34:37
Speaker
You have one risk of getting a fake product or product without cold shame. So you put your safety at risk. And you have a second risk, which is a financial risk because you may pay for products that you will never receive. And I think it's very interesting to brief patient and consumer about it because this is not only a potential risk,
00:35:07
Speaker
It's driven by concrete data. And it's nice to see that for my company receive more and more complaint from patient complaining. Oh, I was on your website and I order a product and I never receive it and say, sorry guys, but it was not our website. It's a fake website. So this is really also the new trends in the online medicine, bad business.
00:35:33
Speaker
What we can also highlight potentially is that we have a significant growth in illegal wholesale medicine because now the pharma company and the pharma industry have reinforced their detection capability.
00:35:49
Speaker
We have now some program to monitor what happened on social media, website and marketplace. And this is a recent activity that the company are doing, but which really helped to better understand which type of risk and which type of product trafficking are online. We didn't get this information before, and it helped us to better figure out the concrete risk for patients again.
00:36:17
Speaker
That's really fascinating and we'll talk a little bit more about the mitigation side of things after the break. Thinking a little bit more into this now, so you mentioned these physical risks to the patients taking their medicine. What are these potential risks that they face when they use something that is not genuine?
00:36:34
Speaker
It's very, very frightening. Maybe you heard a recent article in, I think it was in Ireland, where the patient gets paralyzed after buying a weight loss product from an unauthorized channel. And she spent two days with this
00:36:54
Speaker
as paralyzed. And the article was really frightening because she was considering that the website was secure and it was not. And we have also some other evidence about the patient risk. Some journalists, but also some pharma company, are developing chemical analysis on those suspect products online. And
00:37:21
Speaker
Those chemical analyzes have identified that in a lot of counterfeit products sold online, some of them are containing starch or acid or contaminated vaccines. So this is really, again, based on forensic evidence and patients must be aware about it because they have no idea about the risk
00:37:48
Speaker
that they take when they are buying online.
Health Risks of Counterfeit Medicines
00:37:51
Speaker
Some of them are naive, but a lot of patients are just unaware about the risk because they consider that they don't have the idea about what those bad guys can really do it.
00:38:05
Speaker
And there is also some evidence provided by the World Health Organization. You know that WHO is monitoring falsified and substandard medicine, and they are doing a lot of surveys.
00:38:20
Speaker
They have identified that notably in Africa, for example, the impact of counterfeit medicine on patients is the increasing resistance of diseases because the antibiotics are mainly counterfeit. Meaning that now there are less and less possibilities to treat patients against those diseases.
00:38:41
Speaker
because they have developed this resistance. So the impact of counterfeit medicine may be really affect patients on the different geographical area. And when, for example, we are considering the counterfeit of antimalaria treatment,
00:39:01
Speaker
there is no other option. If the patient has developed resistance, there is no alternative treatment for him or for her. So this is really also a long-term impact on counterfeit on population. One thing I'm really curious about hearing these different types of risks, which is the bigger deterrent to consumers? Is it the financial risk or the physical risk? I know it sounds like a stupid question, but I'm really curious.
00:39:28
Speaker
I think it's not a stupid question, but if we consider the people mindset, I will say that financial risk is probably the bigger deterrent because people are again, they will be very upset, don't receive any product when they bought on the counterfeit website or work website.
00:39:52
Speaker
And that's why I'm considering to also push kind of shocking communication to patients rather than to tell them, oh, are you aware that you are taking risks for your safety? A lot of people know that because it's a common message which has been spread since years by WHO, by a lot of institutions.
00:40:14
Speaker
If we started to say, are you aware that if you buy online, you will use money or you will receive treatment without any active ingredients, so you will not lose weight or you will not have a nice re-creative moment. I think it may be interesting to test, okay, what will be the impact for patients? I'm personally in favor of changing a little bit the communication.
00:40:42
Speaker
we have to also communicate according to the trigger situation for the population and for the society. I don't know if you share the same idea than me, but we have nothing to lose to be a little bit creative as well in our communication. And apart from all of these risks to public health that we've been speaking about, are there any other impacts of this phenomenon? So say economic repercussions, for example, you also mentioned how
00:41:12
Speaker
This is something that's often concentrated in markets that do suffer economic disruption. It's very difficult to get some clear data and figure about the economic perpetual recursion. Nevertheless, there are different studies which have raised this economic effect.
00:41:31
Speaker
I would like just to share with you one concrete example that I managed during my career. It was in Africa and there was a lot of counterfeit painkillers distributed in
00:41:47
Speaker
hospital, it was injectable product. And it was so massively counterfeit that the business impact for the company was really high. They really lose money due to this counterfeit delivery in Africa. But what was the most funny element that when the sales force went to the hospital to sell the genuine product,
00:42:17
Speaker
The healthcare professional told to them, no, it's not the real product. Your product is fake. Meaning that the counterfeiter succeeded in convincing the healthcare professional and the hospital that their product was a genuine one and that our product was a fake one.
00:42:36
Speaker
So the impact and the economic impact has been really high because first the pharma company was losing money, then the hospital suffering very bad situation because the counterfeit was five less doses compared to the genuine product. So it has created some diseases and consequences for the patient safety. And then the issue was that
00:43:06
Speaker
at the end because the volume of genuine product order for manufacturing was low. The time to recover and the time to reproduce the genuine product was a little bit long. So it's just to explain that economic repercussions are both for the state
00:43:27
Speaker
because there's impact how to manage this resistance and how to manage those patients not able to be care by the genuine product. Then there was also economic impact for the pharma company. And at least we may have the circle on it. So I think it's also interesting to consider the different perspective about the economic repercussion. And on a more strategic perspective, we also know that some
00:43:56
Speaker
states are also getting money through the counterfeit manufacturing and distribution, and it's not a surprise as well. So this is really a complex situation because if we would like to change this paradigm, it's a long-term process, helping also the country to manufacture the genuine product in the country as well.
00:44:20
Speaker
and to reduce the impact of this counterfeit distribution network. But it's strategic and collaboration between the state, the pharma company, and the regulation authority as well. We're talking to pharma crime expert Anne Devaux about the threat posed by counterfeit medicines. After the break, we'll discuss how to address this challenge.
00:44:50
Speaker
You have been listening to How to Get on a Watchlist, the podcast series from Encyclopedia Geopolitica. If you like this show, don't forget to check out our other content at Encyclopedia Geopolitica, which you can find at howtogettontawatchlist.com, where you can find our analysis on various geopolitical issues, as well as reading lists covering topics like those discussed in the podcast.
00:45:14
Speaker
Please also consider subscribing to the podcast on your streaming platform of choice, giving us a rating and joining our Patreon. And so now looking at the mitigation side of things, how can consumers be certain that the medication that they have is actually genuine?
Consumer Advice on Medicine Authenticity
00:45:44
Speaker
And how can they tell that it's fake? And what do they need to do when they actually identify something that is a box of fake product? So first question, how consumers can be certain that medicines are genuine? As I explained before, because it's more and more difficult to identify counterfeit, the best advice for the consumer is first, don't buy any medicine online.
00:46:11
Speaker
go to your doctor and buy your medicine and legitimate pharmacy because this is the most reliable process.
00:46:21
Speaker
For those patients who are still eager to buy online because there are some regions, US or Latin America or China, where it is very common to buy online vitamin and medicine, there is a tip which says check the list of authorized online pharmacy.
00:46:43
Speaker
And this list exists in the majority of country. There is a portal usually hosted by health authority in the country with a list of authorized online pharmacy. And in Europe, there is a new regulation, which is called the Digital Service Act.
00:47:03
Speaker
where any patient in Europe can directly go on the website on the patient country and they can look about the list of authorized pharmacies. And this is something which is recent, but I think very useful for others.
00:47:19
Speaker
How can consumers tell if a medicine is fake? It's difficult, but there are also some good practices that anybody can implement. For example, when you buy your medicine, you can look about the box integrity. If there is any pre-cut already open, or if the glue is not really, or the pack is not really well sealed,
00:47:47
Speaker
It can be an indication that the product potentially is not the genuine one. So the best advice is that if patients have any doped,
00:47:57
Speaker
They have to contact healthcare professionals, go to the pharmacy, or directly call the pharma company call center. All pharma companies, they have a website where patients may report if they have any doubts about how to use the medicine or if they see any discrepancy or something different. They have to reach.
00:48:19
Speaker
And sometimes it's just patient may have some doubts because the packaging has changed due to new regulation or due to new sticker or to new logo. And that's why it's important for patient to report any information to be sure that they are using this genuine product.
00:48:40
Speaker
And this is a very important information because as a pharma company, we receive some nice and very useful information by some patient who knows their medicine. And when they report a discrepancy, usually it is a very reliable information because they know their treatment and if they see a difference in the dose selector and so on, it's an indication for us that it is a counterfeit product. So we are using this information
00:49:09
Speaker
has starting evidence for counterfeit. Let's stay on that topic about how pharmaceutical companies are fighting this. How does that work? One question that I'm always interested in is, do they cooperate on this?
00:49:25
Speaker
First, the pharma company, they are almost victim of the pharmaceutical crime, and they cannot substitute to the law enforcement action. It's tough to say that, but the whole of pharma company is, of course, to protect patient and to protect product. But with high popular product or high expected medicine, for example, new oncology treatment,
00:49:51
Speaker
Those high demand create traffic. It was the case for Viagra a long time ago. It has been the case for COVID masks, where a lot of people would like to get COVID masks during COVID or weight loss products. So, pharma companies are victims, but as manufacturers, of course, we have obligations.
00:50:11
Speaker
because it's our duty of care to protect patients. It's also part of the corporate social responsibility to put in place some mitigation measures. There are different mindset or company strategies, but the idea is to provide some mitigation approach.
00:50:33
Speaker
Let me just share some, I think some insight on it. Some companies are very quiet and they don't want to communicate about counterfeit tissue because they are afraid for their reputation and they are afraid about a patient trust loss. Some of them are really more active in communicating what they are doing because they would like to increase patient trust and transparency. And usually those pharma companies, they have
00:51:00
Speaker
For those who are open to communicate, they built some prevention strategy with three pillar detection. So they are detecting any risk coming from patient or healthcare professional reporting. They are monitoring online prevention. They are developing some security feature, for example, to protect their packaging, or they are developing a warning session for authorities.
00:51:28
Speaker
Some of them are also developing active mitigation response with intelligence, field investigation, and cooperation with law enforcement. This is almost the three pillars which are implemented in the pharma company.
00:51:45
Speaker
What is important also to mention that they cannot investigate every cases, so they have to develop risk assessment and intelligence to decide which action will be the most efficient. So it's always, again,
00:52:02
Speaker
collect information, analyze information, and assess which type of action may be implemented. Of course, cooperation between pharma companies is existing. When we are speaking about fighting crime, we are not competitors. We are really sharing intelligence because it's always a matter of patient safety.
00:52:24
Speaker
So concretely how it works, when we have information about some distributor or some individuals involving counterfeit, we may share this information with some association, for example, PSI that I mentioned previously, to understand, do you know already this company? Did you already collect information on it? And it helped us then to decide the action plan and to motivate authorities to move on it because
00:52:54
Speaker
Usually, those criminal organizations, they are not only focusing on one brand or one company, but they are producing at the same time oncology, weight loss product, or diabetic treatments, because again, they are doing profitable business. So cooperation between pharma is really one of the main, I think, value if you would like to tackle this issue.
00:53:20
Speaker
And keeping on this topic, so many of us involved in this show have intelligence roles or cover intelligence as part of our scopes. So I have to ask, given that Eve, what you've said about intelligence just there, you know, collecting the data and monitoring the geopolitical context, what is the role of intelligence in helping combat counterfeit medicines?
00:53:39
Speaker
And I think it's really a promising area for the new generation who are looking for a role in intelligence. Concretely, what is crucial? You can consider that fighting against climate crime, it's like police and forensic mitigation approach. The analysts will collect information on company location.
00:54:06
Speaker
phone number, what are the batch? Do we have already identified some counterfeit batch in different countries, but referring to the same product or distribution?
00:54:19
Speaker
Connecting the dots is really important, and one of the challenges today is if we are, for example, looking about online information. There was a multiple website offering the product, but behind those multiple websites, potentially,
00:54:37
Speaker
resistant may be the same, or hidden organization may be the same, using the same phone number in different platforms. But at the end, this is the same organization. So how to collect and cluster information to move from online
00:54:56
Speaker
detection to offline investigation, this is really the challenge today. And we cannot do it without any intelligence analysts able to connect information to process in the right way, because if it's not properly in the database, there is no match.
00:55:16
Speaker
So this is really a different way to work, but I get that authority and pharma companies started to implement this. Some pharma companies doing for a long time, some of them is just new, but it's really a big value if we would like to tackle. And most important, the analysts.
00:55:36
Speaker
will be able to present the information with a readable format for authorities because we are using the same software. It's perfectly easy for, for example, a Chinese or a Turkish authority to understand an intelligence mapping. No need for translation. There is connection between individuals, batch, product, phone number. This is really the beauty of having intelligence on board.
00:56:04
Speaker
So let's stay on this topic about the common language between government and intelligence teams. What are governments and law enforcement agencies doing about pharma crime?
00:56:14
Speaker
This is also a challenge. The situation is moving a little bit, but it's difficult. First, because fighting against counterfeit and pharmaceutical crime is not the priority of law enforcement agencies. They are first focused on fighting against narcotic terrorism, but pharma climates
00:56:35
Speaker
an additional role for them. So I think the first element. The second element is that usually the legislation against pharma crime is still incomplete. I also explained that the sentence are usually low compared to other crime. So again, when you have to manage some priorities, authorities harder exist. There are some
00:57:02
Speaker
progress. As I explained, for example, in China with authority or in the US, you're probably aware about the major issue with fentanyl. In the US, authorities are really putting a lot of efforts because it's a very, very frightening situation, a lot of deaths.
00:57:23
Speaker
authority commitments is changing based on the patient risk, but I think potentially the government and law enforcement agency cooperation now, they are more open to share with private sector compared to 10 years ago because the situation has changed and
00:57:45
Speaker
From each side, I think we understood that we cannot be efficient without collaboration. But concretely how it works is that for my company,
00:57:58
Speaker
we are spending effort in detecting and trying to collect evidence as much as possible. When we have nice evidence and concrete file to share with authority, we go to this authority to present the case. We try also to share this information for authority to investigate those individuals because
00:58:23
Speaker
What is interesting is to consider if those criminals are also involved in other crime, counterfeit, of course, but maybe they are also involved in modern laundering, tax fraud, terrorism. And as soon as we share this information with authority, they may develop intelligence and then having an interest of looking about our guys. So what happens once a counterfeit factory is identified by the authorities or someone anyway?
00:58:52
Speaker
And what happens to the substances when they're seized? Are they destroyed? How do you go about that? So usually, when the counterfeit factory is identified, is the result of long-term investigation started from a test purchase or for counterfeit evidence in a pharmacy. So it's a long-term process.
00:59:11
Speaker
The authorities are fully managing the case and a lot of countries, the pharmaceutical companies, they don't need to lodge a complaint because authorities are really responsible for the seizure and for the prosecution. Yes, the substance are sales put in the seal because it's part of the chain of the custody.
00:59:34
Speaker
Sometimes, depending on the country as well, the pharmaceutical companies are authorized to get some samples for analysis in order to assess, again, the content of the product and the dangerousity. But it's really depending on the local legislation. And then the products are usually destroyed, but after the prosecution. So what happened concretely?
01:00:05
Speaker
The counterfeit product may be stored in some warehouse, for example, for two years before the final court decision. So in some countries, we also have some cases where those seized product may be reinfiltrated in the illicit supply chain or illicit supply chain. But usually, this is properly managed. You have to be aware that
01:00:33
Speaker
there is specific destruction process for medicine because again, there are some vials, there are different active ingredients and substance. So for some countries, it's also a challenge to properly destroyed medicine or counterfeit medicine. So this is also part of the regulation, how to help those authority to put in place those regulation and to have the capacity to properly destroy the product.
01:01:03
Speaker
But usually we have not so many details when the counterfeit factory is identified because it's a law enforcement and prosecutor action. So we have limited access, except if we lodge a complaint and if we can get some samples again.
AI in Counterfeit Medicine Detection
01:01:20
Speaker
So we're seeing a lot in the news these days about artificial intelligence and how much it's changing pretty much every field. How is the fight against pharma crime evolving as a result of AI?
01:01:33
Speaker
I think it's really a starting process but as soon as we are looking or improving the detection online,
01:01:43
Speaker
Some companies are currently using some robots or artificial intelligence to search for specific images through optical image recognition to identify, for example, a logo. It can be a luxury logo or it can be the logo of a pharmaceutical company. This artificial intelligence can
01:02:06
Speaker
help to detect, for example, that a website is using the same stock image to attract patients to sell counterfeit. So we had some improvement on it. The issue with pharma is that there are a lot of websites offering product without any prescription. So in this case, artificial intelligence is not able to help us because it's a genuine product.
01:02:35
Speaker
photo of genuine packaging and the bot are not able to recognize any suspicious. So what works for luxury? I think it's more difficult to implement when we are doing pharmaceutical online, but
01:02:51
Speaker
We have some discussion with some company to try to improve maybe the search by providing, for example, a counterfeit batch number. So they are also considering how they may help us in the future. But for me, it's an interesting area to develop, how to use the intelligence to supporting us. That's really fascinating, Em. Thank you for that.
Anne's Motivation and Commitment
01:03:19
Speaker
One question we'd like to ask all of our guests, you know, with everything that we've discussed now about pharma crime. In this field, what is it that keeps you up at night? The first is to put by get in jail because I really, I really
01:03:35
Speaker
I'm fascinating by thinking, okay, what I am doing every day can be just a drop in the ocean. But if it helps, again, to protect population, especially fragile population, against counterfeit and put those by are in jail for me, it's okay. Because I'm really, it's really fit with my value of, again, protecting nation, people,
01:03:59
Speaker
It's also a fun job because we are working with the world, different culture. We are here to collect evidence. We have nice collaboration with a lot of different people. You never know what you will find. So there is strong commitment, but also fun. So this is good. Well, Anne, thank you very much for joining us. Thanks for your invitation.
01:04:27
Speaker
You've been listening to How to Get on a Watchlist, where we've been discussing how to get rich selling fake drugs online with a pharma crime expert and a vote. Our producer for this episode was Edwin Tran, and to our audience, as always, thank you for listening. If you enjoyed this show, please consider checking out our other content at Encyclopedia Geopolitica. We'd also appreciate it if you could subscribe to the podcast, leave a review, or support us on Patreon. Thanks for listening.
01:05:30
Speaker
We're looking at three nine eight five.