U.S. Prescription Drug System Under Attack
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For half a century Americans could boast of the world’s safest, most tightly regulated system for distributing prescription drugs. But now that system is undercut by a growing illegal trade in pharmaceuticals, fed by criminal profiteers, unscrupulous wholesalers, rogue Internet sites and foreign pharmacies. In the past few years, middlemen have siphoned off growing numbers of popular and lifesaving drugs and diverted them into a multibillion-dollar shadow market. Crooks have introduced counterfeit pharmaceuticals into the mainstream drug chain. Fast-moving operators have hawked millions of doses of narcotics over the Internet. The result too often is pharmaceutical roulette for millions of unsuspecting Americans. Cancer patients receive watered-down drugs. Teenagers overdose on narcotics ordered online. AIDS clinics get fake HIV medicines. Normally, drugs follow a simple route. Manufacturers sell them to one of the Big Three national wholesalers — Cardinal Health Inc., McKesson Corp. and AmerisourceBergen — which sell to drugstores, hospitals or doctors offices. Regulators and industry officials have long considered this straightforward chain to be the gold standard. The shadow market exploits gaps in state and federal regulations to corrupt this system, creating a wide-open drug bazaar that endangers public health. A yearlong investigation by The Washington Post has found: • Networks of middlemen, felons and other opportunists operating out of storefronts and garages fraudulently obtain deeply discounted medicines intended for nursing homes and hospices. The diverters have stored drugs in U-Hauls and car trunks in blazing heat, stuffed them in plastic sandwich bags and traded them in a daisy chain of transactions with no purpose except to enrich the traders. Those drugs are ultimately sold to unwitting patients. • The diverters pave the way for counterfeiters who use pill-punching machines and special inks to produce near-perfect copies of the most popular and expensive drugs. Some fakes have passed undetected through wholesalers to the shelves of retail pharmacies. • Pharmaceutical peddlers take advantage of lax regulations to move millions of prescription drugs into the United States from Canada, Mexico and elsewhere. Overwhelmed customs workers inspect less than 1 percent of an estimated 2 million packages containing medicine shipped into the country each year. Virtually all of those shipments are illegal, yet the Food and Drug Administration fails to enforce its own import regulations, saying it lacks the resources to intercept the illegal packages. • Rogue medical merchants set up Internet pharmacies that serve as pipelines for narcotics, selling to drug abusers and others who never see doctors in person or undergo tests. The sellers move tens of millions of doses of hydrocodone, Xanax, Valium, Ritalin, OxyContin and other controlled substances. Scores of customers have become addicted, overdosed or died. The shadow market, which includes both legal and illegal operators, has grown rapidly yet received little public attention. Isolated problems nationwide have attracted the interest of some state and federal prosecutors and resulted in lawsuits. But the increasing recalls of tainted medicines, overdoses on Internet-bought drugs and cross-border pharmaceutical trade are part of a larger pattern. Taken together, the worst elements of the shadow market constitute a new form of organized crime that now threatens public health. In St. Charles, Mo., Maxine Blount, a 61-year-old woman with advanced breast cancer, received a diluted drug distributed to her local drugstore. “It makes you angry,” she said in an interview last year. “It shakes your faith. It saps strength you need to live.” She died of her cancer a month after the interview. In La Mesa, Calif., Ryan T. Haight, 18, died in his bedroom of an overdose after taking narcotics obtained on the Internet. In Sacramento, James Lewis, 47, shopped the world for painkillers that flowed unimpeded from pharmacies in South Africa, Thailand and Spain. His wife discovered him dead of an overdose on the living room couch. These victims are emblematic of the dangers that occur when profiteering and cowboy criminality invade the nation’s drug distribution system. The shadow market takes advantage of technology, global trade, vast disparities in pharmaceutical prices, the explosive growth of enticing new miracle drugs and the self-medicating habits of an aging baby-boom population. It extends from small, backroom operations to buck-raking Internet pharmacies to the warehouses of the nation’s largest drug distributors. Diverters reap millions illegally by buying drugs at a discount to sell to secondary wholesalers, which then sell them to other distributors, including the Big Three wholesalers that supply most major hospitals and chain stores. The Big Three risk buying from these secondary sources because they can get drugs more cheaply than if they bought them directly from manufacturers. In some cases, the drugs have turned out to be diverted, diluted or counterfeited. Source : washingtonpost.com |