Well, I am writing this blog being inspired by the blog of Ms m.sandhya sravya [http://www.pharmainfo.net/msandhyasravya/blog/counterfeit-medicines-and-.... I dedicate this blog to her. She has brought out a very pertinent issue that is not getting required serious attention like bomb blasts. The difference is Counterfeit drugs do not make big noise and there there will be no debris of dead bodies, injured people and damaged properties. But, innumerable people across the marketed area would be suffering silently due to consumption of Counterfeit medicine. Definition: Best way is to adopt layman's definition. Counterfeit item is one that is not original - whatever be the quality. A crime is played on me when I get counterfeit item when I want a original one. The crime is a serious and unpardonable one when it happens in medicine. Availability: There cannot be any outlet for the medicine other than the pharma manufacturers - traders on the one side and the dispensing medical practitioners and the hospitals on the other. patient is only a mute sufferer for any mischief played on him. Who should bell the cat? 1. Drug law enforcement department is a watch dog, would be on beat regularly to smell the rat and takes action as per the law whenever such crimes are traced. But the punishment is either not publicized or goes unnoticed. Example: The case of soframycin that had raised every body's eye brow a decade ago. 2. Original manufacturers since are having there own marketing network and are fully familiar with their original product are the best people to keep an eye on the counterfeit of their product and blow the whistle whenever they come across such a n item. 3. The Drugs trade license clearly mandates that purchase, stock and dispensing and distribution should happen only after due documentation. The purchase bill, sales invoice / bill, delivery note, prescription, medication chart in the patients case sheet / register etc are the documents that helps in back tracking the source from the patient. Details like: name, strength, form, volume, make, batch no and the expiry date should be recorded by every one. 4. Poor / insufficient documentation happens only in the clinics of dispensing medical practitioners and in the hospitals - which unfortunately is not addressed either by the Government or by professional bodies. 5. Adverse Drug Reaction: Off late, talking of ADR is becoming a fashion in the academic and professional circles. It is only a talking matter with glamorous ppt and it is left at that when the talkers and listeners go back to their work station. Now I feel there is a need to widen the scope of study on the adverse effect of drugs. Cant the ineffectiveness of a drug also be called Adverse effect? Why not? If it doesn't suite then lets call it ADE - Adverse Drug Event. When every practitioner monitors the observed / reported efficacy of the drug he / she has prescribed, then it will be easy to sweep out the counterfeit ones much faster than the Drugs controller. Here are some tips: 1. Dispensing by doctors even to their own patients should be prohibited and if allowed should be brought under the drugs enforcement to ensure proper documentation in purchase, storage and dispensing takes place. Here, the difficulty is stocks of emergency drugs and dressings in the charge of the medical practitioner which however should be allowed may be with some rider on quantity depending on consumption. 2. Hospitals should be made to appoint a chief pharmacist in a cadre not below the rank of a medical officer with responsibility to manage drugs logistics strictly within the ambit of the law and policy of the hospital. 3. Hospitals should have a Therapeutic Committee only to discuss the clinical quality of the drugs without involving in the purchase or approval of purchase. 4. Chemists should ensure that all purchases and dispensing happens with the approval of the pharmacist approved for license. 5. Pharmacist should start his/her day by reciting the pharmacist's oath and adopting ethics in practice. Thank you sandhya sravya, Good luck