The online distribution of counterfeit medicines has been growing during the last decades. The role of Internet as an unregulated medicine market is the main reasons behind this phenomenon, especially the effectiveness of "spam" as a tool for advertising and promoting these products. Websites and social media are new powerful instruments that organized criminal groups could exploit to conduct their illicit businesses. The spread of this emerging threat worldwide poses a very high risk for the health and safety of unaware consumers.
Definition
On 29 May 2017, the World Health Assembly hosted by the World Health Organization agreed to have "Substandard and Falsified (SF) medical products" as the term to be used in all future documentation on the subject of substandard, spurious, falsified, falsely-labelled and counterfeit (SSFFC) medical products. Under this definition, a counterfeit medicine is a falsified pharmaceutical product. The term "counterfeit" is avoided as this is connected to intellectual property rights rather than public health. The meaning associated with "counterfeit medicines" incorporates various cases that are ascribable to the intentional replication of a product, or product parts, without permission.
Role of the Internet
The Internet has radically changed the approach towards commerce, drastically modifying also buyers' attitudes towards the purchase of goods in general. Research has demonstrated that using a computer to fill a prescription online and using online chat groups to learn about health topics are strong independent predictors of prescription drug importation from foreign countries by United States consumers. Cheap prices are often the primary reason behind consumers' purchase decisions; Nonetheless, in the specific case of medicines the level of anonymity granted by the Internet is another driving motive pushing consumers to prefer online consumers (i.e. those people with diseases considered as taboos, such as sexual or psychological illnesses); Practical convenience is another good reason: pharmaceuticals are delivered directly at consumers' place; Consumers can also find online a wider range of products, not always authorized in their own countries (illegal medicines).
If on the one side the Internet created new opportunities for consumers, on the other it also represents a new powerful instrument that organized criminals could exploit to conduct their illicit businesses. With the Internet criminals have found an emerging marketplace that could possibly be exploited in many different ways to take advantage of the almost unlimited possibilities offered by cyberspace. In recent years counterfeiters have been exploiting the Internet as an important channel to offer counterfeit medicines both at the wholesale and at the retail level, often creating an independent distribution process which directly targets distributors and final users.
At the wholesale, counterfeiter can exploit distributors' constant search for low costs products to maximize the profit. For what concerns the retail level, counterfeiters deceive consumers both with low prices and by sending a constant stream of spam messages to their e-mail inboxes. It is clear that the development of new communication technologies and the possibility of exploiting the massive Internet market, has unwillingly favored illegal activities.
E-pharmacies
Browsing through the Internet, it is easy to hit on online pharmacies that operate according to the regulations and with transparency. For them, criminals are harsh unscrupulous competitors who advertise fake drugs and put at risk the reputation of all online pharmacies which operate honestly. However, the Internet nowadays plays a significant role in the worldwide diffusion of counterfeit pharmaceutical products. To support the business of legal online pharmacies, some institutions (for instance in the U.S.) developed an accreditation system for both online pharmacies connected with territorial ones and for those only operating through the Internet. Main limits concerning these systems are: the official seals of these institutions, to be posted on pharmacies website as a warrantee, can be roughly imitated; these institutions operate at the national level and, due to the different domestic laws of the countries, it is difficult for any of them to provide customers with reliable information concerning the quality of pharmaceuticals available online.