Counterfeit trade is a global crisis, with approximately 5% of all world trade in branded goods being fake1. Alarmingly, this extends to life-saving medicines: the WHO estimates that one in 10 medications in low- and middle-income countries are substandard or falsified2. The threat has evolved beyond brick-and-mortar stores or street peddlers to infiltrate online marketplaces, where up to 50% of medicines sold through rogue websites are counterfeit. These falsified products cause treatment failures, drug resistance, toxic poisoning, and prolonged illness. As a pharmacist, here’s what you need to know to better safeguard the public’s health, especially in this digital age.
Proliferation of Counterfeit Medication in the Philippines
The country faces a serious problem with counterfeit drugs. A 2019 United Nations Office on Drugs and Crime (UNODC) report noted that the Philippines recorded the highest incidence of falsified medicines in Southeast Asia, with 193 documented cases between 2013 and 2017, significantly higher than Thailand (110), Indonesia (93), and Vietnam (49).
But we are not only at the receiving end of counterfeit drugs from other countries. The Philippines is also a source of falsified medicines in Japan, USA, and Germany.
E-commerce and social media have amplified this threat. With minimal restrictions and easy anonymity, anyone can set up shop online. For busy buyers looking to save money, these platforms offer a tempting alternative to legitimate pharmacies.
In the Philippines, criminals are targeting essential OTC medicines, such as pain relievers, antacids, and fever reducers5. But the threat doesn't stop there. The US Food and Drug Administration has noted that many unsafe online pharmacies claim to sell prescription drugs at lower prices, and without requiring a doctor's prescription5. These medicines are unapproved, counterfeit, or otherwise unsafe, the agency said.
Dangers of Taking Counterfeit Drugs
Counterfeit medications endanger patients through multiple ways. According to the WHO, falsified medicines may contain:
- No active ingredients
- Wrong active ingredients
- Incorrect amounts of ingredients
- Toxic substances
The consequences are severe. Products with no or insufficient active ingredients fail to treat the underlying condition, allowing diseases to progress unchecked. For example, during Niger's 1995 meningitis epidemic, a falsified vaccine was administered to over 60,000 people, preventing the timely control of the outbreak.
The harm is not always immediate. Fake antibiotics may accelerate antimicrobial resistance, compounding an already critical public health threat. Furthermore, when patients take fake medicines that don't work, they may lose faith in evidence-based medicine and healthcare professionals, driving them toward unproven, potentially dangerous alternatives.
Public Health Warnings from FDA Issued vs Counterfeit Drugs
The Philippine Food and Drug Administration (FDA) continuously issues public health warnings against counterfeit drugs.
These warnings alert the public to circulating falsified medicines and provide essential details: which products are affected, photos comparing counterfeit versus legitimate versions, and explicit prohibitions against their sale or distribution.
To keep updated of these public health warnings, you may proceed to FDA’s Drug Advisories published online.
You may also share these advisories on your or your pharmacy’s social media account. This gives you the reach to protect not just the patients who walk through your door, but entire communities scrolling through their feeds.
But beyond monitoring and sharing advisories, help your patients develop safe purchasing habits. Remind them to buy only from FDA-licensed drugstores and authorized retailers, never from unverified online sellers or street vendors. Teach them to question unusually low prices, as deals that seem too good to be true often are. Most importantly, remind them of the dangers of taking counterfeit drugs: saving a few pesos today could cost them far more tomorrow, and not just in money, but in their health and wellbeing.
Laws to Protect Against Counterfeit Medication and How Pharmacists Can Support Them
The Philippine government has established a comprehensive legal framework to combat counterfeit medications. As a pharmacist, you are not just a healthcare provider, but critical enforcer of these protections through vigilance and reporting.
Special Law on Counterfeit Drugs (RA 8203)10
Republic act 8203 serves as the cornerstone of the country's fight against falsified medicines. It establishes clear definitions, identifies who can be held liable, and outlines severe penalties for violations. Importantly, its reach is comprehensive, extending beyond physical pharmacies to cover online transactions and digital marketplaces.
- What qualifies as counterfeit?
Pharmaceutical products intentionally and fraudulently mislabeled regarding identity or source. This includes medicines with incorrect ingredients, insufficient active ingredients, or no active ingredients whatsoever.
- Who is liable?
Anyone involved in the manufacture, import, distribution, or sale of counterfeit drugs. If you have actual or constructive knowledge that drugs are counterfeit, you can be held legally accountable.
- What are the penalties?
The law scales punishments based on harm to patient safety. Mere possession carries six months to six years imprisonment. But when counterfeit drugs cause illness aggravation or death, perpetrators face fines up to ₱5 million plus imprisonment exceeding a decade.
The Food and Drug Administration Act of 2009 (RA 9711)11
Republic Act No. 9711 transformed the Bureau of Food and Drugs into the Food and Drug Administration, significantly expanding its regulatory teeth.
The law empowers the FDA to conduct inspections, issue cease and desist orders, and impose penalties of one to 10 years imprisonment plus fines ranging from ₱50,000 to ₱500,000, with higher penalties for manufacturers, importers, and distributors. It also mandates nationwide testing laboratories and field offices, creating a stronger monitoring network to catch counterfeit drugs before they reach your patients.
Universal Health Care Act (RA 11223)12
The Universal Health Care Act of 2019 introduced critical supply chain transparency measures that help combat counterfeit drugs.
For instance, FDA-registered manufacturers are required to track and report their financial relationships with healthcare professionals to the Department of Health. Drug outlets must also carry generic equivalents of all Primary Care Formulary drugs and provide customers with lists of therapeutic equivalents and their prices.
These transparency requirements create accountability throughout the pharmaceutical supply chain, making it harder for counterfeit products to slip through unnoticed.
How Pharmacists Take Part in Ensuring Patient Safety
Now that falsified medicines circulate the vast digital space, how can pharmacists advocate for patient safety? You can make a difference through two essential actions: spotting counterfeit medications and reporting them, then teaching your patients to do the same.
How to Spot Fake Medicines5
Thorough visual inspection remains your most powerful tool. Train yourself and your patients to recognize these red flags that distinguish counterfeit from legitimate products:
- Ingredient discrepancies: Claims of too little, too much, or entirely different active ingredients
- Physical differences in size, shape, color, or taste
- Labeling issues including misspellings, missing information, or no labels at all
- Suspicious dates such as expired or absent expiration dates
- Compromised packaging that appears tampered with or has unusual texture, finish, or shade
How to Report Fake Medication
In the digital marketplace, most platforms allow you to report suspicious products or sellers before making a purchase. If you spot counterfeit medicine online, report it immediately so the platform can remove the listing.
Always escalate your report of counterfeit drugs to two additional parties: the FDA and the legitimate manufacturer. This creates a comprehensive response that protects more than just one platform's users.
Contact the FDA at (02) 8857-1900 or ereport@fda.gov.ph. Their intervention can trigger wider investigations and prevent these dangerous products from reaching vulnerable patients.13
If you suspect that a Unilab product may be counterfeit, please contact FDA at (02) 8857-1900 or ereport@fda.gov.ph or reach out to Unilab Customer Care at 8-UNILAB-1 (8-864522-1).
Unilab supports FDA in its mission to safeguard public health by helping identify, verify, and educate consumers. When reports involving suspected Unilab products are received, Unilab works closely with the FDA to validate authenticity through product markers, batch traceability, and verification. Findings are shared with the FDA to support regulatory action.
As a pharmacist, you can help protect your patients’ health by providing an extra layer of scrutiny when it comes to recognizing and reporting counterfeit medication. As a pharmacist, you play a vital role in protecting patients by exercising vigilance when sourcing, dispensing, and reporting suspected counterfeit medication. By working together—FDA, manufacturers, and healthcare professionals—we can keep our supply chain safe and preserve public trust in genuine medicines.
