Counterfeit Prescriptions

One of the newest and least-known rackets in the U.S. today is the traffic in stolen, counterfeit, outdated and smuggled, substandard drugs. An honest pharmacist may unwittingly buy them from an apparently legitimate wholesaler. A crooked druggist may seek them out. So far, no regulatory agency has been able to determine how many of the billion or more prescriptions handled annually by U.S. pharmacists are filled with substandard items. But the racket is growing, and with it, the potential danger to unsuspecting patients.

Margaret Kreig, a freelance writer who specializes in medical matters, began investigating the illicit prescription-drug business in 1964. She convinced the Food and Drug Administration that her intentions were serious, and thus became the first outsider to take part in FDA undercover operations and to have access to many of its records. The just-published result is Black Market Medicine, a compendium of chilling crime data and "What can be done about it?" questions to which there are no ready answers.

Pillistics. For the racketeers, says Author Kreig, setting up a bootleg drug shop is a relatively simple matter. Machines to compress, count and package tablets can be bought secondhand from salvage companies that deal in equipment discarded by legitimate manufacturers. Small print shops will run off a few thousand imitation labels, with no questions asked. The counterfeiters hire chemists, some of whom are moonlighting while holding jobs with ethical manufacturers. They bribe technicians to steal punches and dies, and raw materials from the big companies. Much of their manufacturing is done at night in small plants that do an apparently respectable business by day.

The small band of FDA investigators have had to devise their own techniques of investigation. Some of the brand marks impressed on tablets and printed on gelatin capsules are such expert forgeries that the agency's Bureau of Drug Abuse Control (TIME, May 5) has developed a science it calls "pillistics," an equivalent of ballistics that adapts microscopy and other laboratory tests to tracing counterfeit medicines to a particular machine.

Proof of Delivery. Mostly, the investigators rely on legwork. While Margaret Kreig was working with the FDA, she became an observer and at times a disguised participant in lurid whodunits, and a target of death threats. In an unmarked car filled with walkie-talkie radio equipment and a spaghetti tangle of wires for tape recorders, she waited outside Macy's in Manhattan one afternoon with a chief inspector. In another car parked near by, a second inspector, posing as a black-marketeer known as "Wally from Denver," was scheduled to make an incriminating deal with a genuine crook called "Tom." Wally had been offered a counterfeit version of Upjohn's antidiabetes drug, Orinase. His assignment: to persuade the racketeers to show him their manufacturing plant as proof that they could really deliver him 200,000 doses a week for a year or more.

With Wally and Tom in one car and the inspectors following, the trail led through Manhattan's afternoon rush-hour snarl, through the Lincoln Tunnel (no radio reception there), down the New Jersey Turnpike to Newark Airport. All evening and most of the night, the tailing went on, from scruffy diners to B-girl bars, across Hackensack Meadows on Fish House Road, around rail-truck terminals. In the long hide-and-seek, the cars got separated, and the chief feared for Wally's life. But Wally played his part well. He later emerged with a carton of counterfeit drugs, evidence for which he had paid $4,200.

Another case led to a secret room, hollowed out of the hillside behind the garage of a $45,000 home in a Westchester County suburb, north of New York City. The items confiscated there included half a pail of capsules marked "SKF" (for Smith Kline & French, the makers of Dexedrine), a small barrel of counterfeit Seconals, paper bags containing yellow tablets imprinted "Ciba," bags of waterlogged, unidentified tablets, and a 110-lb. drum marked "Made in Italy" and containing a dubious white powder. Added together these items gave the FDA an unusually persuasive collection of evidence.

Misbranding Misdemeanor. The range of phony drugs is broad--tranquilizers, sedatives, hormones, heart stimulants, diuretics, antibiotics, drugs to lower blood pressure, asthma and arthritis remedies, injectable liquids such as Vitamin B12. Profits can be staggering: genuine crystalline B12, for example, costs $8,000 an ounce. The risks are relatively minor.

Margaret Kreig quotes a racketeer who was persuading a petty crook to move over to fake drugs from the numbers game, which had earned him many convictions: "There are no problems. It's not like junk [narcotics]. FDA has a helluva time making any kinda case. And when they get you--if they get you--it's only a misdemeanor for misbranding, or some such. So you hafta pay a couple hundred dollars' fine. You can make it back in a couple of hours."

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