Pharmaceutical experts say that the lack of effective drug sourcing, the expansion of the EU and the growth of global trade is making Britain a prime target for crime syndicates pursuing the lucrative market in fake medications.

The report, by the Stockholm Network, a European think-tank, has identified Britain as being at risk of becoming a big new market in counterfeit drugs, which can be sold to the health service for huge profits.

This year, the Medicines and Healthcare Products Regulatory Agency, which monitors drugs in Britain, has ordered the recall of batches of two NHS medications found to be fakes — the impotence drug Cialis and the anti-obesity drug Reductil. Three other big investigations are currently under way into British-based mass production and importing of counterfeits.

Eric Noehrenberg, of the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA), said that some drugs finding their way to Britain had been repackaged many times, making it impossible to know if the source was legitimate. He said that profitable medicines being targeted included lifestyle drugs such as Viagra, statins and even cancer treatments.

“The profits are huge and the risks are actually very small compared with trafficking narcotics. As global trade continues to grow and borders get more porous, and with the expansion of the EU, the threat is only increasing.

“Britain is a lucrative market for counterfeiters. Sometimes people just take medication and it doesn’t work. Nobody thinks to ask what was actually in their pills and whether they were genuine. But if you are unlucky you will get really serious health effects.”

Mr Noehrenberg, IFPMA’s director of international trade, said that criminal gangs were now so professional that they often bought the same packaging equipment as drug companies and even attended the same trade fairs.

“It makes it very difficult, if not impossible, to tell the true products from the fake ones, except through extensive chemical tests,” he said.

Graham Satchwell, a former police superintendent and the author of the new report, A Sick Business, said that while most counterfeit drugs found their way to developing countries, crime syndicates were seeking footholds in Europe and America. In the US, the number of fake drug discoveries has quadrupled in recent years.

Until now, the greatest danger has been in the Third World, where counterfeiting has been rife for years. Half the malaria medicines in use in Africa are reckoned to be worthless fakes.

Mr Satchwell said that contrary to most perceptions, Britain was now a target because drug prices were higher than in many other countries. He said that “parallel trading” — a legal business in which traders buy drugs in cheaper markets and sell them in Britain — provided an easy route of entry for counterfeit drugs.

His report concludes that NHS trusts are encouraged to buy drugs as cheaply as they can and, as a result, as many as one in five drugs prescribed on the NHS has been imported by parallel traders — a far higher proportion than in any other country. The supply chain for such drugs is so convoluted that the opportunity for introducing fakes is large.

“There are no reasons for confidence in the current systems of control,” he said. “There are no checks by GPs or health trusts. If an elderly person taking a drug for a heart condition suddenly dies, would anybody find out if that had been the result of a counterfeit drug getting into the chain? They certainly would not. There are thousands of deaths in UK hospitals as a result of drug reactions. You won’t find a report where anyone asks if the medicine might not be what it purports to be.”

In the US, the Food and Drug Administration sounded the alarm after the number of fake drugs quadrupled, from five cases a year in the 1990s to 20 per year in 2001 and 2002.

At least half the Viagra sold through the internet is believed to be worthless. More alarming cases have also emerged, such as the counterfeiting of life- saving drugs such as statins. More than 200,000 bottles of fake Lipitor, a statin which is taken to lower cholesterol levels, recently had to be withdrawn in the US.

Mr Satchwell believes that most cases that come to light are discovered by accident, not as the result of active investi- gation by law enforcement agencies.

China is believed to be the source of many fake drugs. Last year, 994 drug counterfeiting factories were closed down there and $60 million (£32 million) of drugs seized.

Many drugs are thought to reach Britain through Poland and Russia, Mr Satchwell said, with not only organised crime but also terrorist organisations reaping the profits. Interpol has claimed connections between the illegal trade and al-Qaeda.

The Association of the British Pharmaceutical Industry said that it believed the supply chain in Britain was secure. But a spokesman acknowledged that parallel trade did make it far easier to slot illegal products into the market. “We still have no evidence to suggest that this is a widespread problem in this country,” he said.

Mr Satchwell said that drug companies were still in denial over the scale of the problem, or were cautious in addressing it for fear that it would damage their leading brands. He added that the National Patient Safety Agency had “no active work in this area”.

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