text: What do we know about the factors feeding the fake drugs market and what new action could be taken? Drug shortages, uneven demand and high prices create opportunities for counterfeiters, while the lack of quality controls in producing nations adds to the problem.
  Counterfeit pharmaceuticals affect more than 145 countries around the world, according to the Vienna-based Pharmaceutical Security Institute. The dangers of substandard and falsified medicines are well-documented:
  They waste money and valuable resources.
  They fail to cure sick people, and sometimes even kill them.
  And they can encourage drug-resistant infections.
  A 2018 study on substandard and falsified medicines revealed that drug shortages, irrational demand and high prices push consumers outside of the regular supply chain, providing an easy entry point for falsifiers. Poor quality medicines are found where there’s a shortage of affordable, quality-assured medicine and complex supply chains put consumers at increased risk.
  Global pharmaceutical company Pfizer reports that many consumers may not know that the medicines they have purchased are counterfeits, and advises customers to buy prescription medicines from legitimate pharmacies and known pharmacists. But the market for cheaper consumer pharmaceuticals purchased online has seen massive growth since 2015, which is set to continue.
  Quality first: in procurement policies and producing countries
  The authors of the 2018 study argue that unless quality is explicitly included in procurement policies, the pressure to contain costs can incentivise falsifiers to produce substandard medicines. Additionally, regulators in consuming countries are currently responsible for quality assurance but greater focus on quality assurance in producing countries would be more efficient in such a globalised industry.
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