Laboratory Lottery

Where do online pharmaceuticals come from?

by Emily Witt and Malia Politzer

When GenericPharmacy.bz opened for business in 2002, its Web site claimed the Viagra, Ambien, Xanax and other drugs sold came from Canada and were manufactured under the best of conditions. It claimed prescriptions would by approved by a doctor after customers completed an online questionnaire.

But court records and media reports tell another story of GenericPharmacy.bz, PlanetPharmacy.bz, GenericViagra.bz and other domains owned and operated by a Norcross, Georgia-based company, Hi-Tech Pharmaceuticals, and its proprietor, Jared Robert Wheat.

In February 2009, Wheat was convicted to four years in prison and forced to forfeit $4 million in profits for manufacturing and importing illegal counterfeit pharmaceuticals.

According to federal court records, Hi-Tech Pharmaceuticals was supplying its online pharmacies not with Canadian drugs, but with knock-offs cooked in nonsterile conditions in a four-room house in rural Belize.

Wheat ordered active pharmaceutical ingredients for the drugs he sold from China through a company based in New Jersey. He had a blender, dyes, and packaging sent to the house in Belize. He printed out recipes and set up shop. He raked in millions of dollars in sales.

Wheat’s Central American pill factory is no longer in business, but evidence shows that there are many other bootleg pharmaceutical enterprises operating with the same ease. In the world of illicit online pharmacies, perhaps the only consistent expectation a consumer can have is that his purchase will not come from a legitimate U.S. purveyor of pharmaceutical drugs.

Federal records of online pharmacy busts indicate that drugs bought online can come from almost any source imaginable, but most suppliers are offshore.

Law enforcers and investigators from pharmaceutical companies say drug suppliers can range from small-time operations such as Wheat’s to legitimate manufacturers, but knowing a drug’s true provenance can be nearly impossible for the online customer.

While drug company investigators say China and India are the largest manufacturers of counterfeits, illegal generics, or fake drugs, the means to manufacture pharmaceuticals are easily available to almost anyone. Counterfeit operations to manufacture popular drugs have been found in Peru, Colombia, Nigeria and other countries as well.

According to Bryan Liang, the executive director of the Institute of Health Law Studies, a brisk online trade exists in pill presses, blister packs – even the raw chemicals needed to produce a drug.

“If you search on AliBaba.com you can get 55-gallon drums of this stuff,” said Liang, referring to active pharmaceutical ingredients.

Search “active pharmaceutical ingredient” and 337 hits come up on AliBaba.com. A search for sildenafil, one of the active ingredients in Viagra, turned up 206 hits. Of those companies, 187 claimed to be located in China or India, and most claimed to provide the raw ingredient in quantities of a single kilogram or in 25-kilogram drums.

Patrick Ford, a senior investigator with Pfizer and a former FBI agent said that he has encountered bootleg operations where the manufacturers used everything from boric acid to brick dust to chalk in their operations.

In one often-cited case from December 2006, Marcia Bergeron, a 58-year-old resident of British Columbia, died of acute metal toxicity from anti-anxiety pills she had ordered online. Media reports stated that Canadian and American government investigators found Bergeron had purchased the pills from an Eastern European-based online pharmacy. The pills themselves were suspected to come from Southeast Asia and had contained aluminum, titanium and tin.

There are other hazards as well. Even drugs manufactured under the best conditions could be improperly stored or have passed their expiration date. According to the WHO, half of all drugs purchased over the internet fail tests for active pharmaceutical ingredients. A drug’s efficacy goes beyond the active ingredient, however.

“It’s not just the active pharmaceutical ingredient, but a drug has to have an identical molecular structure so it’s digested correctly,” Liang said.