Trojan drugs: counterfeit and mislabeled pharmaceuticals in the legitimate market.

Over the past five years, there have been over 140 reported incidents of counterfeit and mislabeled drugs being sold by legitimate pharmacies in the United States. Thousands of patients have consumed these medications, sometimes with dire consequences. The extent of counterfeits in the legitimate market, however, is unknown. It is certain that the detected incidents of fakes are a fraction of the total number of incidents. How did these drugs wind up in the bloodstreams of unsuspecting patients? Despite elaborate safety precautions, strict regulations and battalions of enforcement personnel, the stream of phony pharmaceuticals continues unabated. This article will consider the practical and legal dimensions of trade in Trojan drugs. This paper will not consider the two major sources of counterfeit medications in the U.S. – direct importation and internet pharmacies. These routes are the subject of numerous scholarly articles and the field is so vast that they deserve separate