Leading article: The right medicine

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Britain is faced with an increasing problem by the trade in counterfeit medicines, according to the Medicines and Healthcare Products Regulatory Agency. It emerges that counterfeiters are targeting the UK's pharmaceutical supply chain, selling counterfeit drugs to wholesalers who supply the NHS.

The attraction for counterfeiters is obvious. Drugs worth hundreds of thousands of pounds are traded in a single transaction in the NHS. If they can tap into this market, it is much more efficient than hawking their counterfeit drugs over the internet. The scale of the problem appears to be growing. Five cases of counterfeit drugs reaching patients through High Street chemists have been detected in the past two years, twice the rate registered in 2004.

The obvious danger this trade poses to public health lies in the absence of any quality control. One counterfeit drug seized by EU customs last year was packaged as a heart drug but contained only brickdust. If someone buys drugs over the internet they must, arguably, be prepared to take their chances. But it is intolerable that someone should be subjected to a risk through the NHS.

However, the reality is that most counterfeit drugs have precisely the same effects as the legitimate ones. Fraudsters want to avoid detection and keep their customers returning. Selling dud or harmful products is not in their interests. In the five cases so far detected in which counterfeit drugs have reached the NHS, no patients have suffered detectable harm.

Some might feel limited sympathy for the drug companies who lose out as a result of this fraud. Pharmaceuticals are increasingly focused on "blockbuster" drugs such as Viagra from which they are making hefty profits. If it turns out someone in China or India can manufacture these "lifestyle" drugs more cheaply, is that not welcome? Why should such producers not be allowed to compete with the pharmaceuticals legally? The answer is intellectual property rights. Genuine drugs are priced to reflect research and development costs. Whatever one's opinion on a particular product, pharmaceuticals firms have a right to profit from their investment. Otherwise no new products would be brought to market.

That is not to say drug companies should have it all their own way, though. The amount spent on drugs has been rising across the developed world in recent years. In the past five years, the drugs bill of the NHS has risen by 46 per cent to £8bn. This pays for nearly 700m items a year. National bulk buyers, including the NHS, should be driving a much harder bargain with the drugs companies. And there is no reason they should not act in concert to bring the prices down. An expanding market has been very good to the drug manufacturers. It is time patients began to reap some rewards too.

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