Shocking headlines about substandard and counterfeit medicines are frequently featured in the Indian media. Some recent examples from 2009 are as follows (and a far larger list is presented in Appendix 1)

“Fake drug racket busted”, Times of India, 23rd December 2009

“Fake medicine sale rampant, cops helpless”, Indian Express, 1st December 2009

“Six commonly used drugs found substandard”, 18th August 2009

“Fake cancer drugs make it to your homes”, The Times of India, 24th March 2009

In 2010 a huge fake drugs racket was exposed in Chennai. At the time of going to print, over 30 suspects had been arrested in relation to the scam, which involved putting fake labels on expired products. Over half the pharmacists we interviewed in this study (prior to the Chennai case hitting the news) said that the most popular method of counterfeiting was to re-label expired drugs with a new expiry date. But anecdotes merely give a loose impression, and so this paper presents analysis of data based on surveys of Indian pharmacies and drug traders in Delhi and Chennai.

The paper refers to both “substandard” and “counterfeit” medicines – with a full explanation of our definitions explained in Appendix 2.