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Fake medicines are getting harder to spot
This article is authored by Devashish Singh, CEO & co-founder, MrMed.
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For most patients, buying a medicine is a simple act of trust. We recognise the name on the package, check the prescription, pay the price and assume that what is inside is exactly what the label promises.
That assumption is becoming harder to take for granted.
Substandard and falsified medicines are not new. What has changed is what they can look like. Recent enforcement cases in Delhi and Karnataka have shown how products allegedly moved through the system looking entirely genuine. In one case, vials were allegedly refilled and relabelled under the names of well-known brands. These cases also showed how medicines could pass through multiple intermediaries and, in some instances, reach healthcare facilities before anyone detected a problem.
For patients, the question is simple: if a medicine looks genuine, how can they know that it actually is?
When we think about fake medicines, we often picture poorly printed boxes, spelling mistakes or visibly damaged tablets. That is no longer enough. Sometimes the packaging gives nothing away. The problem is inside: the wrong ingredient, the wrong strength. Or the medicine has left the authorised supply chain altogether.
This becomes particularly concerning for critical medicines, including antibiotics, vaccines, injectables, biologics, anti-cancer medicines and medicines used to manage serious or chronic conditions.
Take a temperature-sensitive medicine. Even if the packaging is completely genuine, prolonged exposure to inappropriate temperatures can affect its quality. The patient looking at the vial cannot identify that by appearance alone.
That is why the conversation needs to move beyond asking whether a medicine is fake. We also need to ask whether it is genuine, authorised, properly handled and traceable.
The first factor is urgency, and it is easy to underestimate how quickly it changes decision-making. When someone is trying to continue treatment, they are not comparing supply-chain models. They are trying to get the next dose.
Then there is complexity. Medicines pass through manufacturers, distributors, stockists, pharmacies and hospitals before reaching a patient. Every handoff is another point where verification matters.
The biggest challenge, though, is information asymmetry. Patients cannot independently verify everything about a medicine. They can inspect a box, but they cannot determine whether its contents were manufactured correctly or stored under the required conditions. Even trained professionals cannot verify a medicine's contents by sight alone.
That is exactly why the responsibility cannot rest with patients alone. Trust has to be built into the systems around a medicine, not placed solely on the person receiving it.
India has already started moving in this direction. Since August 2023, the top 300 medicine brands have carried QR codes under Schedule H2. The framework is now being extended to vaccines, anti-cancer medicines and narcotic and psychotropic drugs from July 1, 2027, and to antimicrobials from July 1, 2028.
This is an important step. But it is worth being clear about what it solves. A QR code helps confirm what a pack claims to be. It does not yet record the path that pack took before reaching a patient.
If authentication establishes identity, the next step is tracing movement.
For critical medicines, the legitimate path from manufacturer to authorised distributor, seller and patient should be digitally recorded. That would make unusual diversions easier to identify and strengthen accountability across the supply chain.
Hospitals and pharmacies have an important role here. Stronger supplier verification, batch-level record-keeping, appropriate storage monitoring and quicker reporting mechanisms can create additional checkpoints before a medicine reaches a patient.
The online medicine ecosystem needs the same safeguards.
Cost matters too. When genuine medicines become difficult to afford, unverified sellers become much easier to believe. Making legitimate medicines more accessible and affordable also reduces the space in which illegal markets operate.
(The views expressed are personal)
This article is authored by Devashish Singh, CEO & co-founder, MrMed.
