When the UK medicines watchdog unveiled its first ever strategy to tackle counterfeiting last week,1 it was responding to growing concern about the increasingly complex, dangerous, and expanding international traffic in fake drugs. A few weeks earlier, the Medicines and Healthcare Products Regulatory Agency had brought to trial one of the most ambitious prosecutions to date, leading to the imprisonment of four men for handling £1.5m (€2m; $3m) in counterfeits.2 Other cases concerning still more elaborate schemes are scheduled in the months ahead.

In the past three years, the agency has issued nine withdrawal notices for suspect prescription medicines discovered in the legal distribution chain, compared with just one in the previous decade. Pharmaceutical companies such as Pfizer have been forced into costly withdrawals of batches of their medicines faked by criminals.3