Identifikacija krivotvorenih lijekova za erektilnu disfunkciju iz ilegalnog lanca opskrbe

The appearance of counterfeit medicines in supply chains is a global public health problem that may seriously affect patients. Counterfeit drugs do not meet quality standards and do not declare their real composition and/or source for the purposes of fraud. They may be generic or innovative, they may contain genuine constituents in a fake packaging, or wrong ingredients, or inactive ingredients, or an incorrect quantity of the active substance. In Croatia, no cases of counterfeit medicines have been detected so far, but the Agency for Medicinal Products and Medical Devices has received 34 samples of medicines and other products for testing from Zagreb City Police. The samples included medicines for erectile dysfunction: sildenafi l, tadalafi l, and vardenafi l. Twenty-three samples of tablets without marketing authorisation in Croatia were tested with high-performance liquid chromatography (HPLC) for the declared sildenafi l and tadalafi l content. Samples labelled 1 (batch T/33), 3 (batch T/33), 5 (batch 4), 6 (batch M0016J), 10 (batch T-070235), 12 (batch T-070544), 15 (batch 314833201), 16 (batch 832718474), and 17 (batch 504830028) containing sildenafi l and samples labelled 20 (batch 070356), 21 (batch 05668), and 22 (batch T 378 5) containing tadalafi l did not contain the active substance within the acceptable 95 % to 105 % margin of deviation from the declared content. While most samples cannot be described as fake with a reasonable amount of certainty, there is still a suspicion of counterfeit. A correct conclusion can be drawn only with the assistance of the manufacturers and by conducting additional laboratory tests.Pojava krivotvorenih lijekova u lancima opskrbe globalni je javnozdravstveni problem koji može imati ozbiljnih posljedica za pacijenta. Krivotvoreni lijekovi ne zadovoljavaju propisane standarde kakvoće te su u svrhu prijevare drugačije deklarirani u odnosu na njihov stvarni sastav i/ili podrijetlo. Mogu biti generički, ili inovativni, mogu sadržavati ispravne sastojke, ali pogrešno pakiranje, pogrešne sastojke, ne sadržavati djelatnu tvar ili ne sadržavati dovoljnu količinu djelatne tvari. U Hrvatskoj do sada nisu zabilježeni slučajevi krivotvorenih lijekova, ali je Agencija za lijekove i medicinske proizvode od policijske uprave Zagrebačke zaprimila 34 uzorka lijeka i ostalih proizvoda u svrhu ispitivanja. Od lijekova, radilo se o lijekovima za erektilnu disfunkciju sildenafi lu, tadalafi lu i vardenafi lu. 23 uzorka tableta koji nemaju odobrenje za stavljanje lijeka u promet u Hrvatskoj ispitana su metodom tekućinske kromatografi je visokog učinka (HPLC) na deklarirani sadržaj sildenafi la i tadalafi la. Ustanovljeno je da uzorci pod oznakama 1 (serija T/33), 3 (serijaT/33), 5 (serija 4), 6 (serija M0016J), 10 (serija T-070235), 12 (serija T-070544), 15 (serija 314833201), 16 (serija 832718474), 17 (serija 504830028) koji su sadržavali sildenafi l te uzorci 20 (serija 070356), 21 (serija 05668), 22 (serija T 378 5) i 23 (702099) koji su sadržavali tadalafi l, ne sadržavaju djelatnu tvar unutar prihvatljivih granica odstupanja od 95 % do 105 % od deklarirane vrijednosti. Iako se ne može sa sigurnosti za većinu uzoraka reći da se radi o krivotvorini, ipak se može govoriti o sumnji na krivotvorinu, a cjeloviti zaključak može se izvesti jedino uz suradnju i mišljenje proizvođača te provedbom dodatnih laboratorijskih ispitivanja

ARE THERE COUNTERFEIT MEDICINES IN CROATIA?

Krivotvoreni lijekovi postaju sve veći problem u svijetu jer ugrožavaju zdravlje pacijenta i javnozdravstveni su rizik. Ovi su lijekovi rezultat dobro organiziranog kriminala koji u svrhu stvaranja dobiti plasira na tržište lažne lijekove. U otkrivanje i sprječavanje trgovine takvim proizvodima uključena su regulatorna tijela za lijekove, policija, carina, pravosudna tijela i farmaceutska industrija. U Hrvatskoj do sada nije zabilježena pojava krivotvorenih lijekova u ovlaštenim lancima opskrbe. Međutim, na crnom tržištu katkad se jave lijekovi koji potječu iz drugih zemalja i koji nemaju odobrenje za stavljanje u promet u Hrvatskoj. Najčešće su to lijekovi za liječenje erektilne disfunkcije: sildenafil, tadalafil i vardenafil. U ovom radu ispitani su uzorci 26 lijekova zaplijenjenih u ilegalnom lancu opskrbe, a koji su namijenjeni za liječenje erektilne disfunkcije. Za kvalitativno i kvantitativno određivanje djelatnih tvari u ispitanim uzorcima lijekova upotrijebljena je metoda tekućinske kromatografije visokog učinka (HPLC). Utvrđeno je da od 26 uzoraka 13 ima odstupanja od deklariranog sastava i sukladno tomu ne udovoljavaju zahtjevima kakvoće. Nadalje, dva uzorka nisu uopće sadržavala djelatnu tvar vardenafil, što upućuje i na mogućnost krivotvorine.Counterfeit medicines are a growing problem in the world, for their use may endanger patient’s health and therefore they pose an enormous public health risk. The manufacture of counterfeit medicines usually involves organised crime groups which place the counterfeit medicines on the market for reasons of profit. Detection and prevention of trade in counterfeit medicines requires close cooperation between medicine regulatory authorities, police, customs, judiciary and pharmaceutical industry. To this day, there have been no recorded cases of counterfeit medicines in the legal supply chain in Croatia. However, medicines without marketing authorisation in Croatia, originating from different countries, could be found on the illegal market. Most frequently, this includes medicines for the treatment of erectile dysfunction such as: sildenafil, tadalafil, vardenafil. In this study, 26 medicines for the treatment of erectile dysfunction, seized in illegal supply chain, were tested. High performance liquid chromatography (HPLC) was used for identification and quantification of active substances in the tested samples. It was determined that 13 out of 26 samples did not comply with declared composition of medicine and quality specification. Furthermore, two samples did not contain declared active substance vardenafil and that may indicate that these medicines are counterfeit

Regulating Medicines in Croatia: Five-year Experience of Agency for Medicinal Products and Medical Devices

Aim To present the activities of the Agency for Medicinal Products and Medical Devices in the first 5 years of its existence and to define its future challenges. Methods Main activities within the scope of the Agency as a regulatory authority were retrospectively analyzed for the period from 2004-2008. Data were collected from the Agency’s database and analyzed by descriptive statistics. Results The number of issued medicine authorizations rose from 240 in 2004 to 580 in 2008. The greatest number of new chemical and biological entities was approved in 2005. The greatest number of regular quality controls (n = 5833) and special quality controls was performed in 2008 (n = 589), while the greatest number of off-shelf quality controls (n = 132) was performed in 2007. The greatest number of medicine labeling irregularities was found in 2007 (n = 19) and of quality irregularities in 2004 (n = 9). The greatest number of adverse reactions was reported in 2008 (n = 1393). The number of registered medical devices rose from 213 in 2004 to 565 in 2008. Conclusion Over its 5 years of existence, the Agency has successfully coped with the constant increase in workload. In the future, as Croatia enters the European Union, the Agency will have to face the challenge of joining the integrated European regulatory framework