* Fake Roche drug entered UK from Turkey before sale to U.S.
* British medicines agency says liaising with FDA on case
* Richard's Pharma and River East exported drugs to U.S.
By Ben Hirschler
LONDON, April 4 A new batch of counterfeit
cancer drug Avastin discovered in the United States was bought
in Turkey and shipped through Britain by UK-based middlemen,
officials said on Wednesday, revealing a shipment pattern very
similar to an earlier episode.
The first discovery of fake supplies of the Roche
drug shipped into the United States from the Middle East via
Europe hit the headlines in February.
The repetition of the illegal trade highlights
vulnerabilities in the global medicine supply chain, which
leaves patients at risk of receiving ineffective or contaminated
Britain's Medicines and Healthcare products Regulatory
Agency (MHRA) said it was looking into how the latest
counterfeit batch entered Britain before being sold in the U.S.
"It's an ongoing investigation," said spokeswoman Jennifer
Kyne. "We're helping the FDA (Food and Drug Administration) with
their investigation and doing all we can on our side."
So far, the MHRA has established that British wholesaler
Richard's Pharma imported 120 packs of the medicine from a
Turkish supplier, 38 of which were exported direct to the United
The remainder were sold to another British firm, River East
Supplies, which also exported them to the U.S. market. River
East was previously identified by regulators as one of the
parties involved in the earlier fake Avastin incident.
No-one was immediately available to comment at either
Richard's Pharma or River East, which are based respectively in
Warwick and Nottingham, central England.
The MHRA's Kyne said there was no evidence to suggest that
any of the counterfeit product had reached patients in Britain.
Scrutiny of the supply chain has grown since the first
episode of fake Avastin set alarm bells ringing by underscoring
the lack of a clear system to track medicines as they change
The Avastin case is viewed as particularly serious because
it marks a step change by criminal counterfeiters, who until now
have tended to focus on simple pills. Avastin, by contrast, is a
complex injectable biotech drug with annual sales of $6 billion.
NO ACTIVE INGREDIENT
The FDA said on Tuesday the new batch of bogus vials of the
cancer treatment contained none of Avastin's active ingredient,
The fake versions of the Swiss drugmaker's top-selling
product were labelled as Altuzan, which is the brand name that
Avastin is sold under in Turkey. Kyne said the MHRA was informed
on March 28 by the FDA that Altuzan batch B6021 was counterfeit.
A Roche spokesman said that authentic Altuzan only had
Turkish-language packaging, whereas images of the fake medicine
posted by the FDA on its website showed English-language
The FDA said U.S. medical practices had bought the latest
counterfeit Avastin from overseas suppliers, in particular
In the case of the fake Avastin that came to light in U.S.
clinics in February, the source of supply was also Turkey but
the network - involving middlemen based in Egypt, Switzerland,
Denmark and Britain - was different.
River East, however, was a common link in both cases, having
been identified by officials as buying fake product from
Denmark's CareMed in the initial case.
The World Health Organisation estimates that less than 1
percent of medicines available in the developed world are likely
to be counterfeit. Globally, however, the figure is around 10
percent, while in some developing countries as much as a third
of medicines are estimated to be bogus.