Don't believe every baggy full of little blue pills that you see. (Eddie Cheng/Reuters)

Fake Viagra, and more, in Bangkok

Pharmo-piracy sweeps Thailand, and the rest of Southeast Asia. It's a deadly problem.

By Patrick Winn - GlobalPost
Published: October 23, 2009 05:27 ET
Updated: October 23, 2009 08:54 ET

BANGKOK, Thailand — Little is real in Patpong, a glowing bazaar and sex district here in Bangkok. The Gucci is fake, the DVDs are pirated and the go-go girls tell every man he’s handsome.

Drugs too are sold here openly. Not speed or cocaine, but Viagra — or at least diamond-shaped, blue pills that resemble the real thing. After dark, one aging female vendor displays dingy Viagra boxes at her stall to attract customers.

When a man shows interest, she dispatches a teenage runner to retrieve the pills from a secret location nearby. The price: $6 per tablet, $4 cheaper than the average U.S. cost.

“You want it?” asks the runner. “It’s a good price.”

It’s likely too good to be true. Counterfeit pharmaceuticals are widespread in Southeast Asia, sold for cheap on the street or in rural mom-and-pop markets.

Though Viagra is one of the most common knock-offs, it’s much less worrisome than fake meds to fight malaria, tuberculosis and even HIV. They often contain little or no active ingredient. The result: Sickness, fatalities and a host of drug-resistant viruses.

“It might contain the correct active ingredient, but the wrong dose. Or it might contain nothing at all,” said Clemence Gautier, consultant at the Bangkok-based law firm Tilleke & Gibbins. The firm specializes in prosecuting counterfeiters for clients that include pharmaceutical firms Pfizer, Novartis and GlaxoSmithKline.

Thai customs police, trained by Tilleke & Gibbins to spot fakes, often set aside boxes of seized goods for the attorneys to inspect and share with clients. Their stash amounts to 3,500-plus knock offs, many of which look astonishingly real.

Along with convincing bottles of Stolichnaya vodka, Casio calculators and even a working motorbike — all counterfeit — raids turn up a lot of fake medicine. The packages of “Throatsil” and faux-Viagra tablets stamped with the letters “VAG” are easy to spot. Many others aren’t.

“The counterfeiters are quite good at what they do,” Gautier says. “All the way down to the holograms on the box.”

The scope of counterfeit meds is difficult to gauge. But the World Health Organization has said that, in the worst-affected parts of Southeast Asia, as many as 30 percent of pharmaceuticals are lacking the stated active ingredient. This covers outright fakes, expired meds and even pills made improperly by well-meaning but barely regulated factories.

About 77 percent of bad meds are produced in China, according to GlaxoSmithKline. Just this week, a Chinese national was arrested in Bangkok with nearly $450,000 worth of Viagra knock-offs and sex toys, which are also illegal to buy or sell in Thailand.

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Posted by david wayne osedach on October 23, 2009 08:25 ET

You can buy "generic" Viagra in Tijuana for $5 per pill. They say it's made in India and it works.

Posted by hardtawork on October 24, 2009 10:20 ET

I buy Viagra from India and it goes through customs in New York before it gets to me here in Florida. It works the same as the Viagra I could buy here for a much higher price.

Posted by t0pher007 on October 23, 2009 18:28 ET

I really like your articles, but you can do better than this. While the entertainment value of this article is high, the substance is remarkably low. Its a shame that Patpong is used to draw readers into a story that pretends to be about public health. You may want to give your readers more credit. If you did research outside of BKK, you would find other lurid aspects of Thai or Laotion culture that could attract readers (minor wives, obsession with fermented fish, high low as a gambling game). Most importantly, you fail to draw a distinction between counterfeit drugs, which can be extremely harmful, and generic drugs, which have helped many rural Thais. For instance, generic ARVs are helping many HIV/AIDs positive Thais live longer and healthier lives (for pennies a day). These aren't counterfeited because the government pays for ARVs. This is unclear though because the only source of the article is a law firm that is contracted by Pfizer, who has every reason to classify generic drugs as dangerous. If you want to write a public health article - please do your readers a favor and do your research.

Posted by Patrick Winn on October 24, 2009 00:55 ET

Did you click to the article's second half? It's almost entirely devoted to U.S.-backed efforts in SE Asia to halt counterfeit meds for malaria, TB, etc.

I led with Viagra because -- in Thailand, the country I cover for GP -- it's among the most widely available counterfeit drugs. Later you have a source from a non-profit explaining why it's prevalent, but by no means the largest health risk.

And what's so lurid about fermented fish?

Thanks for commenting.

Posted by wrisjarrett on October 27, 2009 02:35 ET

Clearly you have no compassion for shredded green papaya, Patrick. But that's probably because you've never been pulverized with a wooden mallet, while drowning in a pool of putrid plaa raa, have you?

Oh, but if those verdant strands were only served with a topping of erectile dysfunction medicine, rather than toasty peanuts, you'd probably have a story on your hands, wouldntcha Patrick?

Sensationalist.

Posted by Thailandblog on October 30, 2009 10:42 ET

The drug problem is very big even as the drinking problems in Thailand. I will write soon about it on my blog: http://www.thailandblog.nl

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