Complex supply chains
Awareness campaigns, such as those promoted by the Council of Europe, can assist in this regard. These programs, among other things, direct consumers seeking online pharmaceuticals to the legitimate supply chain. New complex channels of distribution and dispensation, however, are developing. These changes, coupled with economic constraints in public healthcare systems are opening the door to fraud committed by rogue players.Anticounterfeiting efforts among regulators and business stakeholders have increased in the US and Europe since 2007. During these past few years, several serious incidents of counterfeiting, contamination, and adulteration have occurred, affecting, among others, Plavix, Casodex, and Zyprexa in the UK, and heparin worldwide.
A European mass-serialization strategy
The Council of Europe and its European Directorate for the Quality of Medicines & HealthCare (EDQM) have developed a comprehensive anticounterfeiting strategy that includes several activities, including the training of customs, police and health officers and the adoption of the Medicrime Convention on counterfeiting of medical products and similar crimes involving threats to public health. The Medicrime Convention will be opened for signatures this month (October 2011), and will constitute, for the first time, a binding international legal instrument to combat counterfeiting by criminalizing these activities (1).
As part of this anticounterfeiting strategy, a new EDQM project called eTACT aims to develop a traceability and mass-serialization system that authorities and stakeholders (i.e., manufacturers, suppliers, distributors, healthcare professionals, patients) across the global pharmaceutical supply chain can use.
At its current stage of development, eTACT consists of a live demonstration IT system, developed using nonproprietary standards, with inherent flexibility. The system's repositories will contain data on the pharmaceutical products and items traced (e.g., transaction data, such as the commissioning and registration of new items, packing, shipping, and dispensing).
The main standards followed will be those from GS1, the international nonprofit association dedicated to improving the efficiency and visibility of supply chains. Product identifiers will thus be the GS1 Global Trade Item Numbers (GTINs) and also national product numbers, such as VNRs in the Nordic countries. Master data (i.e., the product name, marketing authorization holder, dose strength) will be registered together with these product number(s).
The item data will be formed by combining the product number(s), a nonsequential and unpredictable serial number, the batch number, and the expiry date of the item. The resulting unique number, a Unique Medicine Identifier (UMI), compliant with GS1 standards, will be placed on the secondary packaging of medicinal products in the form of a 2D Datamatrix barcode. A switch to RFID tags is possible at a later stage when the technology for this data carrier is sufficiently mature.
Transaction data will be registered by system administrators. What data is recorded, who has access to those data and under what circumstances (e.g., alerts, or recalls) will be decided upfront by the stakeholders depending on the market destination of the products, the panEuropean architecture of the system, and the data-sharing option chosen by the manufacturer.
The IT system will be usable along the entire pharmaceutical supply chain to the patient level to prevent entry of the counterfeit products into the marketplace. The system will allow verification of any individual item or package of a medicinal product by querying the directory of the repositories.