Estimating the Prevalence of Using Suspected Counterfeit Medications in the General Population

Counterfeit medications, sometimes referred to as "fake" or falsified drugs or pills, are drugs that are illicitly manufactured but designed to look like legitimate pharmaceuticals. Counterfeit medications are a growing public health concern. This study estimated the prevalence of self-reported use of suspected counterfeit medications by adults in the US and to assess what ingredients these individuals suspected were in the counterfeit medications.

This general population survey, drawn from an online panel, was administered across 2 waves in 2022 (15 April 3 June and 9 September 21 October) to 59,041 adults aged 18 and older. Statistical calibration weighting was used to calculate estimates representative of the national adult population.

An estimated 1.8% (95% CI 1.7%-1.9%) of respondents, corresponding to approximately 4.6 million adults, suspected past 12-month use of counterfeit medications. Fentanyl was the most commonly suspected ingredient in the counterfeit product (16.1%, 95% CI 12.8%-19.3%). The next most prevalent response was "I don't know" (15.0%, 95% CI 11.0%-18.9%) followed by methamphetamine (14.9%, 95% CI 11.4%-18.4%).

These data show the scale of the issue in relation to other well established drug use data points in the US. System-level methods, such as drug scanning software, should be implemented to reduce the likelihood that counterfeit drugs end up in the hands of individuals.