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

Introduction: 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.

Methods: 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.

Results: 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%).

Conclusions: 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.