Scott McLennan

Be careful for what you wish for

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The internet is an amazing place, where you can literally get lost for hours searching reviewing learning being grossed out or being entertain. On top of all of that you can also shop… It’s what you can shop for that should have many segments of the market a little more concerned than what is currently being portrayed… 

There is an increase on the number of people presenting into clinics across the world proudly showing products and treatments they have bought on line and demanding to have these injected or performed by their trusted local medical professionals. Now this poses several challenges for all parties concerned. 

·      For the patients:

o   you are offered really great products with amazing claims and have now bought these wonderfully cheap products on line. They look like what clinics are using (or what you have had injected previously. Their claims make them sound like the real pharmaceutical product, but can you be really sure that they are? Do they come from a qualified manufacturer that has been rigorously tested and approved, or are they brick dust? Often when these products arrive their labels often filled with spelling mistakes, or written in foreign languages how can patients know what they have bought is the real deal? 

·     For the clinicians:

 a patient has presented and demanded to have this random product injected that they are brandishing in front of you. What is it? Why have they got it in their hand? What is the product – it looks like something that is approved and used locally – but can you be sure? What if something goes wrong? Who is responsible? The product clearly hasn’t been tested or approved by the local authorities. What if I refuse? Will the patient go somewhere else? Or worse still: will they try and inject it themselves?

·     For the authorities:

purchasing counterfeit pharmaceutical products or medical devices online poses a real threat to the health and wellbeing for the citizens and public that they are trying to protect, and for those countries with nationalised healthcare systems, places an undue burden or risk upon the public funds used to support and correct adverse events from illegal products and devices. However controlling all products coming into the country is very difficult, and possibly infringes upon individuals basic right to freedom (I will leave that argument to the lawyers and activists).

·     For the companies:

Manufacturers and Distributors who take the time to develop, invest and then register their products – how are they responding? What are they doing to increase the consumer awareness about the risks? Are they allowed to educate the patient about their products (unfortunately in Australia companies are not allowed to educate the general public directly about their products – thus leaving it up to the physicians) Should they lobby harder for a full share of voice? Do they see it as part of their role and/or responsibility? 

Through my own eyes I have witnessed the number of people presenting to clinics with online purchased products and devices is increasing, and it’s not just in Asia. More and more patients are presenting in Australia, New Zealand, and Europe with these products and devices. Colleagues in the US have also stated similar occurances. So how do we respond? 

Some clinicians are taking the responsible tact of working with the patients about the products and about the regulatory system, the testing and the approval process, all designed with their safety in mind. Some patients a quite reasonable about this, but there are some that suggest that they don’t care, and are willing to take the risk. We have seen this voiced on numerous occasions, but when things did go wrong the patients all blamed the clinicians, not themselves for forcing their clinicians hand. Or worse still, when refused – do the patients attempt to inject themselves?

Some companies are now promoting directly to patients about making sure it is an approved product, with visual clue on what to look for. This works in some countries, but in Australia for example, a pharmaceutical company cannot advertise directly to the patient, so improving patient’s knowledge and understanding is left to the clinicians – which in itself is a challenge. 

There are stories coming out of India, Asia and Africa where cheaper products are sent or purchased by local health authorities or NGO’s and they either turn out to be brick dust (this was the case of HIV medications bring used in Africa shipped from China that weren’t working, it wasn’t until they were actually tested that they were proven to have nothing active in them at all); or they contain different amounts of the active ingredient thus reducing the efficacy (this was the case of an injectable product being sold as the real version, it wasn’t until closer inspection of the packaging and then formal testing showed it only had 10% of the active ingredient) – this was the case of several counterfeit products coming out of India and China being sold in the Medical Aesthetic Market space around Asia.

Unfortunately it is not only the patients purchasing these products. There are now reports of clinicians and local distributors purchasing these products and promoting them directly to the patients and clinicians as the either just like the “approved” versions or worse informing people that they are the approved versions.

So the moral of the story, pharmaceutical products and medical devices go through rigorous testing, trials and approval processes all designed with the patients’ safety and wellbeing in mind.

Risking disfigurement, permanent damage or worse, for the sake of a few dollars, or risking your reputation and livelihood for the sake of trying to make a few more dollars – is it really worth it? If it sounds too good to be true – it probably is.






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