Counterfeit Avastin shipped to Europe as well as US

Counterfeit versions of Roche's cancer drug Avastin, which caused a stir in the US in 2012, were also shipped to the UK, Switzerland and Denmark, according to Turkish police.

Further details have emerged from the enforcement operation towards the end of last year that resulted in 56 arrests across nine Turkish cities and the takedown of a medicines counterfeiting operation that focused on high-value oncology products and involved hospitals, wholesalers and at least 20 pharmacies.

The illicit operation hit the headlines in 2012 after counterfeit versions of Altuzan - the Turkish brand name for Avastin - were intercepted in the US, but it has now been revealed that Egyptian and Syrian intermediaries were involved in shipments to Europe in previous years.

A report in the Turkish newspaper Milliyet suggests the criminals produced counterfeit cancer drugs at a printing house in Bağcılar, Istanbul, using raw materials smuggled from Syria, Iran, Libya, Azerbaijan and Egypt.

Around 5,000 counterfeit medicines were seized in the operation, which included fake Altuzan as well as copies of Roche's Mabthera (rituximab; sold as Rituxan in the US), which is used to treat non-Hodgkin's lymphoma (NHL) and chronic lymphocytic leukaemia (CLL).

In the wake of the operation last December, Turkey's Association of Research-Based Pharmaceutical Companies (AIFD) issued a statement saying that the incident was "alarming", given that the country has implemented a national programme of medicine serialisation via 2D barcodes - the drug tracking system (ITS) - which should make it hard to carry out this sort of illegal activity (assuming the codes are actually scanned).

It is thought that the counterfeit operation may have targeted export markets as well as private sales of the medicines to patients within Turkey who want to avoid waiting for access to medicines or lack coverage under the country's healthcare insurance system.