November 15, 2004
Tiny Antennas to Keep Tabs on U.S. Drugs
By GARDINER HARRIS
http://www.nytimes.com/2004/11/15/health/15drug.html (must
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The Food and Drug Administration and several major drug makers are
expected to announce initiatives today that will put tiny radio antennas
on the labels of millions of medicine bottles to combat counterfeiting
and fraud.
Among the medicines that will soon be tagged are Viagra, one of the most
counterfeited drugs in the world, and OxyContin, a pain-control narcotic
that has become one of the most abused medicines in the United States.
The tagged bottles - for now, only the large ones from which druggists
get the pills to fill prescriptions - will start going to distributors
this week, officials said.
Experts do not expect the technology to stop there. The adoption by the
drug industry, they said in interviews, could be the leading edge of a
change that will rid grocery stores of checkout lines, find lost luggage
in airports, streamline warehousing and add a weapon in the battle
against cargo theft.
"It's basically a bar code that barks," said one expert, Robin Koh,
director of applications research at the
Auto-ID Labs of the Massachusetts Institute of Technology. The
technology, Mr. Koh said, could "make supply chains more efficient and
more secure."
Wal-Mart and the Department of Defense have already mandated that their
top 100 suppliers put the
antennas on delivery pallets beginning in January. Radio tags on
vehicles and passports could become a central tool in government efforts
to create a database to track visitors to the United States. And
companies are rushing to supply scanners, computer chips and other
elements of the technology.
The labels are called radio-frequency identification. As in automated
highway toll collection systems, they consist of computer chips embedded
into stickers that emit numbers when prompted by a nearby radio signal.
In a supermarket, they might enable a scanner to read every item in a
shopping cart at once and spit out
a bill in seconds, though the technology to do that is still some
distance off.
For drug makers, radio labels hold the promise of cleaning up the
wholesale distribution system, where most counterfeit drugs enter the
supply chain, often through unscrupulous employees at the small
wholesale companies that have proliferated in some states.
Initially, the expense of the system will be considerable. Each label
costs 20 to 50 cents. The readers and scanners cost thousands of
dollars. But because the medicines tend to be very expensive and the
need to ensure their authenticity is great, officials said, the expense
is justified.
Costs are still far too high for individual consumer goods, like the
amber bottles that pharmacies use to dispense pills to individuals. But
prices are expected to plunge once radio labels become popular, so drug
makers represent an important set of early adopters.
Privacy-rights advocates have expressed reservations about radio labels,
worrying that employers and others will be able to learn what
medications people are carrying in their pockets. Civil-liberties groups
have voiced similar concerns about ubiquitous use of the technology in
the marketplace. But under the current initiatives, the technology would
not be used at the retail level.
The food and drug agency's involvement is crucial because drug
manufacturers cannot change a label without the agency's approval. In
its announcement, the agency is expected to say that it is setting up a
working group to resolve any problems that arise from the use of radio
antennas on drug labels.
Counterfeit drugs are still comparatively rare in the United States, but
federal officials say the problem is growing. Throughout the 1990's, the
F.D.A. pursued about five cases of counterfeit drugs every year. In each
of the last several years, the number of cases has averaged about 20,
but law-enforcement officials say that figure does not reflect the
extent of the problem.
Last year, more than 200,000 bottles of counterfeit Lipitor made their
way onto the market. In 2001, a Sunnyvale, Calif., pharmacist discovered
that bottles of Neupogen, an expensive growth hormone prescribed for
AIDS and cancer patients, were filled only with saltwater.
"We've seen organized crime start to get involved," said William
Hubbard, an associate food and drug commissioner. With some drugs
costing thousands of dollars per vial, the profit potential is huge, he
said.
The weak point, Mr. Hubbard said, is the wholesaler system, which ships
more than half of the 14,000 approved prescription drugs in the United
States. While three large companies - McKesson, Cardinal and
AmerisourceBergen - account for more than 90 percent of drugs that are
sent through wholesalers, there are thousands of smaller companies
throughout the country, many little more than a room with a
refrigerator.
State pharmacy boards are responsible for regulating drug wholesalers,
but most boards do almost nothing to police them.
In many states, only a small fee and a registration form are needed to
set up shop. A 2003 report by a Florida grand jury found that the state
had 1,399 approved wholesalers, one for every three pharmacies in
Florida.
Radio labels fight counterfeiting by providing a unique identifier that
is almost impossible to copy. When pharmacists receive delivery, they
should be able to pass a wand over the bottles and, through an online
database, check the history of each.
Any bottles that have been reported missing or previously sold, have an
unusual delivery history or are not recognized by the system will be
flagged as suspicious.
Makers of prescription narcotics say radio labels could help cut down on
the booming trade in stolen pills.
"We get calls once a week from state troopers saying they got a guy with
one of our bottles," said Aaron Graham, chief security officer for
Purdue Pharma, the maker of OxyContin.
With radio labels, Purdue will be able to trace those bottles to
individual pharmacies. "If that pharmacy was robbed, we'll know for
certain that that guy is in possession of stolen property," Mr. Graham
said.
Radio labels could conceivably help ensure that imported drugs are safe,
Mr. Hubbard of the F.D.A. said. But drug manufacturers are unlikely to
put radio labels on drugs sold in other parts of the world for many
years, he said. The F.D.A. has been a fierce opponent of legalizing drug
imports.
"This is about securing the domestic supply," said Tom McGinnis, the
F.D.A.'s chief pharmacist.
So far, the agency is relying on a nonprofit industry group, EPCglobal,
based in Lawrenceville, N.J., to set standards for radio labels.
The labels will remain voluntary until 2007. After that, the agency may
require the labels and specify which types must be used, Mr. Hubbard
said.
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