ABC News Investigation Into Counterfeit Prescription Drug Operations in the US

— -- A year-long ABC News “20/20” investigation uncovered numerous operations involving the sale of dangerous counterfeit prescription drugs, many of which were sold under the guise of being authentic medication shipped in from Canada, or sold openly on the streets, Flea Markets, or retail stores in Los Angeles.

For the past year, an ABC News’ “20/20” investigation team has been working behind the scenes with U.S. Homeland Security, U.S. Customs and Border Protection, FBI, Los Angeles Police Department, the L.A. Sheriff’s department, among other law enforcement agents to investigate the prevalence of counterfeit goods being sold across the United States. These items range from everyday home goods such as bicycle helmets and perfumes, to more dangerous fakes, such as airbags and prescription drugs.

We rode along with authorities to multiple counterfeit prescriptions drug raids in Los Angeles. One apartment agents raided contained boxes of illegal and counterfeit medicine – Amoxicillin, vitamin shots for b12 deficiency; Terramyacin, an antibiotic for eye infections, Ampicilin for ear infections. Investigations said these drugs can fetch thousands of dollars in sales on a good week.

Other raids turned up counterfeit Viagra, heart medication, morphine and other injectable arthritis drugs.

In another raid, investigator Brian Wong with the Los Angeles Sheriff’s Department, who is also a trained pharmacist, helped uncover counterfeit prescription drugs being sold at a flea market. There, fake drugs that are meant to be kept refrigerated are being sold in the heat of the day. Wong uncovered a range of counterfeits at that location, ranging from unapproved prescription vitamins, to pain medication.

“This Buscapina is actually for pain, and these are tablets that we’ve been told are actually counterfeit,” he said.

Authorities say customers are drawn to these unlicensed sellers because much of the medicine is cheaper than if they had it filled at their local pharmacy. But counterfeit drugs can be dangerous because the pills aren’t using the correct chemical compounds, or substituting in unsafe substances.

The operation that we were allowed to join in that week, according to pharmaceutical company Merck -- there as consultants to spot the fake and illicit drugs –netted an incredible 415,000 doses of illicit pharmaceutical products.

A popular way many customers get cheaper prescription drugs is to try to order them online from Canada. There are numerous small storefronts across the country with names like Canada Drugs or Canada Direct, advertising inexpensive drugs, but there are questions over whether the medicines being sold are pure, or even from Canada.

I was one of several ABC News producers to investigate these stores, using real prescriptions from our doctors for four different drugs -- Viagra, Zocor heart medication, generic Cialis and generic Propecia for hair loss -- to see if what we received from these stores was authentic.

First, a producer went to a Canada Direct store in Overland Park, Kansas with a prescription for Viagra. There, it was just a woman sitting behind a desk with a computer. There was nothing there to resemble a pharmacy, no pills on the shelves or anyone in a lab coat. Their pitch was that we were to give the person behind the counter our prescription, and they would put in the online order for us, and our prescription would be sent to our house.

We were assured that the prescription was pharmacist-approved.

At a store in Ocala, Florida, which advertised “Canadian meds,” another producer brought in a prescription for a Cialis trial pack and was told that the order would be for a cheaper, generic version of Cialis. The employee also changed the prescription in the system to give our producer more pills.

At another storefront in Belleview, Florida, touting the “Canada” connection, the owner filled a prescription for Propecia, a medication for hair loss. This owner also changed the quantity on the prescription. Instead of 30 pills with an option to refill, the owner ordered 100 pills of what he said was generic brand.

But while all of these stores advertised a Canada connection, Howard Sklamberg with the U.S. Food and Drug Administration Global Regulatory Operations, who is also a former prosecutor, said in reality only a “small percentage” of drugs coming through these storefronts are actually from Canada. He said most of the medicine ordered from these storefronts do not meet FDA standards.

“They could have dangerous contaminants,” he said. “And that's just a really, really, really big risk to take with your health.”Federal authorities point multiple examples of where these counterfeit drugs actually come from – Columbia, Peru, even China. ABC News had all four drugs – the Viagra, Zocor, generic Cialis and generic Propecia – tested at a variety of labs, from the Custom and Border Protection Lab in Newark, New Jersey, Eli Lilly’s Lab in Indianapolis, Indiana and the University of Montreal’s Department of Chemistry.

The generic Cialis and generic Propecia both arrived in packages from India and both came back containing impurities. In fact, a chemical test on the generic Propecia tablet revealed an unknown ingredient and unknown properties mixed in with the active ones.

The Zocor arrived from Spain, shipped through the United Kingdom. A chemical test showed a match for Zocor. American drug maker Merck, the maker of the authentic Zocor, told “20/20” that it is illegal to ship this drug from a factory in Spain, sent through the UK, calling it a diverted product and they could not vouch for this product we received. Our original report on this product stated it also arrived expired, however that now appears to be incorrect. We are in contact with Merck to see if there is a way to verify the expiration date on this diverted product, and will keep this report updated.

The Viagra was made in Turkey and arrived with Turkish instructions, and authorities said it came through illegally from Singapore. The FDA said they cannot vouch for the authenticity of the drug. Viagra’s maker Pfizer told “20/20” that the medicine we received was not a legal product in the United States.

“Even more importantly, it sounds potentially dangerous,” Sklamberg said.

With proof that none of these drugs came from Canada, we went back to the storefronts to confront the employees with our findings.

In Wichita, Kansas, where I had had ordered the heart medication Zocor, I went back to speak with the woman who ordered our prescription, as well as the store owner, who we reached and who claimed they had used the website CanadaRxConnection to order drugs for customers for 10 years and “never had that kind of problem.”

We looked into CanadaRxConnection, via multiple channels, including the FDA’s official approved online pharmacy website and on none did it show up as an approved site to sell pharmaceutical drugs to US customers.

In Overland Park, Kansas, where one of our producers dropped off a prescription for Viagra at a Canada Drugs storefront, the woman who had taken the prescription at first denied remembering ever filling it for us. The owner then asked us to reach out to him about our findings. ABC News did, and has not heard back from him.

Next in Belleview, Florida, to the Canadian Discount Rx storefront where another producer dropped off a prescription for Propecia for hair loss, the employee admits that they do not have a pharmacy license but denied he knew that it was illegal to have medicine sent into the United States.

Lastly, in Ocala, Florida, where we had dropped off a prescription for Cialis at a Canada Meds storefront, the woman there denies all wrongdoing and says we should speak to the actual owner at another Canadian storefront in a town 15 minutes away, there, the owner is waiting and tells us “Americans are allowed under federal law to order up to a 90 day supply of non-controlled medications.”

The FDA said that statement is untrue, they only allow the importation for a very rare exception when someone has a serious health condition for which there is no treatment. Not the case in any of our drugs ordered.

It was an eye-opening 9-month whirlwind – from the streets of Los Angeles to the everyday strip malls in Middle America. No one can deny medicine in this country is expensive, at times unattainable for people with poor or no health insurance. It also seems clear after this experience people need to be fully informed as to what’s really behind the services they are using to get cheaper drugs, and aware of the dangerous counterfeit drugs lurking in plain sight.

ABC News' Lauren Effron contributed to this report