1*Strategic Global Project Manager, Sourcing & Procurement Management, Presidency University. Email: twindeepthy@gmail.com
2Associate Professor, School Of Management, Presidency University. Email: edwin.t@presidencyuniversity.in
Counterfeit pharmaceuticals represent a significant and evolving threat to public health and pharmaceutical governance in India. This comprehensive narrative review examines the prevalence of counterfeit medicines across major therapeutic drug categories and analyzes the structural vulnerabilities that enable diversion within the Indian pharmaceutical supply chain. Drawing on peer-reviewed literature, policy documents, and international research, the study identifies uneven distribution of counterfeit risks, with heightened exposure observed in anti-infectives, oncology drugs, and central nervous system medicines. These high-risk categories are influenced by strong market demand, high economic value, and misuse potential. The review further highlights systemic weaknesses within India's multi-tier distribution network, including manufacturing compliance gaps, wholesale opacity, informal retail practices, and digital marketplace expansion. Diversion mechanisms-such as warehouse theft, prescription manipulation, and parallel trade-emerge as critical pathways that blur the distinction between legitimate and illicit pharmaceutical circulation. The findings indicate that counterfeit activity in India is strategically driven by market incentives, supply chain fragmentation, and regulatory coordination challenges rather than isolated criminal acts. Emerging trends reveal increasing digitalization of counterfeit trade and convergence between diversion networks and substance misuse markets. Addressing these risks requires an integrated approach combining strengthened regulatory oversight, technological traceability systems, and improved inter-agency governance. This review underscores the need for coordinated national strategies to safeguard pharmaceutical integrity, protect patient safety, and preserve India's global credibility as a leading supplier of generic medicines.
Keywords: Counterfeit pharmaceuticals, Drug diversion, Pharmaceutical supply chain, India, Public health governance
How to cite this article: Deepthy C, Edwin TS. Counterfeit Pharmaceuticals in India: An Analysis of Prevalence Across Major Drug Categories and Strategies to Mitigate Diversion. Int J Drug Deliv Technol. 2026;16(16s): 203-208. DOI: 10.25258/ijddt.16.16s.21
Source of support: Nil.
Conflict of interest: None