Swiss customs agents have seized one million fake tablets of anti-anxiety drug Xanax at the Zurich airport,authorities said on Friday. “Counterfeit medicine is one which is deliberately and fraudulently mislabeled with respect to identity and/or source,” states the World Health Organization (WHO). “Counterfeiting can apply to both branded and generic products and counterfeit products may include products with the correct ingredients or with the wrong ingredients, without active ingredients, with insufficient active ingredients or with fake packaging.”

The counterfeit tablets, packed in four crates and weighing 400kg, had originated in China, according to Swissmedic, the Swiss Agency for Therapeutic Products. “Analyses in the Swissmedic laboratory revealed that the drugs, which are prescribed to treat symptoms of acute anxiety, contained no active ingredients whatsoever,” Swissmedic said in a statement. The Swiss regulator said in June that it had already seized about 90 shipments this year representing a high-potential health risk. It also has ordered the shutdown of Internet websites trading drugs illegally. “According to experts, the drugs would be unrecognisable as counterfeits at a first glance.” Xanax is a drug manufactured by Pfizer used to treat severe anxiety or panic disorder. The fake tablets were destroyed.

Developing countries are a massive market for counterfeit medications, a massive trade worth billions of dollars that is often deadly. According to the WHO, fake drugs range from antibiotics to birth-control medicines, anti-tetanus serums, antimalarials, organ transplant drugs, heart disease and diabetes. In parts of Asia, Africa and Latin America, fraudulent medicines are thought to amount to as much as 30 per cent of the market, according to the UN drug agency.

Also making up a large part of medicines sold online, fake medicines can contain the wrong dose of active ingredients or toxic substances such as rat poison, according to the UN drug agency.

Back in July 2012, Chinese police seized $182 million worth of counterfeit medicine in one month during a countrywide sweep. Drugs found during the seizure included medication for diabetes, high blood pressure, and even rabies. Unlike drugs found at the Zurich airport, most of the medication did contain harmful substances.

Governments are fighting to safeguard the distribution of legitimate drugs and crack down on counterfeit products. Systematic checks of medical shipments are carried out every year, and imports of bogus medicines have been declining in Switzerland, Swissmedic said in June. Counterfeit drugs generated an estimated $75 billion in revenue in 2010, according to the National Association of Boards of Pharmacy. Each year more than 100,000 people around the world may die from substandard and counterfeit medications, according to an estimate by Amir Attaran, an associate professor at the University of Ottawa, and Roger Bate, an economist at the American Enterprise Institute.

The United States has a growing problem with counterfeit drugs. In 2012, tainted steroids killed 11 people near Boston and sickened another 100. In another case, vials of the cancer medicine Avastin were found to contain no active ingredients. The vials were sourced in Turkey, shipped to Switzerland, then Denmark, finally to the United Kingdom from which they were exported to U.S. wholesale distributors. The Wall Street Journal reported that the U.S. wholesale distributor was hired by Canada Drugs, which also owns CanadaDrugs.com, a retail pharmacy website that sells prescription medication internationally, with a focus on the American market.

In 2007-08, 149 Americans died from a contaminated blood thinner called Heparin that was legally imported into the United States. Investigated by the FDA Office of Criminal Investigations, the Albers Medical investigation is the most prolific example to date.

On August 21, 2005, the U.S. Attorney’s Office for the Western District of Missouri issued a press release announcing that three businesses and eleven individuals were indicted for their involvement in a $42 million conspiracy to sell counterfeit, smuggled and misbranded Lipitor and other drugs and for participating in a conspiracy to sell stolen drugs. As part of this investigation, FDA initiated a recall of more than 18 million Lipitor tablets, which ranks as the largest recall in the history of criminal investigations of counterfeit medications. Participants in this scheme conspired to purchase and sell counterfeit, misbranded and illegally imported drugs. Foreign versions of Lipitor and Celebrex were smuggled into the U.S. from South America and re-sold after being re-packaged to conceal the true origin of the drugs. Counterfeit Lipitor also was manufactured in South America and then smuggled into the U.S. where it was co-mingled with the genuine foreign Lipitor and sold in the U.S.

In addition, participants conspired to buy, sell and traffic almost eight million dollars worth of stolen Glaxo Smith Kline and Roche drugs, using fake pedigrees to launder the drugs and thereby concealing that they were stolen. There also were charges related to the sale of counterfeit Procrit, as well as counterfeit and misbranded Serostim and Neupogen. Procrit is an injectable drug used in the treatment of anemia and Neupogen is an injectable drug used by cancer patients to stimulate the production of white blood cells in order to decrease the incidence of infections.