Both worldwide and in Europe, the illicit medicine market is growing. This year, Europol dismantled a large network producing and shipping fake products, spanning Bulgaria, Greece, Moldova, Romania, Hungary, and Poland.

Fake pharmacies draw consumers in by offering low prices. Some buyers turn to the black market when they don't get the required prescription for medicine, according to Oksana Pyzik, associate professor of pharmacy practice and policy at University College London.

It's easy to mistake counterfeit medicine for the real deal. Fake pharmacies flourish on social media, and users often struggle to differentiate a legitimate seller from an unlicensed website.

“With counterfeit medicines, you don't know what's inside; there's no quality assurance. You don't know if there's the right pharmaceutical ingredient, and if so, whether the right amount – it can be toxic if too high,” Pyzik told us. Depending on the substances used, counterfeit medicines can lead to strokes or poisoning, and in the worst cases, death.

One of the reasons the illegal medicine trade is growing in Europe has to do with shortages of pharmaceuticals in several EU countries, according to Europol; criminal organisations fill the gaps with fake medicine.

Another reason may be digitalisation: “As it becomes normalised for people to purchase and access healthcare online, there will be an increased risk of exposure to fake online pharmacies,” Pyzik said.

Finally, the regulation of fake pharmacies on social media is weak, according to Pyzik. Fake pharmacies are rarely deplatformed, even when reports prove wrongdoing. In the rare case of suspension, a criminal organisation can simply copy and paste the website under another newly registered domain, Pyzik noted.

The counterfeit medicine market costs the EU's pharmaceutical manufacturers and wholesalers around €10 billion per year in revenue. Money made through their sale risks being used by criminal groups to finance human or weapons trafficking, Pyzik noted.

It's one of the least legislated industries, making it a low-risk, high-reward business, according to Interpol. “Seizures are regularly valued in the tens of millions of euros, underlining the scale and sophistication of this criminal trade,” Thomas Kirchberger, press officer at Europol, told us.

To fight the rise of counterfeit medicines, the EU passed a law in 2011 pushing member states to strictly regulate the sale of medical products at a distance. Many countries, like Spain and Greece, have completely banned the sale of prescription-only medicines online.

Although a welcome step, this isn't enough, according to Pyzik: “We need more training for law enforcement and prosecution. Everyone along the supply chain needs to be more aware.”