The trail of counterfeit copies of the multibillion-dollar cancer drug Avastin leads to an address in a crowded Cairo suburb, with no sign of the firm named by international suppliers as the source of the product.
Last week's discovery in the United States of the fake Avastin — containing no active ingredient — sent shock-waves through the medical community by showing how even expensive injectable medicines, not just pills like Viagra and Lipitor, are at risk from criminal counterfeiters.
Now healthcare regulators on both sides of the Atlantic are investigating how bogus packs of Roche's cancer therapy entered the supply chain in the world's biggest market, after travelling from Egypt through Switzerland to Britain en route to California.
Hadicon, based in Zug, Switzerland, told Reuters it imported the Avastin from a business called "SAWA for importing and exporting" in Giza, near the pyramids on the outskirts of Cairo.
But there was no company by the name of SAWA at the address given by Hadicon — 2 El Eshreen Street, Feassal — and the nondescript five-storey building appeared to house only a small mosque, with a real estate office above it, when visited by a Reuters correspondent on Tuesday.
Local residents said there were doctors' offices on upper floors and there was also a sign outside for an accountant. Several people in the area, including staff at a nearby pharmacy, had no knowledge of any company by the name of SAWA.
A spokesman for the Egyptian health ministry, responsible for the import and export of drugs, said officials had made checks and found that SAWA was not registered with the ministry in any capacity, making it illegal for the company to deal in pharmaceuticals.
Hadicon said in an email that it had never had problems in the past with deliveries from SAWA, adding that Hadicon was licensed to export pre-packaged and sealed medicines, but was not allowed to open them.
"If the fake Avastin did indeed go through Hadicon in the supply chain, we will have been the victim of a large scam, despite all our possible preventative measures," it added.
Hadicon gave no other contact details for SAWA. A second address in Giza for a company called SAWA, found on the Internet, led to a block of flats a few streets away from the first address.
A doorman said a man named on the Internet as the contact for the company was away and had been travelling for at least a month. There were no signs for SAWA at this building either.
The chase after counterfeit Avastin highlights the growing complexity of the global drug supply chain, including both legitimate and counterfeit medicines, and how regulators will be hard-pressed to address potential safety breaches.
The phony Avastin was sold by Hadicon to Danish drug distributor CareMed, which shipped it on directly to Britain's River East Supplies, according to Danish and British regulators.
