Singapore Health Sciences Authority seized 1.12 million units of illegal health products in 2023

The Singapore Health Sciences Authority (HSA) continues to clamp down on the sale and provide of illegal health products at focused hotspots and on-line.

An HSA media launch right now summarised the motion taken by the federal government company in 2023 with regard to illegal health products. It stated that focused operations, intel-sharing and joint enforcement efforts with native and abroad businesses led to the seizure of over 1.12 million units of illegal health products and the removing of practically 12,500 listings of illegal health products from native e-commerce and social media platforms.

These products had been unregistered, counterfeit, or had potent medicinal substances and/or banned substances illegally added.

Over 50 per cent enhance in seized health products

Compared to 2022, the quantity of illegal health products seized in 2023 by the HSA elevated by greater than 50 per cent.

The sorts of products seized remained comparable, with sexual enhancement or male vitality products and addictive medicines comparable to codeine cough syrup and sedatives, persevering with to be the most typical classes [Figure 2.1].

The 50 per cent enhance in products seized was on account of heightened surveillance and enforcement in hotspot areas, together with a significant operation in June 2023 alongside the Singapore Police Force (SPF) to clamp down on a suspected illegal codeine syndicate.

This operation was the largest involving illegal codeine syndicates since 2019. Approximately 190 litres of codeine cough syrup (equal to about 2,100 90ml prescription-sized bottles sometimes allotted at clinics) and an assortment of tablets had been seized, making this one of the most important seizures in the previous 5 years.

Nearly 12,500 product listings faraway from on-line platforms

In 2023, the HSA additionally labored with the directors of native e-commerce and social media platforms to take down 12,474 listings of illegal health products. This was virtually thrice increased in comparison with 4,569 listings eliminated in 2022.

The vital enhance was largely on account of two worldwide operations led by Interpol that focused the web sale of sexual enhancement products and different health products, which passed off in June 2023 and October 2023.

In addition, the HSA utilised expertise, together with e-commerce surveillance instruments, which enabled offending listings to be recognized and brought down a lot sooner.

The majority of the eliminated listings had been promoting sexual enhancement or male vitality products; hair and sweetness products, comparable to anti-hair loss remedy; facial fillers and adulterated pores and skin whitening products; COVID-19 associated products, comparable to check kits and symptom-relieving products; weight reduction products; contraceptives; and products for administration of power circumstances (e.g., eczema, psoriasis, gout, diabetes, hypertension).

A complete of 1,895 sellers acquired warnings from the HSA. Based on the knowledge obtainable in these eliminated listings, roughly 48 per cent of these sellers had been primarily based in Singapore.

Prosecution actions in opposition to illegal health products

From 2021 to 2023, the HSA prosecuted 55 individuals for the sale and provide of illegal health products.

The company will proceed to take stern enforcement actions in opposition to anybody who sells or provides illegal health products. Sellers and suppliers of such products are liable to be prosecuted and, if convicted, could also be imprisoned for as much as 3 years and/or fined as much as SGD 100,000.

Of the 16 individuals prosecuted in 2023, one notable case concerned the illegal importing and promoting of medicines on Telegram.

The HSA labored with the Immigration & Checkpoints Authority (ICA) to focus on the vendor’s illegal actions. This culminated in profitable operations at Woodlands Checkpoint and a industrial unit in Ang Mo Kio.

In complete, greater than 94,000 units of sedatives and codeine tablets, and roughly 45 litres of cough syrup (equal to about 500 prescription-sized bottles) with an estimated avenue worth of about SGD 190,000 had been seized. The 35-year-old male vendor was sentenced to 30 weeks’ imprisonment.

Products discovered to comprise potent substances and/or banned substances

During the previous yr, the HSA issued public alerts on 15 illegal health products detected by way of adversarial occasion reporting from healthcare professionals, suggestions from shoppers, or from the HSA’s surveillance.

These products had been both adulterated with potent substances and/or banned substances, or unregistered.

The commonest adulterants detected had been sibutramine (a banned substance) and potent steroids comparable to dexamethasone, betamethasone, and prednisolone.

Sibutramine was detected in 5 products marketed for weight reduction, whereas steroids had been discovered in 5 products marketed for ache reduction or administration of power circumstances like cough and gout.

At least 13 individuals reported adversarial results by way of their docs or on to the HSA, after consuming or utilizing one of the 15 illegal health products. Some of them skilled severe adversarial results comparable to Cushing’s syndrome and Stevens-Johnson syndrome.

These products had been both bought on-line, domestically from peddlers, or from abroad by way of pals or family members, and had been marketed to satisfy numerous health and/or life-style wants.

Serious adversarial results attributable to illegal health products

Four shoppers developed severe adversarial results after taking 4 products that had been examined by the HSA and located to comprise dexamethasone and different steroids.

Case research 1

One of them, a person in his 30s, had obtained the product “DND Rx9” from a web based vendor primarily based in Malaysia. He had been taking it for a number of months to handle his gout, and subsequently developed signs of Cushing’s syndrome. This is a severe steroid-induced situation, characterised by a spherical or “moon face” look, and irregular blood outcomes.

His physician suspected that the product could possibly be adulterated with steroids and reported the case to the HSA. Of the remaining three shoppers who took products adulterated with steroids, two additionally developed Cushing’s syndrome, whereas one had irregular blood cortisol ranges.

Case research 2

Another product, “EUZEMA Confidence Revival Cream”, which was offered on-line, brought about a person in his 30s to develop purpura, a pores and skin response characterised by purplish crimson spots on account of small bleeds below the pores and skin.

The product was marketed to be “steroid-free”, “100% all-natural herbs” and “in a position to beat eczema for good with this highly effective pure formulation”. However, the HSA examined the product and located it to comprise betamethasone (a steroid) and really excessive ranges of arsenic, at over 430 occasions increased than the allowable limits.

The man, who had used “EUZEMA Confidence Revival Cream” for a yr, shared, “Everyone has a component to play in reporting such products and the adversarial results they could trigger to their docs. I did assume it will be inconvenient to report it and maybe another person would have completed it, nevertheless it turned out that wasn’t the case.”

His physician, Dr Kuan Ling Yee from the National Skin Centre, cautioned, “Understandably, eczema sufferers hope to discover various remedies as they search an answer for his or her situation. However, they need to bear in thoughts that they could encounter false info and inaccurate representations of products, particularly with the development of the Internet.”

Case research 3

Three males in their 30s skilled severe adversarial results after taking modafinil or armodafinil inappropriately to remain awake or enhance alertness. They developed a number of mouth ulcers and different signs like rash, fever, and conjunctivitis.

Two developed Stevens-Johnson syndrome (SJS), a life-threatening pores and skin situation with blistering and extreme peeling of the pores and skin.

Modafinil and armodafinil are potent medicines that ought to solely be prescribed by a physician for medical circumstances comparable to narcolepsy and used below medical supervision.

Self-medication with modafinil or armodafinil to remain alert or enhance focus may be dangerous as it might trigger severe adversarial results comparable to coronary heart issues, hypertension, and psychiatric circumstances together with anxiousness, hallucinations or mania.

Serious pores and skin reactions, together with SJS and poisonous epidermal necrolysis (TEN), have additionally been reported with the use of modafinil and armodafinil, and might result in hospitalisation, severe problems and even demise.

Singapore officers advise individuals to safeguard personal health

Associate Professor Lee Haur Yueh from the Singapore General Hospital, who handled one of the shoppers who was hospitalised, suggested, “Avoid acquiring medicines from unregulated sources or on-line platforms and search medical recommendation earlier than consuming new medicines.”

Consumers should play a task in safeguarding their very own health. Health products comparable to medicines or health dietary supplements are usually not like different commodities comparable to garments or family units, the place their high quality defects may be readily recognized by the person.

Associate Professor Chan Cheng Leng, Group Director of the HSA’s Health Products Regulation Group

The HSA official warned the general public, “There isn’t any telling whether or not a health product is substandard or adulterated with dangerous medicinal substances, and the adversarial affect on the individual’s health may be severe and even deadly.”

Consumer advisory issued by the HSA

Illegal health products stay a menace to public health and security. As lengthy as there may be demand, unscrupulous sellers will proceed to fabricate and promote products with guarantees of fast health fixes.

The HSA has the next advisory for shoppers, itemizing the methods in which illegal health products can hurt the general public:

• False claims and dangerous substances: Illegal health products are sometimes falsely promoted to be “pure”, “natural” or have fast or miraculous outcomes. In reality, they comprise undeclared potent substances, which might trigger severe adversarial results when used in the absence of medical supervision.
• Lack of quality control, manufacturing and product info: There isn’t any figuring out how these products had been made, what substances they comprise and below what circumstances they had been manufactured and saved.
• No recourse for shoppers: It may be troublesome to find out the supply of products bought from unknown or unfamiliar sellers, comparable to from abroad, on-line or avenue peddlers. Consumers could, due to this fact, not be capable of declare for any damages or get any refund ought to something go unsuitable.

Follow the A-B-C-D steps to remain secure

It will not be attainable to know for positive whether or not a health product is illegal or dangerous simply by a product or its packaging. Hence, shoppers are suggested to at all times be cautious and comply with the A-B-C-D steps earlier than shopping for or taking a health product:

• A: Avoid making purchases from suspicious or unfamiliar sources. Find out who you might be shopping for from and what you might be shopping for, even when the product is really helpful by somebody you belief. As a basic guideline, purchase from respected sources comparable to pharmacies or established retail shops. When buying from e-commerce platforms or over the Internet, shoppers are strongly inspired to buy from companies with established retail presence.
• B: Beware of offers that sound too engaging. If the worth is far decrease than anticipated, or product info sounds too good to be true, it most likely is.
• C: Check the claims and products. Not all marketed claims are true and they are often exaggerated or over-promise. Do not be misled by constructive product testimonies or opinions on-line as they can’t be verified. Consumers may discuss with the HSA’s database of notified health dietary supplements and conventional medicines (https://www.hsa.gov.sg/vns-list) earlier than making their purchases.
• D: Discuss along with your physician or pharmacist on the suitability of a product if you’re uncertain.

Members of the general public who’ve any info on the sale and provide of these illegal products could contact the HAS’s Enforcement Branch at Tel: 6866-3485 throughout workplace hours (Monday to Friday) or e mail: hsa_is@hsa.gov.sg.