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US prosecutors are charging a Canadian pharmacy website with smuggling, money laundering, and conspiracy after it allegedly sent millions of dollars worth of counterfeit medications, including fake cancer drugs, to American doctors.A Montana grand jury returned an indictment against the Winnipeg-based canadadrugs.com last year, the Associated Press reported, but the case against 14 defendants was sealed until now.The indictment alleges that the company, along with its affiliates in Barbados and the UK, sold cheap foreign versions of lifesaving drugs, which were not approved by the Food and Drug Administration (FDA). Some of those drugs were mislabeled or improperly stored, or imported under falsified customs declarations, according to the Associated Press.The total value of the questionable medications could be as high as $78 million.One of the counterfeit drugs was passed off as Avastin, a cancer drug used in conjunction with chemotherapy, which can cost as much as $2,400 for one 400 ml vial. But the packages actually contained Altuzan, a Turkish drug not approved for use in the US. According to Genentech, Avastin's manufacturer, some shipments of Altuzan contain no active ingredient. Several other medications mentioned in the indictment are also used to fight cancer.The FDA began its investigation of canadadrugs.com in 2012, according to the Associated Press. Canada's health regulator suspended the company's license as early as June 2009, but that only stopped sales to wholesale distributors and pharmacies. Health Canada said that the decision would not affect the company's ability to ship to consumers, which is governed by the College of Pharmacists of Manitoba, a provincial body.A representative of the College of Pharmacists told VICE News that they conducted an investigation when the case first broke, but decided against revoking the website's license. The alleged fraud only concerned the company's wholesale operations, the representative said, and not their direct-to-consumer sales. Individuals can still buy drugs from the website today.Attempts to reach representatives of canadadrugs.com went unanswered by the time of publication. Only one of the defendants has appeared in court, according to the Associated Press. The remaining 13 are outside the US, and will have to be extradited to face charges.Drug fraud is a global issue, with counterfeits forming about 10 percent of the world's drug trade, and possibly as much as 35 percent, according to the the National Center for Biotechnology Information. Kenya faced one of the most serious cases in 2011, when over 3,000 HIV patients received fraudulent antiretrovirals. Two people died in China in 2009 from counterfeit diabetes medications. Along with weapons, illegal drugs, and human trafficking, it's one of the most lucrative underground markets in the world.The prevalence of fake drugs is much lower in developed countries like the US, however, due to stronger regulatory systems. But the advent of online pharmacies sourcing from Turkey, India or China is breaking down borders and confounding attempts to keep consumers safe. According to the WHO, more than 50 percent of medications sold over illegal sites that conceal their address have been found fraudulent.Follow Arthur White on Twitter: @jjjarthurImage via Flickr Creative Commons
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