Blockchain Technology for Detecting Falsified and Substandard Drugs in Distribution: Pharmaceutical Supply Chain Intervention

Background Drug counterfeiting is a global problem with significant risks to consumers and the general public. In the Philippines, 30% of inspected drug stores in 2003 were found with substandard/spurious/falsely-labeled/falsified/counterfeit drugs. The economic burden on the population drug expenditures and on governments is high. The Philippine Food and Drug Administration (FDA) encourages the public to check the certificates of product registration and report any instances of counterfeiting. The National Police of Philippines responds to such reports through a special task force. However, no literature on its impact on the distribution of such drugs were found. Blockchain technology is a cryptographic ledger that is allegedly immutable through repeated sequential hashing and fault-tolerant through a consensus algorithm. This project will develop and test a pharmacosurveillance blockchain system that will support information sharing along the official drug distribution network. Objective This study aims to develop a pharmacosurveillance blockchain system and test its functions in a simulated network. Methods We are developing a Distributed Application (DApp) that will run on smart contracts, employing Swarm as the Distributed File System (DFS). Two instances will be developed: one for Ethereum and another for Hyperledger Fabric. The proof-of-work (PoW) consensus algorithm of Ethereum will be modified into a delegated proof-of-stake (DPoS) or practical Byzantine fault tolerance (PBFT) consensus algorithm as it is scalable and fits the drug supply chain environment. The system will adopt the GS1 pedigree standard and will satisfy the data points in the data standardization guidelines from the US FDA. Simulations will use the following 5 nodes: for FDA, manufacturer, wholesaler, retailer, and the consumer portal. Results Development is underway. The design of the system will place FDA in a supervisory data verification role, with each pedigree type–specific data source serving a primary data verification role. The supply chain process will be initiated by the manufacturer, with recursive verification for every transaction. It will allow consumers to scan a code printed on the receipt of their purchases to review the drug distribution history. Conclusions Development and testing will be conducted in a simulated network, and thus, results may differ from actual practice. The project being proposed is disruptive; once tested, the team intends to engage the Philippine FDA to discuss implementation plans and formulate policies to facilitate adoption and sustainability. Registered Report Identifier RR1-10.2196/10163

[1]  Daisuke Ichikawa,et al.  Tamper-Resistant Mobile Health Using Blockchain Technology , 2017, JMIR mHealth and uHealth.

[2]  C. S. Gautam,et al.  Spurious and counterfeit drugs: a growing industry in the developing world , 2009, Postgraduate Medical Journal.

[3]  Matthew E. Falagas,et al.  Substandard/Counterfeit Antimicrobial Drugs , 2015, Clinical Microbiology Reviews.

[4]  Michiko Miyakawa,et al.  Economic analysis of use of counterfeit drugs: health impairment risk of counterfeit phosphodiesterase type 5 inhibitor taken as an example , 2010, Environmental health and preventive medicine.

[5]  J. Fuhr,et al.  The health and economic effects of counterfeit drugs. , 2014, American health & drug benefits.

[6]  Paul N. Newton,et al.  The Global Threat of Counterfeit Drugs: Why Industry and Governments Must Communicate the Dangers , 2005, PLoS Medicine.

[7]  T. Mackey,et al.  A review of existing and emerging digital technologies to combat the global trade in fake medicines , 2017, Expert opinion on drug safety.

[8]  Guillaume Chapron,et al.  The environment needs cryptogovernance , 2017, Nature.

[9]  Viswanath Venkatesh,et al.  Unified Theory of Acceptance and Use of Technology: A Synthesis and the Road Ahead , 2016, J. Assoc. Inf. Syst..

[10]  Atholl Johnston,et al.  Substandard drugs: a potential crisis for public health , 2013, British journal of clinical pharmacology.

[11]  Z. Babar,et al.  Pharmaceutical policy in countries with developing healthcare systems , 2017 .