More than 200 advocacy groups participated in a survey in January, conducted by Together4Health and commissioned by PatientView, to discover the perceived extent of counterfeit medicines across Europe and the measures that should be instituted to combat the black market. According to the results, just 18 per cent of respondents thought that counterfeit drugs were a serious problem - meanwhile the trade has seen a five-fold increase for 2006 with the market currently sitting at more than $40bn (€27.8bn) and expected to be worth more than $75bn by 2010. Eighty-two participants thought the trade in counterfeit drugs was only a minor problem or no problem at all. The results of the survey reveal "a worrying lack of knowledge among patients and patient organisations into the scale of the counterfeit medicines problems across Europe", the authors of the report based on the results, 'What should be done about counterfeit medicines?', said. Despite the lack of awareness, there was a strong response in favour of a pan-European body to track and police the sales (and use) of counterfeit medicines. However, only a minority of the respondents back the World Health Organisation's (WHO) recommendations for more legal intervention. "Respondents admit to being fearful that the extra bureaucracy generated by intervention might inhibit the cross-border trade that helps reduce drug prices overall," the report said. "Most survey participants do not favour new regulations to combat the trade in counterfeit medicines. Rather, they would prefer stronger enforcement of current legislation, allied to efforts to raise public awareness, and measures that would allow better monitoring of national/international drug distribution systems." But most of those surveyed who opposed legal intervention would sanction new regulations to upgrade the standard of packaging and regulations that require medicines to not be repackaged. Meanwhile, 80 per cent of the respondents believed pharmacists should not be permitted to purchase medicines from any source they choose, including the internet. Rather those surveyed recommended that pharmacists only obtain medicines from wholesale suppliers and manufacturers who have been accredited by a drug regulatory agency, indicating that tighter control over the drug supply chain is needed. Seventy per cent of respondents were unaware of national and international initiatives to combat the counterfeit drug market. Together4Health director Simon Williams said: "We asked 236 executives of patient groups in 34 countries across Europe what they felt should be done to reduce the trade in counterfeit medicines. The responses were varied but telling and, I believe, would help form the basis of a Europe-wide agreement that could be adopted in association with IMPACT (the WHO's International Medical Products Anti-Counterfeiting Taskforce) partners and implemented at a local level." The full survey is available here.