Illegal imports of medicinal products in 2024: continuing trend in high-dose erectile dysfunction products

Together with the Federal Office for Customs and Border Security (FOCBS), Swissmedic secured 5,668 packages containing illegally imported medicinal products during 2024. This is around 15% less than in 2023. The majority of these illegal imports were erectile stimulants, following by psychotropic agents, laxatives and other lifestyle drugs. Illegal preparations from dubious online sources often contain wrongly declared, overdosed active substances, or none at all. Taking them can cause serious harm to health.

In 2024, the Federal Office for Customs and Border Security (FOCBS) seized a total of 5,668 illegal medicinal product imports on behalf of Swissmedic, the Swiss Agency for Therapeutic Products (previous year: 6,659 consignments). At 57%, the proportion of erectile stimulants confiscated has fallen compared with the previous years (average of just under 80%). Medicinal products that are potentially addictive (psychotropic agents, sleeping tablets and tranquillisers, 10%), nasal sprays and laxatives (6%), hormones such as melatonin (4%), hair-loss products and weight-loss drugs (4% each) as well as medicines to combat pathogens (antibiotics, antiparasitics, antivirals, 3%) were also seized.

Illegal medicinal products come into Switzerland from various countries. The dispatch routes vary from year to year. Once a country is subjected to closer monitoring, illegal traders move their activities to regions with less surveillance. Half of the packages confiscated in 2024 were sent from Western Europe and India (25% each), followed by Eastern Europe (24%) and Asia (14%). The majority of the illegal imports of medicinal products from Eastern Europe came from Hungary, while numerous letters and parcels containing illegal erectile stimulants from Asia were sent via Belgium in order to conceal their origin and make it more difficult to monitor them. Other popular “hubs” include Hong Kong and Turkey.

85% (4,796) of the cases handled by Swissmedic were dealt with by the Control of Illegal Medicines Unit using the simplified procedure. In this, those who illegaly order medicines for their own use receive a warning, and the illegally imported goods are destroyed in order to safeguard health. Swissmedic also handled 260 regular administrative proceedings for which a fee is charged. These included repeat orders by persons who had already been the subject of a simplified procedure. The Penal Division carried out 32 prosecutions under criminal law for illegal import of medicinal products and reported a further 130 cases involving “mixed packages” of narcotics and other medicinal products to the competent cantonal public prosecutors.

Fewer erectile dysfunction products, but often dangerously overdosed

Although the proportion of confiscated packages containing erectile stimulants has declined, illegal orders from dubious sources are still a risk to health. Targeted investigations have shown that more and more preparations are hugely overdosed.

During a focus campaign, the official Swissmedic laboratory OMCL analysed 100 samples from the erectile stimulants seized in April, May and June. Around 32% of the products examined contained between two and four times the dosages of the active substances sildenafil, tadalafil or vardenafil that are authorised in Switzerland for the treatment of erectile dysfunction. These active substances, which are authorised as monopreparations in Switzerland, are also increasingly being combined, which is extremely worrying from a medical point of view. Mixing and overdosing these substances do not increase the desired effect, but only the risk of severe side effects such as a drop in blood pressure or hypersensitivity reactions.

Further laboratory tests were carried out as part of the European “SHIELD” focus campaign, which showed that as many as 44% of the seized consignments with erectile stimulants contained these overdosed preparations.

So much for “natural”

Products claiming to be purely “plant-based” or “natural” such as honey, pastes or even chocolate with undeclared active substances are particularly dangerous, as consumers are unaware of the risks on the basis of the description on the packaging. In the summer of 2024, Swissmedic ordered a recall of the supposedly purely natural tonic “Power Men XXX”, which also contained two synthetic active substances at far more than the recommended maximum dose. For people with risk factors or pre-existing conditions in particular, taking mixed or overdosed active substances may cause serious health problems such as cardiac arrhythmia or even a heart attack.

Danger instead of savings: illegal medicines are a health risk

Swissmedic advises against purchasing and taking unauthorised products offered in printed advertisements, promotional e-mails or via the Internet or social media. Medicinal products with unknown origins pose a health hazard and are not worth the supposed cost savings. These products are almost always supplied without any patient information (package leaflet), have the wrong dose, or contain undeclared constituents that are dangerous to health. Anyone who chooses to take prescription medicines without medical advice is risking their health. Ordering illegal products from dubious websites also encourages therapeutic products crime.