Holograms, QR codes and other things that are not verification

The health authority in Singapore has issued a warning on falsified exenatide injection pens found in the legitimate supply chain. The Journal has reviewed the notice and the accompanying photographs; the distinguishing features are a batch-number font difference and a needle-shield colour, neither of which a patient could reasonably be expected to detect.

Comparison of 14 certificates supplied by the reseller against the laboratory’s public archive matched 3 of them to reports commissioned by other parties, in some cases more than a year earlier. The reseller did not respond to two written requests for comment.

The document is the weakest link in this trade. A certificate is a PDF; a laboratory letterhead is an image; a lot number is a string. Nothing in the ordinary transaction allows a buyer to confirm that a given report was issued for a given vial, and the four independent services differ in whether they offer any lookup at all.

Alastair Renshaw, pharmaceutical supply-chain consultant, said the underfill finding was the more consequential one. "Nobody is being poisoned by a low content figure. Everybody using that vial is out by a fifth in every calculation they make."

Our series on identity confirmation covers the analytical detection of substitution in detail, including the mass differences that correspond to the commonest related compounds.