Medicine counterfeiting is a serious worldwide issue, involving networks of manufacture and distribution
that are an integral part of industrialized organized crime. Despite the potentially devastating health
repercussions involved, legal sanctions are often inappropriate or simply not applied. The difficulty in
agreeing on a definition of counterfeiting, the huge profits made by the counterfeiters and the complexity
of the market are the other main reasons for the extent of the phenomenon. Above all, international
cooperation is needed to thwart the spread of counterfeiting. Moreover effort is urgently required on
the legal, enforcement and scientific levels. Pharmaceutical companies and agencies have developed
measures to protect the medicines and allow fast and reliable analysis of the suspect products. Several
means, essentially based on chromatography and spectroscopy, are now at the disposal of the analysts
to enable the distinction between genuine and counterfeit products. However the determination of the
components and the use of analytical data for forensic purposes still constitute a challenge. The aim
of this review article is therefore to point out the intricacy of medicine counterfeiting so that a better
understanding can provide solutions to fight more efficiently against it.