Originally published on Medium.
A Birmingham warehouse held 12,000 fake weight-loss pens and packaging for 30,000 more. That ratio is not new. An Atlanta wholesaler sold counterfeit designer patches into Oklahoma, had his conviction thrown out because the patches were not attached to anything, and in 2006 Congress rewrote the law to close the gap his case exposed.
That ratio alone suggests an operation stocked to produce far more than it had made.
The Medicines and Healthcare products Regulatory Agency’s Criminal Enforcement Unit and West Midlands Police raided an industrial unit in Birmingham on October 14, 2026. The MHRA’s account, published the following day, lists what was inside: “over 12,000 fake retatrutide and tirzepatide pens” and “packaging for around 30,000 more products.” Around £2 million worth. Tim Duffield, Head of Intelligence at the unit, described it as “a filthy warehouse on an industrial estate.”
Read the two numbers together. The site held two and a half times as much packaging as it held product.
That is not an accident of this one raid. It is the shape of several counterfeit seizures published in recent months, and it points at something easy to miss when these stories are reported as hauls of fake goods. In several recent cases, the fake goods were not the main inventory. The identity is.
Four seizures, one ratio
The MHRA’s own earlier cases make the pattern plainer still. In October 2025 the agency dismantled what it called the first illicit weight-loss medicine production facility found in the UK, and seized “5,000 unauthorised retatrutide and tirzepatide pens, thousands of empty pens and raw chemical ingredients.” In February 2026 it took about 2,000 doses awaiting dispatch, along with manufacturing equipment, suspected ingredients, packaging and commercial vehicles. Empty pens, held in thousands, are a product in their own right. Somebody made them, somebody shipped them, and somebody was waiting to fill them.
Samut Sakhon and Bangkok, September 23, 2026. The Thai FDA’s release on four raided sites producing counterfeit Allergin antihistamine syrup itemises more than 1.4 million seized items. About 37,000 of them were finished bottles. The rest included more than 150,000 label stickers, more than 850,000 caps and more than 400,000 empty brown plastic bottles. For every finished counterfeit bottle, the operation held roughly eleven empty ones and four labels.
Aba, Nigeria, reported October 17, 2026. In a feature on NAFDAC’s enforcement figures for January to August 2026, Vanguard records counterfeit packaging materials seized from five shops on Old Court Road Market, Aba, valued at over 200 million naira. Not counterfeit medicine. Counterfeit packaging, sold from shops, at a price.
Bangkok and Ratchaburi, February 2026. In the Thai peptide case reported by Thai PBS, one raided seller held about 5,000 peptide products and 42,312 labels. Another held roughly 22,000 items including about 8,000 labels. The products arrived as powder plus solvent for buyers to mix themselves. What distinguished a vial of unknown powder from a branded medicine was the sheet of stickers sitting next to it.
What is being manufactured
Put those together and the thing being produced in volume is not a copy of a medicine. It is a copy of a medicine’s identity, manufactured separately, warehoused separately, and priced separately.
This is worth stating carefully because it changes what the counterfeit is. The usual mental model is that someone makes a bad product and dresses it up. The seizures describe something closer to the reverse: a supply of finished, convincing identity, into which almost anything can be placed at the last step.
Reporting from Korea in October described the production side of the cosmetics trade in the same terms, with separate suppliers making the contents, the containers and the boxes, assembled by a central operator. If the box supplier is a separate business, then boxes are a market with customers, prices and inventory. The Aba seizure is that market, visible on a shelf.
It also explains the economics. Filling is cheap and the input can be anything. The Thai syrup contained flavoured, coloured syrup and no active ingredient at all. The cost and the skill sit in the identity layer, which is why that is the layer held in bulk.
None of this is new, and the law is the proof
Here is the part that reframes the ratio. Trafficking in packaging alone is not an emerging tactic. It was litigated in American courts a quarter of a century ago, it produced a circuit split, and Congress legislated specifically to reach it.
In 2000 the Tenth Circuit decided United States v. Giles, 213 F.3d 1247. The defendant had sold wholesale sets of patches bearing a designer logo. The patches were not attached to any bag. Writing in the AIPLA Quarterly Journal in Winter 2007, Tiffani L. McDonough records the holding: “Section 2320 does not clearly penalize trafficking in counterfeit labels which are unattached to any goods.” The court applied the rule of lenity and the conviction did not stand.
Six years earlier, in United States v. Koehler, 24 F.3d 867, the Sixth Circuit had affirmed a conviction that included trafficking in counterfeit labels and containers, without addressing whether they counted as goods. So from 2000 until 2006, whether a crate of counterfeit labels was a federal crime could depend on which circuit you were caught in. McDonough’s account notes what happened in the meantime: counterfeiters “have evaded federal law by importing counterfeit labels and other component parts” separately from the assembled goods, and by 2004 component parts had risen into the top ten commodities seized by US Customs.
Congress closed it. H.R. 32, the Stop Counterfeiting in Manufactured Goods Act, passed the Senate unanimously on February 15, 2006 and was signed on March 16, 2006 as Public Law 109–181.
What the statute actually reaches
The amended text is worth reading, because it is unusually specific about physical objects. 18 U.S.C. § 2320(a)(2) now covers whoever intentionally “traffics in labels, patches, stickers, wrappers, badges, emblems, medallions, charms, boxes, containers, cans, cases, hangtags, documentation, or packaging of any type or nature, knowing that a counterfeit mark has been applied thereto, the use of which is likely to cause confusion, to cause mistake, or to deceive.”
The definition goes further than the offence. A counterfeit mark includes one that “is applied to or consists of a label, patch, sticker, wrapper, badge, emblem, medallion, charm, box, container, can, case, hangtag, documentation, or packaging of any type or nature that is designed, marketed, or otherwise intended to be used on or in connection with the goods or services for which the mark is registered.” Intended to be used. The product it was intended for need never have existed.
And trafficking is defined to include “to make, import, export, obtain control of, or possess, with intent to so transport, transfer, or otherwise dispose of.” Making the cartons is the offence. Holding them with intent to sell or pass them on is the offence.
The penalties are not nominal. An individual faces a fine of up to $2,000,000, up to ten years in prison, or both, and a company a fine of up to $5,000,000; for a repeat offence the maximums rise to $5,000,000 and twenty years for an individual and $15,000,000 for a company. Where the offence involves a counterfeit drug, an individual faces up to $5,000,000 and twenty years at first offence.
So in United States terms, packaging for 30,000 products that will never be made is not a lesser finding alongside the 12,000 pens. It is a separate felony in its own right.
Europe names the authenticity feature itself
The European Union reached the same conclusion from the civil side. Article 10 of Regulation (EU) 2017/1001 on the European Union trade mark is headed “Right to prohibit preparatory acts in relation to the use of packaging or other means”. It opens: “Where the risk exists that the packaging, labels, tags, security or authenticity features or devices” could be used in relation to goods in a way that would infringe the proprietor’s rights, the proprietor may prohibit affixing the sign to such items, and prohibit offering them, placing them on the market, stocking them for those purposes, importing them or exporting them.
Note what is in that list. Not only packaging and labels, but “security or authenticity features or devices.” European trade mark law explicitly contemplates that the thing designed to prove a product is genuine is itself an item counterfeiters make, stock and ship.
The asymmetry nobody has fixed
Set the two bodies of law next to the way products are actually checked, and the contradiction is complete.
The law treats the identity layer as the offence. Congress accepted in 2006 that cartons, labels and hangtags circulate independently of any product, and made handling them criminal on that basis. The EU accepted the same about packaging and authenticity devices.
Verification treats the identity layer as the proof. Twenty years later, nearly every check available to a pharmacist, an installer, a customs officer or a shopper still infers the product from its packaging. Look at the box. Check the hologram. Read the batch number. Scan the code printed on the carton.
Both positions cannot be right about the same object. Either packaging is a thing that travels on its own, in which case reading it tells you about the packaging, or it is reliably bound to a product, in which case the 2006 amendment was unnecessary. The statute books have already chosen, and the verification systems have not caught up.
The MHRA’s advice is the honest version of this. It does not tell anyone how to spot a fake pen. It says avoid unregulated sources, speak to a healthcare professional, and obtain medicines only from a registered pharmacy against a valid prescription. The agency is directing people to verify the channel, not the pen.
Retatrutide makes it sharper still. Duffield notes that it “has not been authorised for use in the UK,” so any product sold as retatrutide outside a clinical trial is illegal by definition. There is no authorised retatrutide product on the UK market for a fake one to be compared against. The packaging is not imitating an authorised product. It is inventing one, which is precisely the case the statutory words “intended to be used” were written for.
The objections, briefly
Seizing packaging is enforcement working. It is, and the MHRA’s run of cases since October 2025 is a serious operation against real criminal networks. The point is not that enforcement failed. It is what the inventory composition tells us about where counterfeiters put their effort, and therefore about which checks will hold.
If the law already covers packaging, the problem is solved. The law lets a prosecutor act after the cartons are found. It does nothing for the person holding a pen that came out of one. Criminalising the supply of identity and being able to verify identity are different problems, and only the first has been addressed.
Packaging ratios might just reflect what is easy to stockpile. Possibly. Packaging is non-perishable, and until it is used it attracts less attention than finished product. That reasoning supports the same conclusion: the identity layer accumulates safely, which is why it is abundant.
Tamper-evident and specialist packaging is hard to copy. Some is. The counts above show ordinary packaging being produced at six-figure volumes, EU law lists authenticity devices among the things traded, and in the Kuwait perfume case reported this week investigators seized a tool for sealing bottles alongside the stock.
This is a medicines problem. The cases here cover medicines, syrup, perfume and consumer packaging sold from market shops, and the 2006 amendment was prompted by handbag patches. Nothing about the mechanism is specific to pharmacy.
What each party should be able to prove
For a manufacturer, the test is whether anything about your product establishes it came from your line once the carton is no longer evidence. If your entire claim to identity is printed matter, you are competing on printing against businesses that buy printing by the hundred thousand.
For a regulator, the test is whether a seizure of empty packaging can be acted on as seriously as a seizure of finished product. United States law already says it can. On the evidence above, the packaging is also the better predictor of volume still to come.
For a brand protection team, the test is whether your programme covers the supply of your packaging, your labels and your authenticity features as products in their own right, with their own suppliers and their own markets. Article 10 gives you the civil instrument in the EU and § 2320 the criminal one in the US. Neither works if nobody is looking at that layer.
For a pharmacy or retailer, the test is what you would do with a pen that looks right. The MHRA is telling you to trust your supplier rather than your eyes, which is honest, and which is also the whole of the available method today.
For a patient or buyer, there is no test, and it is worth saying so plainly rather than offering a checklist that the 150,000 stickers have already defeated.
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