Falsified medication is the leading concern in the healthcare industry. The incidence of these drugs is increasing worldwide, especially after the COVID-19 pandemic. The falsified drugs do not have any prescribed quality or quantity of pharmaceutical ingredients or the presence of fake ingredients. These fake medications cause a negative effect on the consumers, including treatment failure, disease worsening, and drug resistance, also reduce the trust in the healthcare system and reduce medication adherence. This research looks at how these fake drugs affect pharmacists and consumers in India, by mainly focusing on the knowledge about the falsified drugs, how they identify these drugs, and how the falsified drugs impact consumer's trust and medication adherence after the identification. The study also explores the regulatory implications to tackle this issue from the Indian pharmaceutical market. The research adopted a mixed methodology approach, combining surveys administered through Microsoft Forms for both pharmacists and consumers, along with Zoom interviews involving experienced pharmacists. These interviews offered comprehensive insights from professionals skilled in identifying falsified drugs. The study was conducted over a concise three-month duration. The survey received responses from a total of 93 participants, including 50 pharmacists and 43 consumers. Additionally, three pharmacists with direct expertise in identifying falsified medications were interviewed.

The study's findings show that customers and pharmacists are both fully aware of the presence of fake drugs and their major effects on the pharmaceutical market. While most customers (81.4%) and pharmacists (74%) lack formal education or training on the subject, there is a significant knowledge gap in this area. Visual inspection is still the most effective way to identify fake pharmaceuticals, underscoring the need for technical solutions like track-and-trace systems and Mobile applications. Consumers' faith in the healthcare system is considerably reduced because of the discovery of falsified drugs, with 41.7% of customers expressing afraid of taking medication after their discovery, a concern shared by 98% of pharmacists. Since COVID-19, there has been an increase in occurrences involving fake medications, which is mostly due to online pharmacies. Falsified NSAIDs and over-the-counter medications are frequently found by customers, particularly as a result of online purchases made without a prescription. Both pharmacists and consumers advocate for stricter penalties and more robust regulations to combat the counterfeit drug issue in India.