Civil police in Rio Grande do Sul, Brazil's southernmost state, are investigating a suspected scheme of counterfeit cancer medicines combined with fraud in court-ordered drug purchases that reached at least 39 cancer patients, according to investigators. Seven of the people who received the medicines died during treatment, and the police have not established a link between the deaths and the drugs. The case was laid out by Globo's weekly newsmagazine Fantástico on Sunday. The first raids came on June 29, when Operation Placebo served dozens of search warrants and arrested a pharmaceutical distributor in flagrante delicto.
What is confirmed so far is narrower than the initial suspicion, and investigators have been careful to separate the two. According to the lead detective, Daniel Severo, the inquiry focuses on 39 treatments obtained through lawsuits filed by private lawyers, and so far only one case of a delivered adulterated medicine has been identified. The first warning came from the Santa Casa de Caridade hospital in São Gabriel, in the state's interior, where the pharmacist in charge of preparing oncology medicines noticed inconsistencies in a batch of a breast cancer drug: misspellings on the packaging, odd coloring and texture, and a leaflet in a foreign language. The manufacturer examined a sample, did not recognize the batch as legitimate, and distribution was suspended immediately.
How the scheme allegedly worked
In the police account, the group combined an oncologist, lawyers and business owners. The doctor, named as Fernando Borges da Silva, of Santa Maria, prescribed medicines not supplied by the SUS, Brazil's public health system, and referred patients to lawyers who sued the state to fund the purchases. Under Rio Grande do Sul rules, the patient, through the lawyer, must gather three price quotes. Nearly all the pharmacies submitting those quotes belonged to or were tied to businessman Lisandro Henriques Hermes, arrested during the operation and described by police as the group's main organizer, who allegedly used front partners to control the companies. At his home, officers seized boxes of medicines and blister packs with no identification. One drug cited by police is Enhertu, a real, high-cost breast cancer medicine.
"The evidence gathered points to an organized structure that, in theory, turned the judicialization of health care into a mechanism for illicit profit. The suspected sale of adulterated or counterfeit medicines makes the facts even more serious, because it goes beyond property damage and directly affects the health and lives of patients," detective Daniel Severo told G1.
Among the cases reported by Fantástico is Maria Jupira, who was being treated for lung cancer. Her court-obtained medicine was part of the suspect batch and was seized; her family says she went two months without proper treatment before receiving other medicines, and she died at 57. Her family does not know whether she took any counterfeit medicine. Another patient, Mara Rodrigues, waited about eight months for a new appointment after losing contact with the doctor and only received new medicines in late August. In Cascavel, in the state of Paraná, a pharmacy linked to the group won the bid to buy medicines for Yasmin, a 12-year-old girl with neuroblastoma. According to the investigation, about 2.5 million reais transferred by the state government were diverted and only part of the medicine was delivered. The girl died in February.
In a statement, the Santa Casa hospital said it suspended the doctor as soon as it learned of the investigation, that the hospital is not a target of the operation and that it is cooperating. The state medical council, Cremers, said it would open an inquiry once it receives official notice of the facts. Operation Placebo executed 57 search warrants and one arrest warrant in 11 cities of Rio Grande do Sul, according to G1, plus actions in São Paulo, Rio de Janeiro, Minas Gerais and Goiás, targeting 15 people and 14 companies; the Fantástico report counted 56 search warrants. Courts also blocked about 2.5 million reais in assets of the suspects in Rio Grande do Sul. Hermes denies any wrongdoing, says he has no ties to the lawyers or the doctor and knows nothing of any counterfeiting. He and a partner have already been convicted of fraud by a court in Paraná.
Guidance for patients in treatment
For patients, the central message from authorities is not to interrupt treatment. At a news conference on June 30, detective Severo said there is no evidence of indiscriminate distribution of counterfeit medicines in oncology and that patients served through official SUS channels or through lawsuits filed by the public defender's office have no reason to distrust their medication. He warned that interrupting cancer treatment can bring unpredictable and irreversible consequences. The state health department asked oncology units to immediately tighten oversight of medicines. In practice: keep appointments and doses on schedule; check the packaging, including the spelling on the label and the languages of the box and leaflet; and take any inconsistency to the hospital pharmacy team or the local health surveillance authority before using or discarding the product.