On October 4, 2012, US Immigration and Customs Enforcement (ICE) and the US Food and Drug Administration (FDA) announced the results of the largest coordinated international law enforcement operation to date to take action against internet pharmacies selling counterfeit or illegal medicines. The global operation, called Pangea V, is an annual exercise coordinated by INTERPOL and the WCO with participation of other international organizations. This year, it took place between September 25 and October 2, 2012 and involved 100 countries and was aimed at disrupting the organized crime networks behind the illicit online sale of counterfeit drugs. Worldwide, preliminary results show Pangea has accounted for 79 arrests and the seizure of 3.7 million doses of potentially life-threatening counterfeit medicines worth an estimated value of $10.5 million. Additionally, approximately 18,000 websites engaged in illegal sale of counterfeit drugs were taken down. In the United States, the Pangea V operation was part of “Project Bitter Pill,” a project of Operation In Our Sites (IOS), and was managed by the National IPR Coordination Center. It involved the FDA, ICE, CBP, FBI, and the Department of Justice. Various payment processing companies supported the operation by identifying and blocking payments connected to illicit online pharmacies, identifying individuals responsible for sending spam emails and identifying abuse of electronic payment systems. The counterfeit drugs seized in the US during Bitter Pill included anti-cancer medication, antibiotics and erectile dysfunction pills as well as weight loss and food supplements.

According to the FDA announcement, the one week operation resulted in action against more than 4,100 Internet pharmacies that illegally sell potentially dangerous, unapproved drugs to consumers. Actions taken include civil and criminal charges, seizure of illegal products, and removal of offending websites. The ICE announcement said that IOS is a sustained law enforcement initiative that began two years ago to protect consumers by targeting the sale of counterfeit merchandise on the Internet. Those websites are now shut down and their domain names are in the custody of the federal government. Visitors to the websites will find a seizure banner that notifies them that the domain name has been seized by federal authorities and educates them about the federal crime of trafficking in counterfeit goods. The 686 domain names seized during Bitter Pill bring the total number of IOS domain names seized in the last two years to 1,525.