DSCSA Track-and-Trace: How the U.S. Is Stopping Counterfeit Drugs Before They Reach Patients

alt
Kestra Walker 17 December 2025

The U.S. pharmaceutical supply chain handles over 5 billion prescription drug transactions every year. That’s a massive flow of medicine - and a huge target for counterfeiters. Fake pills, stolen batches, contaminated products - they all slip in if there’s no way to prove a drug’s origin. Since November 27, 2024, the DSCSA track-and-trace system has been the final line of defense. It doesn’t just track drugs. It verifies them, one package at a time.

What the DSCSA Actually Does

The Drug Supply Chain Security Act (DSCSA) isn’t a suggestion. It’s a federal law that forces every player in the drug supply chain - manufacturers, wholesalers, repackagers, and pharmacies - to use electronic systems to track prescription drugs from the factory to the patient. Before DSCSA, each state had its own rules. Some had traceability laws. Others didn’t. That patchwork made it easy for bad actors to exploit gaps. DSCSA replaced all of that with one national standard.

The goal? Stop counterfeit drugs before they reach your medicine cabinet. The FDA estimates that DSCSA will reduce counterfeit drug incidents by 95% once fully operational. That’s not a guess. It’s based on data from countries like the EU, which saw a similar drop after launching their own track-and-trace system.

Every prescription drug package now has a unique identifier. That’s not just the National Drug Code (NDC). It’s also a serial number, lot number, and expiration date - all in a machine-readable 2D barcode and human-readable text. This isn’t optional. Every bottle, box, and vial must carry it. And every time the drug changes hands, the next party must scan it and verify its legitimacy.

The Three Pieces of the Puzzle: TI, TH, TS

DSCSA doesn’t just require a barcode. It demands three key pieces of data with every transfer:

  • Transaction Information (TI): What’s being shipped? NDC, serial number, quantity, date, and the names of the sender and receiver.
  • Transaction History (TH): Where has this package been? Every prior transaction back to the manufacturer.
  • Transaction Statement (TS): A legal certification that the transaction is legitimate and compliant.
These three documents must be shared electronically. No more paper forms. No more handwritten logs. If you’re a pharmacy and you receive a shipment without these, you’re legally required to reject it. That’s the power of DSCSA. It turns every handoff into a verification checkpoint.

How It Stops Counterfeit Drugs in Real Time

Here’s how it works in practice. A pharmacy receives a shipment of insulin. The scanner reads the barcode. The system checks the serial number against the manufacturer’s database. Is it valid? Is it on the approved list? Is the lot number correct? If the serial number doesn’t match - or worse, if it’s been used before - the system flags it as a suspect product.

That’s not just a warning. It’s a legal trigger. The pharmacy must immediately quarantine the product and report it to the FDA. They can’t just put it on the shelf and hope for the best. In 2022, a regional distributor got a warning letter from the FDA for failing to do exactly that. They had received a batch of fake blood pressure pills. They didn’t report it. Patients could have been harmed.

The system also catches stolen drugs. If a wholesaler’s warehouse is robbed and someone tries to resell the stolen pills, the serial numbers won’t match the original shipment records. The system knows. And it stops the sale.

A pharmacist scans a medicine box with a magical device, causing counterfeit pills to vanish in smoke.

Who’s Compliant - And Who’s Struggling

By mid-2023, 98% of manufacturers and 95% of wholesale distributors had full serialization systems in place. They had the money, the tech teams, and the incentive. The real challenge? Independent pharmacies.

A 2023 survey by the National Community Pharmacists Association found that 68% of independent pharmacies called DSCSA compliance their top technology challenge. Why? Cost. Upgrading software, buying scanners, training staff - it can run $185,000 per pharmacy. Chain pharmacies like CVS and Walgreens spent over $100 million each on compliance. But small pharmacies? Many are still using legacy systems that can’t talk to modern track-and-trace platforms.

The result? Only 72% of pharmacies were fully compliant by the November 2024 deadline. That’s a problem. Because if one pharmacy in a chain is outdated, the whole system is vulnerable. A counterfeit drug can slip through if the verification step is skipped.

The Tech Behind the System

DSCSA doesn’t rely on one vendor. It uses open standards - primarily GS1 for barcodes and EPCIS for data sharing. GS1 ensures every serial number is unique and follows global rules. EPCIS is the language that lets different software systems talk to each other. If Company A uses TraceLink and Company B uses SAP, they still need to exchange data cleanly.

That’s where things get messy. Many companies built their own systems without fully following EPCIS. That led to data mismatches. A serial number might be recorded as “ABC123” in one system and “abc123” in another. Case sensitivity. Extra spaces. Different date formats. These tiny errors caused delays. Pharmacists waited 2-3 extra days to verify shipments. That’s not just frustrating - it’s dangerous if a patient needs medication urgently.

The biggest players - TraceLink, SAP, Oracle - now dominate the market. Together, they control over 70% of the track-and-trace software space. But even they had to adapt. Many updated their platforms in 2023 to fix interoperability issues. The FDA gave a one-year stabilization period to let these fixes roll out without penalties. That window closed in November 2024.

A glowing chain of pill-shaped nodes connects factory to home, defeating shadowy counterfeit figures with light.

What Happens After November 2024?

The deadline passed. Enforcement is now active. The FDA is no longer giving grace periods. If a pharmacy can’t verify a drug, they can’t dispense it. If a wholesaler sends a shipment without full transaction data, they’re in violation.

But the work isn’t done. The FDA is already looking ahead. In March 2023, Commissioner Dr. Robert Califf said the agency is evaluating whether to extend DSCSA to certain high-risk over-the-counter drugs - like insulin pens, nicotine patches, and erectile dysfunction pills. These are already targets for counterfeiters. The same system that works for prescriptions could protect them too.

Long-term, the savings are huge. PwC estimates DSCSA will generate $2.3 billion in annual savings by 2027. How? Fewer recalls. Instead of pulling every bottle of a drug because one lot is bad, they can pull just the affected serial numbers. Fewer diverted drugs. The system cuts drug diversion by 40%. Fewer counterfeit deaths. That’s the real win.

What You Should Know as a Patient

You won’t see the DSCSA system working. You won’t scan a barcode at the pharmacy. But you should know this: every pill you take now has a digital fingerprint. That fingerprint is checked every time it moves. That’s why your medication is safer than it’s ever been.

If you ever get a drug that looks odd - wrong color, wrong shape, wrong packaging - don’t take it. Report it. The system is designed to catch fakes, but it needs your help. The FDA’s MedWatch program lets you report suspicious drugs directly. That report could trigger an investigation that stops a whole batch of fake pills from reaching others.

Final Reality Check

DSCSA isn’t perfect. It’s complex. It’s expensive. It’s still fixing interoperability glitches. But it’s working. Since 2020, McKesson has processed over 1.2 billion serialized transactions with 99.98% accuracy. CVS cut suspect product investigations by 75%. These aren’t marketing claims. They’re real results.

The goal was never to make the supply chain perfect. It was to make it trustworthy. And for the first time in U.S. history, we have a system that does exactly that.