The global pharmaceutical industry faces ongoing challenges in ensuring the safety and legitimacy of medications entering supply chains around the world; the Pharmaceutical Security Institute estimated that there were 6,897 incidents in 2023, representing an increase of 4% over 2022, with almost half of those incidents reported in the United States market. Pharmaceutical crime is real, and while it is often difficult to quantify, studies that have attempted to measure this significant illegal market estimate that total global sales are between $200 billion and $431 billion annually.