Mapping the Economic and Fiscal Burden of Illicit Medicines: A Systematic Literature Review and Bibliometric Analysis Using VOSviewer
Abstract
Illicit medicines, including counterfeit and substandard pharmaceutical products, pose a growing threat to global health systems and economic stability, particularly in both developed and developing countries. This study conducts a systematic literature review combined with bibliometric mapping using VOSviewer to analyse the economic and fiscal implications of illicit medicine markets. A comprehensive search of peer-reviewed articles published between 1995 and 2025 was conducted from Scopus, following PRISMA guidelines. A total of eligible studies was analysed to identify key research trends, thematic clusters, and knowledge gaps. Bibliometric analysis using VOSviewer 16.20 revealed dominant research themes, including pharmaceutical regulation, supply chain vulnerabilities, public health risks, and economic burden. The findings indicate that illicit medicines contribute to significant tax revenue losses, increased healthcare costs due to treatment failure, and reduced productivity. Additionally, the expansion of informal pharmaceutical markets undermines formal sector employment and weakens regulatory systems. The review highlights the fragmented nature of existing research and the limited integration of fiscal and employment perspectives in current literature. It concludes that stronger regulatory frameworks, improved surveillance systems, and coordinated policy responses are essential to mitigate the economic and health impacts of illicit medicines. This study contributes…
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