Four years after counterfeit Lipitor led to the largest recall of a prescription drug in the US, Pfizer is still working to convince anyone who will listen that the problem of fake medicines is, well, real. So a Pfizer exec trudged down to Trenton, NJ, to persuade a roomful of legislative aides, government staffers, hospital workers and journalists.

“This is an industry problem,’’ John Theriault, Pfizer’s vp of global security, told a crowd that gathered for an hour-long talk billed as a health policy seminar. “The trend is upward. We’re seeing more rather than less.’’ Pfizer isn’t alone, actually. Johnson & Johnson has reported counterfeit versions of its drugs, and just last month, the FDA said consumers had received fake versions of Xenical, Roche’s weight loss drug.

Theriault, whose first brush with counterfeit meds came after the 1998 launch of Viagra, says the Internet, globalization and the public quest for less expensive meds combine to create a multi-billion-dollar opportunity for criminals. But thwarting the problem isn’t easy, he says. Counterfeiters have proven to be sophisticated and play internationally. And the lack of what he called tough US law creates a “low risk, high reward’’ opportunity.

“One of the things I hope to do is raise an awareness of what’s going on here,’’ Theriault said. “This is not about generics. This is not about small businessmen. These are criminals who are putting the entire healthcare system at risk in some respects.’’

There are positive side effects from this vigilance, at least for his employer. According to Pfizer’s investigators, the counterfeiters have switched from making phony Viagra to Lilly’s Cialis.

Contributed by Susan Todd of The Star-Ledger of New Jersey