The growing use of tirzepatide for weight loss, which began in the second quarter of 2025 and intensified in 2026, has attracted the interest of criminal organizations in the Triple Border region. What started with pharmacy robberies evolved into organized smuggling and, more recently, into counterfeiting of the drug.
In Brazil, only one pharmaceutical company is authorized to produce tirzepatide-based drugs, which drives up prices. In Paraguay, three licensed companies compete in the market, lowering prices and making the country an attractive source for smuggling. The Friendship Bridge, which connects Ciudad del Este to Foz do Iguaçu, is the main route for illegal trade.
Police and prosecutors have not responded adequately. “We view with great concern the advance of criminal groups in the black market for medicines. State control is insufficient; the police and the Public Prosecutor's Office neither react nor investigate properly,” he said. The association estimates that robberies have already caused two million dollars in losses to local merchants.
Data from the Federal Revenue Service in Foz do Iguaçu indicate that in the first months of 2026, 64,000 units of the drug were seized, far exceeding the 8,000 seizures for all of 2024. Studies by the Institute for Economic and Social Development of Borders (IDESF) show that smuggling these drugs can generate profit margins of up to 415%, attracting both individuals and criminal factions.
In addition to smuggling, counterfeiting of the product has become a growing concern. Recent operations in Ciudad del Este have identified brands being counterfeited and sold at lower prices than the originals. Rivarola warns that counterfeiting poses an even greater risk to public health. “It is very dangerous for consumers to use counterfeit products. This new way of operating is more dangerous than robbery,” he said.
Despite a ban by the National Directorate of Health Surveillance (Dinavisa) on street advertising, it is common to see promoters handing out flyers and giant dolls promoting tirzepatide brands in the commercial area of Ciudad del Este. Pharmacies also hold events with influencers and giveaways, with strong appeal to Brazilian customers. In some establishments, up to 60% of sales correspond to these weight-loss drugs.