The crime sounded like it was straight out of The Sopranos. Over a cloudy March weekend, huge supplies of several popular medicines made by Eli Lilly were quietly stolen from a nondescript building in Enfield, CT, that serves as a distribution hub for the big drugmaker. Only this was no ordinary heist – the determined thieves carved a sizeable hole in the roof and made off with about $75 million worth of Prozac, Strattera and Zyprexa, among other widely used medications.

The theft quickly made national news. And why not? After all, a lot of meds suddenly disappeared through a hole in a roof, prompting guffaws and astonishment about security at the facility, or lack thereof. It was a made-for-TV moment that featured a brazen operation and caught a big company by surprise. An embarrassed Lilly quickly released the lot numbers and expiration dates for the stolen meds out of concern the drugs would soon find their way to Internet pharmacy sites. At the same, the drugmaker tried to sound reassuring that nothing else would go wrong.

“The U.S. pharmaceutical distribution is tightly controlled and monitored, making it extremely difficult for stolen product to make it to patients through legitimate channels,” said Fionnuala Walsh, Lilly’s senior vice president of global quality, in a statement. “However, we will continue to work closely with local and federal law enforcement authorities, the FDA and our distribution partners to maintain the integrity of our drug supply chain.”

As they should, although this somewhat tortured response would, no doubt, make Tony Soprano laugh mischievously over the chain of events. Clearly, the Lilly theft was the work of an organized group that carefully plotted its moves. More than raise lurid comparisons to the famous television program, though, the episode underscored a growing interest among determined criminals in pilfering prescription meds. Last year, there were 46 such thefts valued at $184 million, up from 35 thefts that were worth $41 million in 2007, according to FreightWatch International, a logistics security provider based in Austin, TX, that tracks commodity thefts.

So far, there have been 10 heists this year that were worth roughly $110 million. Actually, pharmaceuticals only comprise 5% of thefts by volume, and the average theft was valued at $4 million in 2009, surpassing all other commodity groups, but that figure is skewed by a $37 million heist that took place in PA. Otherwise, the average would have been $2.5 million. Just the same, the overall trend appears to be on the rise.

“The value has gone up due to events like this recent warehouse burglary, which is causing overall loss averages to be significantly higher,” said Dan Burges, director of intelligence at FreightWatch. “Clearly, there is active targeting. Cargo thieves find out where manufacturers distribute their product and they’re looking for certain types of drugs. So they conduct surveillance. This is what these people do for a living. As with any other type of crime or business, they’re looking for the most return on investment they can get.”

Cutting holes in roofs isn’t entirely new, however. In fact, there have been more than a half-dozen thefts over the past two years in which peeling back part of a roof has been a modus operandi, although these mostly took place at warehouses storing electronics, fragrances, clothing and tobacco. In general, pharmaceutical warehouse burglaries, such as the one Lilly suffered, are few and far between. Last year, there was a total of just four in the pharmaceutical sector and one so far in 2010, continuing an average of just one per quarter.

Most thefts actually involve stolen tractor-trailer loads that are hijacked from truck stops, secured terminals or distribution centers, which may be easier to pull off than casing a warehouse and finding the right moment to send a team of cat burglars to drill a hole in a roof. Regardless of the method, just what happens to the stolen drugs once they’re stolen? Some get sent to Latin America, others to Asia. They wind up on the black market or are used for counterfeiting purposes, or both.

And yes, some are repackaged right here in the U.S. and find their way onto the Internet, which shouldn’t surprise anyone. There may be more costly brand-name meds facing lower-priced generic competition each year, but the sour economy is likely creating an ever-bigger market for cheaper meds.

Last year, the rate at which prescriptions were submitted to a pharmacy but never picked up was 6.3%, a 24% increase over 2008, according to Wolters Kluwer, a market research firm. And the rate for new prescriptions for brand-name meds hit 8.6% in 2009, up 23% from the year before. In other words, there’s a market right here at home if some enterprising criminals can stock the right website or find some other way to feed them back into the supply chain.

This is hardly a new phenomenon. Several years ago, there was a big bust involving an international ring that was selling counterfeit Lipitor, a scheme that extended from Florida to Latin American and back to the U.S. by way of a few legitimate wholesalers. At the time, Pfizer wasn’t under the same pricing pressure it now faces with low-cost generic simvastatin eating away at Lipitor’s market share, so counterfeiting seemed like a viable way to make a quick buck.

In general, though, brand-name prescription meds remain costly – whether in the U.S. or another country – and so these are products ripe for theft. In fact, several drug makers banded together four years ago to form the Pharmaceutical Cargo Security Coalition in response to several high-profile thefts of pharmaceuticals that were in transit. Security experts say inroads have since been made to blunt the trend and they claim to even have had some success recovering stolen drugs.

“A lot of the past victims are not victims today, and we try to combat thefts with education,” said Chuck Forsaith, who heads the coalition and is also corporate director of supply chain security at Purdue Pharmaceuticals, which is best known for selling the OxyContin painkiller, a controlled substance that is many a criminal’s object of desire. “But recoveries are made. There are significant law enforcement efforts to recover stolen goods. Last fall, in Palm Beach County, FL, two individuals were taken into custody and approximately $10 million in product was located in a private residence. And there have been other instances” where meds were recovered.

Just the same, the larger issue that is likely to spook pharma execs is the possibility that patients and insurers will lose confidence in the supply chain. That’s a problem at any time, but even more so now, given the bad publicity over safety issues associated with Vioxx and Avandia, for instance. The average citizen may not remember the details, or knew many particulars in the first place, but it doesn’t take long to Google a few old headlines to be reminded of a few instances in which a drugmaker was accused of failing to disclose side effects or unflattering clinical trial data on a timely basis. Those episodes undermined trust.

So the last thing the executive suite needs is for the public to have yet another reason to think that the quality of their needed medications can’t be counted on. For their part, security experts preach calm. Mr. Forsaith noted that most of the pharma security professionals once worked in local, state or federal branches of law enforcement, so they not only have sufficient experience with organized thefts, but also share the kinds of networks that can keep tabs on techniques and trends.

Hopefully, he’s right. Of course, there will always be more thefts. No system is foolproof and prescription drugs simply are too valuable to escape the attention of determined thieves. But the Lilly heist does underscore the need for drugmakers to step up their game. And it’s not as if they weren’t warned. In an episode of The Sopranos a few years ago, Tony was sitting in a bar when some sleazeball offered him a large quantity of Merck’s Fosamax osteoporosis pills at an unusually low price. Tony asked if the pills are counterfeit. The guy reassured him that the meds are simply old. “You change the expiry date,” he says. “Nobody knows.”

The message: reinforce those roofs.

Ed Silverman is a prize-winning journalist who has covered the pharmaceutical industry for The Star-Ledger of New Jersey, one of the nation’s largest daily newspapers, for more than 12 years. Prior to joining The Star-Ledger, Ed spent six years at New York Newsday and previously worked at Investor’s Business Daily. Ed blogs about the drug industry at Pharmalot. He can be reached at ed.silverman@comcast.net.