The high cost of branded diabetic test strips has spawned three alternative markets: legitimate third-party generics, illegal counterfeits, and the grey market diversion of genuine goods. Counterfeit strips pose severe health risks, including death, due to inaccurate glucose readings and non-sterile manufacturing; the FDA actively monitors and issues recalls for these products. The Grey Market involves the resale of insurance-obtained or internationally diverted genuine strips, often compromising storage conditions. Third-Party Generics are FDA-cleared, lower-cost alternatives that function with brand-name meters, though they face constant legal challenges and technical "lock-out" attempts (firmware updates, proprietary coding) from major Original Equipment Manufacturers (OEMs) protecting their market share.