
A tiny pharmacy is identifying problems with common drugs - pujjad
https://www.washingtonpost.com/science/a-tiny-pharmacy-is-identifying-big-problems-with-common-drugs-including-zantac/2019/11/08/6dd009ca-eb76-11e9-9c6d-436a0df4f31d_story.html
======
refurb
I dug into this a bit and while they are doing some testing, I’m not sure they
really know what they are doing.

When they originally flagged the NDMA issue in Zantac, they published their
results. One of the tablets had 32,000 ppm of NDMA. That’s an absurdly high
level that should have made them question the result.

Turns out they used a different testing procedure for a different set of
drugs. The procedure required heating the sample to 80c for like an hour. The
FDA came back and said “yeah, that’s not the right test”. Many drugs will
decompose with heat and produce a bunch of impurities. Impurities that aren’t
produced in the human body.

Testing for impurities is actually really hard as your testing procedure can
have a big impact on the measurements.

Based on the latest FDA guidance, it sounds like Zantac does have higher than
allowed NDMA levels, but nothing like what this lab suggests.

So I’d say they are offering a useful service, but they aren’t sophisticated
enough to make a judgement call on.

~~~
satya71
The same article says the level of NDMA is similar to that in barbecue meat.
So much medicine recalled, and panic from major manufacturers (why didn't they
test before panicking?), over a result that may not be even accurate in the
first place.

~~~
refurb
It’s probably two reasons: 1) it’s a carcinogen and cancer risks make
headlines and 2) it’s a risk that wasn’t there to begin with (unlike bbq meat
which was known).

That said, you are correct. Stacked up against all the risk you might face in
life this isn’t that concerning.

------
dm319
This sounds a bit alarmist. So the chief medical officer of the company is
also the editor-in-chief of the journal they publish in? And the paper is
about the rapid release of tylenol, not about the cancerous effects of
ranitidine?

Bear in mind this company makes money by testing regular medications and
assuring their drug content and safety - they have a financial motivation to
find problems in available medications. This is not to say that production
standards may not be ideal for medications, but it does mean one should be
skeptical of their claim.

Alarmism is popular in health. Look at the removal of vaping products, despite
studies demonstrating their general safety. As if the risks of smoking aren't
already known and fairly major.

------
neonate
[http://archive.is/KCfQu](http://archive.is/KCfQu)

Edit: try also [https://outline.com/ykCXfg](https://outline.com/ykCXfg)

[https://web.archive.org/web/20191108165301/https://www.washi...](https://web.archive.org/web/20191108165301/https://www.washingtonpost.com/science/a-tiny-
pharmacy-is-identifying-big-problems-with-common-drugs-including-
zantac/2019/11/08/6dd009ca-eb76-11e9-9c6d-436a0df4f31d_story.html)

~~~
pmoriarty
Is there an archive of this article that doesn't require Javascript?

~~~
PhantomGremlin
Firefox + NoScript + No Previous Cookies (from anyone) --> no problem reading
the original article.

~~~
pmoriarty
It doesn't work for me in emacs-w3m, which does not understand Javascript. I
just get redirected to the the washingtonpost.com front page.

Update: Actually, I just changed my user-agent from one that advertises my
browser as emacs-w3m to one that advertises itself as a common
Mozilla/Chrome/Safari browser and I no longer get redirected and can read the
original article just fine.

~~~
PhantomGremlin
FWIW I just played around with this. OpenBSD used to include lynx, but now
doesn't. I found mailing list question on this and the answer was to use
ftp!!!

I tried and this just worked for me:

    
    
       ftp -o wp.html http://www.washingtonpost.com/science ...
    

That fails and automatically switches to https and then fetches the article.
The formatting isn't ideal but the article text is readable.

So many ways to skin a cat, so to speak!

~~~
upofadown
>OpenBSD used to include lynx, but now doesn't.

Second time I have heard about this ... which is confusing because I use lynx
on a regular basis on OpenBSD.

~~~
aquabeagle
It's in ports/packages now, but it used to be in base.

------
victor106
This sounds kinda a like a bug bounty program for pharama. We should have more
companies specially the big PBM's doing more of this.

~~~
uxp
PBMs are rent seeking middlemen. Their desire to seek the lowest drug price is
arguably what contributes to things like quality standards at pharmaceutical
manufactures slowly loosening and contaminants getting into the supply line.

Honestly, we should have an independent 3rd party with zero financial
investment in either approving or rejecting a quality check of a batch sample.
Something Federal, so manufacturers cant "shop states", that administers and
regulates drugs and their distribution. Not sure what I would call it. I tend
to go with cartoonish things, so Merlin after the bumbling wizard sounds fun,
but the bureaucrat in me thinks the acronym "F.D.A." would suffice.

~~~
gus_massa
Nitpicking: The FDA doesn't test every single batch of each product. They
review the results of the clinical trials and then they set the rules to
approve the batches. When a batch is ready, someone in the drug production
factory is responsible to check that all the test and quality meet the
regulations and then sign a paper approving the release. S/he must have a
degree in pharmacology or chemistry or something similar. If something gets
wrong the person that signed the release approval is the first one that get
questioned, so they should be very careful.

It's somewhat similar to the role of the NHTSA(?). They set the general rules
and approve each vehicle model, but they don't go to the factory to test each
single car.

------
ars
Alternate sources:

[https://www.mysanantonio.com/news/article/A-tiny-pharmacy-
ra...](https://www.mysanantonio.com/news/article/A-tiny-pharmacy-raises-big-
doubts-about-our-drugs-14820025.php)

[https://www.scientificamerican.com/article/what-we-know-
abou...](https://www.scientificamerican.com/article/what-we-know-about-the-
possible-carcinogen-found-in-zantac/)

------
tvanantwerp
This was a really good interview with the CEO of this pharmacy where he
describes they business model and research process:
[https://peterattiamd.com/davidlight/](https://peterattiamd.com/davidlight/)

------
audiometry
I wonder if the exit strategy of this company is to be a big enough nuisance
to Pharma that one of them buys the company in order to absorb and nullify it.

------
liveoneggs
nice ad

~~~
DoofusOfDeath
It does paint a compelling picture of the problem and a company that provides
a solution.

Does you find it somehow misleading?

~~~
newnewpdro
> Does you find it somehow misleading?

Apparently in 2019 it's not advertising unless it's misleading...

~~~
derefr
Insofar as “advertising” is used as a kind of slur against pieces of
journalism, it implies a kind of _mens rea_ where the journalist was either
paid off, or otherwise intended the piece to serve as PR for the company.

Sometimes, as a journalist, you set out to report interesting and important
facts; an the facts are such that just a bare reporting of them leaves readers
with a positive impression of a company, no matter how you editorialize. A
company is just ...doing something good, and good in a novel way. And that’s
news! Just as much as if a company were doing something _bad_ in a novel way.

Presuming the piece was written genuinely, instead of being submarine PR, the
journalist’s goal isn’t _usually_ to get people to interact with the company
(just like their goal with reporting of negative novel behaviour isn’t
_usually_ to cause a boycott—that’d be the job of an editorial.) Instead, the
goal of such pieces is to make readers say “well—this changes things.” To make
them think about how the world is going to be different for the presence of
this new activity in it. Basically, to accomplish what speculative fiction
sets out to accomplish, but with fewer tools in the toolbox.

I can understand calling that “advertising” in some literal technical sense.
But if you are intending to _morally color_ the article by calling it
advertising, while receding back to the claim that it is “literally,
technically” advertising, then readers should be wary: that’s a classic motte-
and-bailey argument† (despite the motte and the bailey both being “it’s
advertising”—‘advertising’ is used in a different sense in each claim.)

† [https://slatestarcodex.com/2014/11/03/all-in-all-another-
bri...](https://slatestarcodex.com/2014/11/03/all-in-all-another-brick-in-the-
motte/)

~~~
newnewpdro
It's a puff piece plain and simple, but that doesn't necessarily mean it's
misleading.

~~~
DoofusOfDeath
I'm trying to become a more discerning / critical reader of news stories. Mind
expanding on what makes this a "puff piece"?

~~~
newnewpdro
As far as I can tell the only source for everything written about the company
described is the company itself, and of course it's all flatteringly positive
and endearing.

