

Dirty medicine – Long-term criminal fraud at Ranbaxy (2013) - gwern
http://fortune.com/2013/05/15/dirty-medicine/

======
refurb
This article is a little old, but I'm glad to see it on HN again.

Yes, Western pharma companies do a lot of questionable and outright wrong
things, but this story just takes the cake. It's in an entirely different
league.

 _In a conference call with a dozen company executives, one brushed aside her
fears about the quality of the AIDS medicine Ranbaxy was supplying for Africa.
“Who cares?” he said, according to Spreen. “It’s just blacks dying.”_

~~~
enupten
Not surprising, there are lots of reports on how India is unapologetically
racist (which is incidentally, also perhaps why Caucasians are so well treated
?).

------
lake99
A few years ago, a close relative of friend was an Assistant Drug Controller
for a particular region of India. As is the case with a huge number of Indian
government officials, this guy was corrupt to the core. I was quite aware of
how his factory "inspection" reports were aided by greased palms. I imagine
that a huge portion of drugs here are shit. My family has been safe so far
probably because we go to reputed doctors who prescribe good drugs.

In a way it's ironic that things that are not essential to our lives... like
computer products, cameras, mobile phones, etc. have so many review and
benchmarking sites. We consumers pore over those reports to help us make the
next purchase. The best part is that none of these reviews or benchmarks are
mandated by government agencies. But when it comes to drugs that can save our
lives, we seem lead our lives mostly in ignorance.

~~~
nebula
Do you see any possible way to bridge this gap, and help people identify and
avoid substandard drugs? I am planning to work in patient empowerment, would
like any ideas in this regard.

~~~
lake99
Well, since you are inviting me to speculate, I'll do so.

1\. Best-case scenario: high-school kids are imparted with some basic
knowledge of drugs. I think they'll understand Pharmacology 101 just fine.
This will raise the quality of journalism too because (a.) journalists are
better educated to seek out such news and (b.) there is a wider demand for
news of greater technical depth. I speculate that UL-like companies will
spring up to meet consumer demand.

2\. In the present world, I'd be happy with a blog/journal that keeps an eye
on pharmaceuticals. Drug Watch[1], for example, focus on just big-pharma and
lawsuits. They come off a bit like ambulance chasers. FDA has several feeds
[2], but the volume of information is rather high. So, a service that sends
out targeted emails would be just fine. So, a user would select a bunch of
ailments and drugs, and this service would send emails when there is ab update
on any of those. That way, users of lipitor would get updates on Ranbaxy's
antics too.

[1] [http://www.drugwatch.com/](http://www.drugwatch.com/)

[2]
[http://www.fda.gov/AboutFDA/ContactFDA/StayInformed/RSSFeeds...](http://www.fda.gov/AboutFDA/ContactFDA/StayInformed/RSSFeeds/default.htm)

~~~
nebula
Thanks! interesting ideas. High school level introduction to pharmacology is
an excellent point. It will bring in a lot of awareness. Thanks for the
pointers on FDA feeds. Your contact is not there in profile. Do you mind
sharing your contact info?

~~~
lake99
I have added my contact info.

~~~
nebula
Thanks. Hoping you won't mind if I drop a mail.

------
lsiebert
Okay, this is a serious question.

We just saw a report about how the SEC is too close with banks, and this shows
the FDA not doing a good job regulating drug companies.

Can someone point to a good US regulatory agency? Like one that operates well,
isn't scared to use it's powers aggressively, and so on?

The closest I can think of is the Justice Department going after voter
surpression.

~~~
tokenadult
Regulatory capture happens to every regulatory agency, as a general rule.
Hiring zealous staff who want to maintain the mission of the regulatory agency
is not easy to do.

[http://faculty.haas.berkeley.edu/dalbo/Regulatory_Capture_Pu...](http://faculty.haas.berkeley.edu/dalbo/Regulatory_Capture_Published.pdf)

[http://www.tobinproject.org/books-papers/preventing-
capture](http://www.tobinproject.org/books-papers/preventing-capture)

~~~
rurounijones
I am waiting for someone to pour out the cons here. But why not align
incentives with expertise.

Allow companies to test others' products, if they find serious problems then
any fines resulting from a resulting FDA investigation are split between the
govt and the company that found the issues. With generics there cannot be that
much "This is a trade secret" since it is already in the open.

I am sure they would be falling over each other to cripple the competition.

Fire away.

~~~
lsiebert
Then you are shifting regulation to cover testing for collusion.

I think one of the issues is that fines need to be huge, penalties painful,
and decisions punishing to companies who get caught doing wrong.

~~~
a3n
CEOs need to be held responsible in the same way that Navy Captains are held
responsible: they're responsible for everything that happens under their
command. If they don't govern to prevent this, then they need the probability
of jail and ending their careers.

"Accountability" is paraded around a lot these days when dressing up a
commpany in buzzwords. Our employees are accountable. I'm accountable. You're
accountable.

Starting sending CEOs and CXXs to jail, and it will stop.

------
fillskills
What blows my mind is that time and time again we call ourselves a developed
nation and still allow companies like Ranbaxy to play around with the health
of our and the world's citizens.

And Ranbaxy - how can people there sleep at night. How

~~~
neindanke
> still allow companies like Ranbaxy

The same we still allowed companies like Bayer to do this:
[http://en.wikipedia.org/wiki/Contaminated_haemophilia_blood_...](http://en.wikipedia.org/wiki/Contaminated_haemophilia_blood_products)

The same we still allowed companies like GlaxoSmithKline to do this:
[http://www.bbc.com/news/business-29274822](http://www.bbc.com/news/business-29274822)

> Ranbaxy - how can people there sleep at night.

The FDA, Bayer, Pfizer, Ranbaxy, big pharma will always sleep well.
[http://articles.mercola.com/sites/articles/archive/2006/08/0...](http://articles.mercola.com/sites/articles/archive/2006/08/05/bayer-
sells-aids-infected-drug-banned-in-us-in-europe-asia.aspx)

~~~
me_again
There have definitely been ethical lapses at many large pharma companies.
Ranbaxy seems in a different class altogether, though.

Incidentally, Mercola.com is absolutely not a reliable source of medical
information. See
[http://en.wikipedia.org/wiki/Joseph_Mercola](http://en.wikipedia.org/wiki/Joseph_Mercola).
Ironically, Dr Mercola has also suggested that HIV is not the cause of AIDS.

------
mikeyouse
Pfizer had similar ethical failures in trialing a meningitis drug in Nigeria.

[http://en.wikipedia.org/wiki/Abdullahi_v._Pfizer,_Inc](http://en.wikipedia.org/wiki/Abdullahi_v._Pfizer,_Inc).

They used a forged certificate of ethics from a hospital, didn't obtain
informed consent from those they were treating, deliberately used a
'substantially lower' dose of the alternative treatment and then hid behind
lawyers for 15 years to avoid a payout.

The Washington Post did a series of very good articles on the problem;

[http://www.washingtonpost.com/wp-
dyn/content/article/2006/05...](http://www.washingtonpost.com/wp-
dyn/content/article/2006/05/06/AR2006050601338.html)

~~~
refurb
_They used a forged certificate of ethics from a hospital_

Pfizer didn't use forged certificates, the Nigerian doctor overseeing the
trial forged the certificate.

I'm not saying Pfizer is without fault here, but it's a pretty complex
situation.

------
gwern
You know HN ops, I chose the title quote I did for a reason: because it
emphasizes an aspect which has become very relevant to Americans recently -
the lack of interest and disdain in African health which is currently rather
backfiring on us in the form of Ebola escaping its shackles.

~~~
zaroth
I really appreciate the submission, it's a great piece of journalism, and a
truly important story, but that does sound a bit like editorializing.

~~~
Terr_
I'd say far more than "a bit" of editorializing, given that 99% of the article
has nothing to do with HIV drugs in particular nor the race of consumers.

------
fasteo
I have a chronic disease that require regular check ups. My neuro, a very
experienced lady, always tells me that she can instantly spot when a patient
is taking a generic. I have always thought that she was showing off. Well,
maybe not.

~~~
hga
At least in times past this has been frequently true with conventional anti-
convulsives, drugs that prevent epileptic attacks.

------
not_that_noob
I'm curious: when getting medicines at my pharmacy (in the US), how can I make
sure I'm not getting Ranbaxy medicines? Is it as easy as telling the
pharmacist?

~~~
hga
Wal-Mart, at least, and the mail order units of the Medicare Part D drug plans
I've been using for a while tell you who makes the drug. Part of their helping
you double check that the dispensed the right one, they also mention the
markings on the pills.

Note that the Indian firm Sun bought most of Ranbaxy, given the brand damage
to the latter I have to wonder about the 1-2 Sun generics I'm taking right
now.

My doctor was certainly happy when I reported, after those two drugs recently
went generic, that to my observation the generics had about the same effects.

------
akersten
Absolutely disgusting that this company remains in business.

------
caycep
I'm curious about Teva, they are the other large (and foreign-owned - Israel)
generic manufacturer selling in the US.

~~~
hga
I don't follow this closely, unless I'm on a maintenance drug supplied by one
of these companies, but as I remember Teva has at least an "OK" reputation. At
the top at least they don't have the myriad pathologies that are endemic in
Indian companies.

For more, read the article: from the very top down Ranbaxy was a totally
fraudulent operation, and any similarity between what they claimed to be
manufacturing and what they actually delivered was fairly accidental.

------
known
Business? It's quite simple. It's other people's money.

