
Widespread fraud in the generic drug industry - ravar
https://peterattiamd.com/katherineeban/
======
radicalbyte
This is the cause of drug shortages here in the EU. It has gotten so bad that
the Dutch government are supporting moving the production of generics into the
EU.

That makes a lot of sense to me, it seems to be a smart strategic move to have
drug production under your control. Just like it's smart to be self-sufficient
in the production of food.

~~~
AstralStorm
Yup, we're getting done of our generics from Slovenian Krka Group and locally
made in Poland too. Some more expensive things mostly from Merck. A few but
common from separate Polish manufacturers - sadly a few bigger ones were
bought up by Valeant or Teva with concomitant price increase.

They're pretty good, compared to random trash from India or China. They cannot
match the volume, not even close, to be more than regional EU players.

------
paulsutter
I would pay to see the book summarized in a “just the facts” format.
Everything I can find is in a turgid storytelling format. For example:

[https://www.nytimes.com/2019/05/13/books/review/bottle-of-
li...](https://www.nytimes.com/2019/05/13/books/review/bottle-of-lies-
katherine-eban.html)

The book itself is written in this same tedious style (first 56 pages
available as a preview):

[https://books.google.com/books/about/Bottle_of_Lies.html?id=...](https://books.google.com/books/about/Bottle_of_Lies.html?id=mGVzDwAAQBAJ&printsec=frontcover)

~~~
oicu812
I agree, even the audiobook was a chore to get through at 1.5x speed. However,
it's not on GetAbstract yet: [http://getabstract.com](http://getabstract.com)

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majos
This is the second cautionary piece about generic drugs I’ve read in the past
two days. The first was from last week’s Economist [1] and made a different
point. It argued that generic drugs are such a viciously competitive market
that the surviving manufacturers are those that cut the most corners. Corners
cut range from outright fraud (as mentioned in this topic) to manufacture that
is both highly consolidated and prone to just-rare-enough breakdowns that —
because more reliable competitors have been priced out of the generics market
— lead to sudden drastic shortages and the attendant problems for consumers.

Zooming out a bit, it looks like a specific example of a wider trend of supply
chains that are long and efficient until their fragility becomes clear thanks
to a well-timed and well-placed break.

I wonder what other specific products have a dysfunctional market like this?

[1] [https://www.economist.com/international/2019/09/14/a-dire-
sc...](https://www.economist.com/international/2019/09/14/a-dire-scarcity-of-
drugs-is-worsening-in-part-because-they-are-so-cheap)

------
jimbob45
Well this is fascinating but the notes run out and I don't have three hours to
listen to a podcast. Does anyone subscribe to this site that can share the
notes?

~~~
cliff
It would be better to read the book she wrote, "Bottle of Lies". I highly
recommend it.

~~~
utopian3
I imagine that is longer than the 3-hour podcast

~~~
pfranz
Correct! Audible clocked in at 14 hrs and 26 mins

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Paperweight
Semi-related: Even though it's been 123 years since Cornflakes were patented,
generic breakfast cereal just isn't the same. Some of them are downright
revolting (e.g. mini-wheat knockoffs) even though they're made in the USA.
Many don't even use the same ingredients. I guess their target market is
people who don't care about quality? At all?

~~~
jdietrich
Processed foods are far more complex and involve far more technology than you
might imagine. The production process used by the original manufacturer is
effectively a black box, so cloning a breakfast cereal involves a major
reverse-engineering effort. The thoroughness of that effort is bounded by the
need to undercut the original manufacturer on price, which may also affect the
quality of ingredients.

~~~
derefr
> The production process used by the original manufacturer is effectively a
> black box

Don't they patent that, too? Isn't that what the parent commentor is referring
to when saying "it's been 123 years since Cornflakes were patented"—that the
original manufacturer's exact factory design should be in the public domain by
now?

~~~
Paperweight
Every reply misunderstood at least one of my points? Like there are even
videos on YouTube that document every step of the Cornflakes production
process...
[https://www.youtube.com/watch?v=NmMNtV8jBqw](https://www.youtube.com/watch?v=NmMNtV8jBqw)

The generics must cut corners (not grinding as fine? not baking as long?) that
surely reduce costs by only a few pennies per box, but at the cost of greatly
reduced sales overall. Maybe it has something to do with everyone knowing that
the generics are bad as a class, so there's no point in any particular white-
label manufacturer achieving any quality better than the bare minimum? Maybe
there's a little-known breakfast cereal commodity market?

------
TheOperator
I remember being in the first wave of people where doctors noticed how
generics were not working as well as the brand name drugs in a big way. Back
when there was basically nothing in the news ever about generics not being as
good as regular drugs and instead people were talking about how smart it was
to buy generic. Generics are used to justify cutting insurance payments for
the actual brand name medication.

Years later after an investigation a decent chunk of generics actually went
off the market because they were crap. This is a field that has faced
unreasonably low levels of scrutiny historically. So it's no shock to see
stories like this.

------
User23
More in the same vein from the always excellent Derek Lowe:
[https://blogs.sciencemag.org/pipeline/archives/2019/07/25/go...](https://blogs.sciencemag.org/pipeline/archives/2019/07/25/got-
it-all-ready-for-you-mr-fda-inspector)

~~~
Scoundreller
Anyone interested in this topic should read everything he’s ever written. The
comments from anonymous insiders reminds me of HN.

