Widespread fraud in the generic drug industry | Hacker News Reader

Widespread fraud in the generic drug industry

peterattiamd.com

96 pointsravar20 comments

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.

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.

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...

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=...

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

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...

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?

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

I imagine that is longer than the 3-hour podcast

Correct! Audible clocked in at 14 hrs and 26 mins

It's not a technical podcast so listening at 1.5 or 2x speed can really shorten the time demand with little lost information.

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?

>I guess their target market is people who don't care about quality? At all?

No, their target market is people who have no other choice. This is what regulatory capture gets you.

I thought "generic breakfast cereal" is "quick oats"?

There is no such thing as "generic" cereal because it has no guaranteed stock ingredients.

You have a white-label producer, and many store-brands that simply slap a label on that white-label product.

Obviously if the goal is to sell a product that's cheaper than the name-brand (Kellog's in this case), it's clear that's a race-to-the-bottom in terms of quality

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.

> 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?

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

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?

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.

More in the same vein from the always excellent Derek Lowe: https://blogs.sciencemag.org/pipeline/archives/2019/07/25/go...

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

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