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Show 1169: What Are the Problems with Generic Drugs?

When investigative journalist Katherine Eban took a close look at medicine manufacturing, she uncovered many frightening problems with generic drugs.
Katherine Eban
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What Are the Problems with Generic Drugs?

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You may not be aware that the vast majority of medications Americans take are generic drugs. This helps hold down the costs that patients have to pay, especially if you are taking one of the medicines offered for an extra-low rate, like $4 a month, at a big-box store. That certainly sounds great, unless you consider quality. Are there problems with generic drugs?

Should You Trust the Quality of Generic Drugs?

Can you trust these medications? The answer to that question is more complicated. For decades, the FDA has assured the public that generic drugs are equivalent to their brand-name counterparts–just as good, only cheaper. However, numerous recalls, including many affecting blood pressure pills like irbesartan, losartan and valsartan, have raised questions about potential problems with generic drugs.

Bottle of Lies:

Investigative journalist Katherine Eban spent years looking into the generic drug industry. With more than 80 percent of the active pharmaceutical ingredients now coming from countries such as China and India, this was a big task. What she uncovered was a shocking story of incompetence, fraud and coverups among companies making generic drugs.

A Whistleblower Comes Forward:

One person Ms. Eban interviewed was Dinesh Thakur. He got his education and began working for the pharmaceutical industry in the US. But he was thrilled to be invited to join a generic manufacturer, Ranbaxy, “back home” in India. Not long after he joined the company, though, he uncovered evidence of fraud regarding problems with generic drugs. Find out what happened when he provided that evidence to the company’s board of directors and later to the FDA.

FDA Disappointments:

Just how transparent is the FDA when it comes to problems with generic drugs? Although the agency continues to claim that these medications are of high quality, it has not always followed the recommendations of its inspectors when they uncover problems.

What Can You Do to Protect Yourself from Problems with Generic Drugs?

There is relatively little any of us can do as individuals. We review options such as buying the brand name product (from Canada, if necessary) or requesting an authorized generic. Together, however, we can encourage Congress to change the rules regarding generic drugs. Shouldn’t we know where our pills come from? Congress could require country-of-origin labeling, but it has not. What else could Congress do to ensure a safer drug supply for Americans? Voters should make sure legislators know that problems with generic drugs are not esoteric or unimportant. They can be a matter of life and death.

This Week’s Guest:

Katherine Eban, an investigative journalist, is a Fortune magazine contributor and Andrew Carnegie fellow. She has also written for Vanity Fair, the New York Times, Self, The Nation, the New York Observer and other publications. She is the author of Dangerous Doses: A True Story of Cops, Counterfeiters, and the Contamination of America’s Drug Supply, and lectures frequently on the topic of pharmaceutical integrity. Her most recent book is Bottle of Lies: The Inside Story of the Generic Drug Boom.  Ms. Eban’s website is https://www.KatherineEban.com

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies. .
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comments (20 total)
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I recently experienced a problem with my prescription for Metoprolol, to control my Afib. I reverted to the symptoms experienced prior to my medication. Since they were severe, I was considering contacting my cardiologist. Since I am a nurse, I began to question whether it might be related to my medication. I went to pharmacy. Without explaining my concern, I asked if there had been a change last month when I purchased my last refill. He checked and confirmed that was when they changed their source to India. Knowing, based on a resent visit there, I was furious!

He explained “we can only fill with the medication given to us”. He refused to supply the chain headquarters phone number, which I was able to find. They gave me the same reply. I informed them that as a nurse, “I am on a mission to tell everyone I know the danger they may be facing with their medications”. I have instruction from the pharmacy and my doctor to request the source of every prescription before I accept them. Usually they fill it from another source (which just happen to be available?) at no increase in charge. Something needs to be done to protect the public who does not know to ask questions!

I absolutely agree with Anne from Wisconsin that the only way to do something about this problem is for the politicians to be aware of this major health issue and decide if they will promote stricter oversight of the FDA.

It is my understanding that currently the funding for the FDA has been cut back. Also, the head of this agency should not be a political appointee but someone who is knowledgable about the problem and will work for the people and not the drug industry.

An acupuncturist is successfully treating my husband for neuropathy.
The symptoms are being walked back by the treatments rather than being cured. The source of his neuropathy is not the same as yours, but Agent Orange.
I hope this helps.

In my experience I will never take a generic brand of medication again especially if it’s regarding my mental illness.

I’ve been diagnosed with Bipolar II, and for the last 2 years I must have tried 15 + different medications to treat my instability.

I am very sensitive to side effects, and that is what has made it so difficult to find the right medication.

For the last 4 months I have been taking lamotrigine (Generic brand) for Lamictal. It helped stabilize my highs and lows to a certain extent but did very little for my severe depression and anger/rage issues.

My psychiatrist disguised adding a new medication to treat my new anxiety and panic disorder as well as my depression and rage.

Before I tried any new medications I was unaware that when I filled my last Lamotrigine prescription that the Pharmacy had given me one that was produced by a different manufacturer than the previous fill because they ran out of the other one, and they’re legally not obliged to inform you of this, at least not in Canada.

The side effects were horrendous, and I was right back to where I started as though I was not taking anything at all.

I asked my doctor to prescribe Lamictal, which is the name brand for lamotrigine, and he specified on the prescription “no substitutes.” The positive effects it had are absolutely life- changing. By the second day of taking Lamictal I noticed a huge positive difference.

All of my symptoms had disappeared, and at this point it’s not necessary for me to take extra medication to treat other issues because Lamictal is working for all of it.

My insurance company does not cover the name brand because they insist on covering only the generic brand.

At this point I pay for my medication myself because without it my quality of life is so bad that there’s no point in living.

I’m currently in the process of fighting to have my medication covered, and I will not stop until I have exhausted every single option available.

There is definitely a difference between generic and name-brand medications. I’m convinced that insurance companies I already know this, and they’re hiding it from the public so they can keep lining their pockets.

It’s disgusting how they have the ability to be judge, jury, and executioner. They’re playing Monopoly with peoples’ lives.

I am a pharmacist working for one of the major chains in America. We do not have the authority in the company to select a “specific” manufacturer due to corporate structured purchase plans from vendors.

As much as we want the FDA to step up their game and protect the American public, they excuse their “oversight” due to insufficient resources for their agency to investigate.

We must have transparency in the products we import from other countries for the safety of the American public’s health. Otherwise, there is no safety.

Hi, I believe generic drugs can cause stroke. My mouth has never been the same. I believe people should not suffer like this for no reason. IT HAS TO STOP. I heard your show on the radio Saturday June 15 2019 morning when I was going to the store. I turned right around to go home to listen to it. Finally, there are people out there who know what I am experiencing. What can I do to help? I wrote your name on post-it notes and pass them out after church. I have time but don’t know computers well at all. Some of our food is also bad for us, but people are not convinced. I have proof. I am happy you are here to tell the truth. Thank you.

I listened to every word of your show hosting Katherine Eban concerning the generic drug problem. Thank you for having someone so thoroughly versed in the material she could answer–in detail– every question she was asked. I literally got sick to my stomach learning this information. Since I am on a medicine that is constantly being recalled for one reason or another, it brought tears to my eyes that we Americans are being subjected to impure generic medicines with little to no help from our FDA or Congress to make things safer for us! I do not feel my safety is a top concern for any of those involved at a level which something could be done. I would rather quit taking the medicines.

I have already had serious issues with generic drugs
I am extremely allergic to the fillers used by 3 companies all owned by the same parent company.
Mylan, Watson, and Actavis all use the same cheap fillers for their generics to which I am extremely allergic. I have had a severe reaction every time I accidentally took a generic drug made by these manufacturers. I had to put on all my medical records I am extremely allergic to these brands of drugs so my pharmacy or a hospital never give me anything made by these companies!
Why does the FDA allow this???

Some prescriptions, such as generic thyroid replacement medications, should not be switched from one generic manufacturer to another because even the slightest changes in the delivery method can upset the delicate balance of how a person’s body can use the medication.

I also have a problem with trusting the generic prescription medications manufactured in third world countries especially India & China – because of the 2008 Warfarin, baby formula & dog food that were adulterated the later 2 with Melamine that resulted in deaths. Then there have been broadcasts on NPR about the FDA not being able to do surprise inspections of overseas pharmaceutical companies manufacturing generic prescription medications because they must apply for Visas, etc., which gives these companies advanced warning about any impending inspections. See: http://www.npr.org/programs/fresh-air/2019/05/16/723960354/fresh-air-for-may-16-2019-the-daek-side-of-prescription-drugs/ & http://www.npr.org/sections/health-shots/2019/05/16/723545864/the-generic-drugs-youre-taking-may-not-be-as-safe-or-effective-as-you-think/ an interview with Katherine Eban author of Bottle of Lies. It’s all fine & good to use generic drugs as long as they are manufactured to exact specifications under FDA required conditions. But, especially in the case of China, if you study the history (& I mean history going back hundreds of years) of the culture & attitudes toward making a product & making as great a profit as possible even when the punishment for getting caught not following standards is death; then, perhaps we Westerners can understand why this happens. That’s not to say some 1st World Countries aren’t above attempting to get away with similar practices . . .

At any rate, it’s not just the FDA allowing companies to manufacture generic medications, etc., it boils down to the thoroughness of the inspections & oversight of the companies manufacturing these medications.

Unfortunately, your article does not address this issue. It simply makes it sound as if it’s all just a matter of getting the generic versions produced & being able to negotiate the price. It’s never that simple.

Very good information!!

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