For more on this, I highly recommend Bottle of Lies by Katherine Eban. Fantastically written book that goes deep on this topic and will absolutely horrify you about everything related to the manufacture of generic drugs.
Ask the US companies to pay more to the contract drug manufacturers in the third world. But these US companies want the cheapest bidder. You get what you pay for. Pay more, inspect more. It is as simple as that. You can't have the cheapest guy to deliver on every metric. Instead, you get contract manufacturers, who cut corners after a few good batches.
I recognize this article is singling out all the negatives and overlooking all the people who benefited from the medications.
But what is the overall likelihood that an individual will suffer significantly from some statistically unlikely event in modern medicine? There are so many.
Manufacturing drugs in India is like manufacturing them in Haiti. Why would anyone think that would be a good idea?
I have a pet theory about the medical industry in the USA.
The US is the most pure-capitalist nation on the planet, and medical services are as bad a fit as it gets for a market economy:
* interactions with the market are ideally as few as possible
* there is massive information asymmetry
* people can't "shop around" during medical emergencies
* the externalities are orders of magnitude more potent than the forces directly acting on a transaction
* most importantly, individuals in many cases *literally cannot exit the marketplace* (unless you consider death a viable consumer choice).
That second property creates a market incentive to squeeze every consumer dry. What can they do about it, really?
But it's insanely unethical, and extremely against the common good (externalities abound).
Those forces push the middlemen, the insurance providers, to do horrible shit. And since they are the middlemen with all of the power, and interact with literally every market actor, the culture of pure evil seeps into everything. Clinicians either becomes numb to the fact that insurance companies will literally just not pay things they agreed to pay, or live a life of endless frustration.
This is just "how it is", and so everyone, including regulators, shift their overton window to be able to function in a decrepit, toxic system.
The report is horrifying, but in the current US political climate it is very hard to see how a government agency could undergo any positive cultural change.
A quick search finds recent firings [1] and [2]... who would lead a change?
[1]: https://floridianpress.com/2025/06/rep-wasserman-schultz-sla... [2]: https://fortune.com/2025/02/16/trump-cuts-fda-layoffs-food-s...
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I'm so angry right now. I did a deep dive into this at one point after being prescribed some generic Vyvanse through Sun via Dillons/Kroger. The pills smell like fish and seem like they didn't work at all. I checked some records from the FDA and Sun wasn't listed. I brought it up to my doctor and they just brushed it off.
I really hope another class action lawsuit is brought against Sun.