Journalist Katherine Eban's investigation over more than ten years has uncovered one of the most shocking medical scandals imaginable, which affects millions of patients across the world.

In this podcast, she discusses the shocking reality of what happens or perhaps more accurately what doesn’t happen, when generic drugs that we import, are manufactured in countries with poor regulations.

When a drug is first approved, it is released with its own brand name, but once the drug’s patent expires, then other manufacturers are allowed to make cheaper generic versions of the same medication.

Now most patients and indeed many doctors think these generic drugs are the same as the brand name ones - but they are not. Current regulations only require the medications to be "bioequivalent" and they also allowed to have very different absorption rates, so may work very differently to the brand name pharmaceuticals, which has huge implications for patients.

But although that is worrying enough, many of the world’s generic drugs are made in India and China - where as Katherine explains - there is little regulation and they can be made very cheaply. In what was India’s largest pharmaceutical company – Ranbaxy - 200 of its generic drugs were revealed to have been filed with the US drug regulator, the FDA, with inadequate, falsified or completely missing data. And furthermore in other companies, an FDA investigator found in over 80 plants in India and China he visited, 80% had falsified data.

These generic drugs are sold into every country, so may well end up on the shelves of your local pharmacy, so what can we do as patients and doctors to protect ourselves?

On her website, Katherine gives some tips for consumers in A Guide To Investigating Your Own Drugs.

Bottle of Lies: Ranbaxy and the Dark Side of Indian Pharma by Katherine Eban is published by Juggernaut.

The host of this award nominated podcast, Liz Tucker is an award winning medical journalist and former BBC producer and director. You can follow Liz on Twitter at https://twitter.com/lizctucker and read her Substack newsletter about the podcast at https://liztucker.substack.com

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