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Threat in Your Medicine Cabinet: The FDA's Gamble on America's Drugs
- soangry 1y agoI'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.
- actionfromafar 1y agoIsn't the new direction of capitalism in America Freedom from Regulation?
- cogman10 1y agoYes. This is a clear example of why that's bad and why these agencies need funding and competent staffing.
- throwawaymaths 1y agothese agencies had funding and competent staffing. they correctly identified that the factories were producing dangerous products.
- cogman10 1y agoThe funding comes in because they didn't have the funds to test the drugs. That's something I'd hope was happening with all drugs. The competence comes in because they put availability above safety. That's an incompetent trade-off.
- throwawaymaths 1y agothe real irony is that price and availability cannot be a consideration in approving indications for new drugs
- billylb42 1y agoHow did you arrive at that conclusion? All of the evidence provided in the article is prior to the “freedom of regulation” as you call it. To me, it’s indicative of a rotting regulatory institution that lost its way. FDA is about safety, not low cost drugs. I don’t know how that mandate became mission critical for them but it happened before the current administration.
- cogman10 1y agoAlmost certainly happened because of Clinton and the FDAMA. It's a law that "cut red tape" IE removed safety protocols and standards. These agencies are rotting primarily because they've been reworked to be business friendly over the last 40 years
- derbOac 1y agoThe US is long past the point where we need to stop talking about medical regulation generically. Some regulation and enforcement needs to be increased, and others need to be decreased or eliminated, at least in my opinion. To me this sort of thing is fraud, and I feel like the FDA needs more resources and oversight to fight it. But with other things I think the FDA needs to back off completely, where it's overstepped its useful mission. I personally would like to see the FDA stop telling people what they can purchase or receive from whom, but spend more time guaranteeing that whatever is on the label is what it says it is and nothing else.
- mindslight 1y agoTo continue making a follow on point, also needing nuance - pharmaceutical manufacturing is exactly the type of industry that can and should be brought back to the US. First, through outright subsidies [0] to get the plants built. And then when domestic supply is high enough, through regulations prohibiting healthcare management plans from buying imported drugs. [0] spending some of the surplus from having a reserve currency on deliberate policies rather than it being blindly given to asset holders
- deleted 1y ago[deleted]
- leereeves 1y agoHow did you find out what factory the Vyvanse was made at?
- sct202 1y agoYou can figure out the generic manufacturer by matching the active ingredient with the pill shape, color, and imprints on a pill identification website. Finding the exact factory of that manufacturer is much harder though.
- wl 1y agoIf you're going to a pill identification website to find out the manufacturer of a prescription drug, you're working too hard. The manufacturer printed is on the prescription label.
- LoganDark 1y agoOh boy. I've had quite the experience with my own ADHD medication (dextroamphetamine in my case, which is essentially the stuff Vyvanse metabolizes into), and when they substituted for a different brand, that brand was completely different and so totally not compatible with this body. So now I have a Brand Medically Necessary because when they tried to switch it on me I went into hypertensive crisis :)
- pyuser583 1y agoThe drug you mentioned had a reputation for these sorts of problems.
- jnsie 1y agoI have nothing but respect for physicians but my experience is that each acts as a more narrow filter than the last and, beyond their direct expertise they have very little expertise in billing, pharmacy or anything outside of their direct domain, nor do they have the bandwidth for it. Add to that the advertising phenomenon of 'ask your doctor about X' and I suspect that anything beyond the immediate care you're receiving has very little chance of receiving thought/cogent answers.
- xpe 1y agoI respect doctors (and people in general), but I don’t give the medical profession a passing grade. To speak in generalities (there are exceptions), their training is somewhat insane: long hours, sleep deprivation, knowledge cramming, and more. Their daily practice leaves little time or incentive for keeping up with studies. Most were not adequately taught statistics in the first place. To vent a bit more, I don’t think it is unfair to say the system is crap. If we could redesign it from scratch, understanding human nature, how people learn, and the need for ongoing learning, and evidence-based medicine, it would not be this. None of this is meant to assign blame to individuals.
- thfuran 1y ago>Their daily practice leaves little time or incentive for keeping up with studies. Their certification requires it, at least to some extent.
- xpe 1y agoTwo responses. First, CME is criticized as being largely influenced by industry rather than primarily intended to advance medical learning. [1] Second, assuming medical continuing education is something like 20 to 40 hours depending on the region [2], this feels meager and insufficient. In contrast, think of how much learning a software developer does during a year -- perhaps close to 5+ hours per week on average! [3] Very different contexts, very different incentives. [1]: https://www.chronicle.com/article/lessons-from-a-professors-10-year-fight-to-rein-in-pharmaceutical-promotion/ https://www.chronicle.com/article/lessons-from-a-professors-... [2]: Based on very quick research: could be off -- corrections are welcome [3]: There are many differences, of course. Just to pick one example: to what degree does a software developer's continuing exploration into an area (such as a specific business process that their application needs to understand) help their craft? Does it improve their skill level? Does it result in transferable skills? Does it improve the quality of their work?
- timr 1y agoThe "fishy odor" is a classic hallmark of amine-containing compounds [1], of which Vyvanse has three [2], including a terminal amine, which is so infamous (at least in the di-amine form) for being smelly that they have delightful names like "Cadaverine" [3]. I don't know if the completely purified drug officially has an odor, but usually you get some free amines that come along for the ride. More likely, some got outside of the gelatin capsule during shipping. [1] https://www.science.org/content/blog-post/amines-and-landscape-chemical-stink https://www.science.org/content/blog-post/amines-and-landsca... [2] https://en.wikipedia.org/wiki/Lisdexamfetamine#/media/File:Lisdexamfetamine_structure.svg https://en.wikipedia.org/wiki/Lisdexamfetamine#/media/File:L... [3] https://en.wikipedia.org/wiki/Cadaverine https://en.wikipedia.org/wiki/Cadaverine
- eightys3v3n 1y agoI pursonally took Vyvance brand name for over 1.5 years by opening the capsule and mixing it in a bottle of water. Never did it have a smell or taste. Even if Vyvance is manufactured with compounds that often have a smell or taste associated with them, the fact that this generic smelled almost certainly speaks to lower quality controls than the brand name based on my experience. At the very least it would speak to them choosing a component that smells over one that does not.
- timr 1y ago> Even if Vyvance is manufactured with compounds that often have a smell or taste associated with them Just to be clear: it's not "associated" -- the drug itself probably smells, and you just didn't notice it. It's very, very common with drugs containing amines. Metformin, for instance, has a distinctly fishy odor (but it also has a couple more amines): https://en.wikipedia.org/wiki/Metformin#/media/File:Metformin.svg https://en.wikipedia.org/wiki/Metformin#/media/File:Metformi...
- yababa_y 1y agofrom my experience washing some mediocre amphetamine cooks, the fishy smell is not characteristic of pure amphetamine, but leftover methylamines from synthesis. vyvanse adds a lysine but none of these amines are free. it’s odorless as well, but any lysine esthers leftover will stank. it was shit product
- VeninVidiaVicii 1y agoI had the same exact issues on generic Vyvanse, which also causes me intense palpitations compared to the brand-name, I legit thought I was going to have a heart attack several times a day. So much so, that I quit it altogether—I couldn’t stand the side effects or the constant unavailability of the brand-name.
- aaron695 1y ago[dead]
- fn-mote 1y agoThe 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-slams-trump-administration-over-recklessly-firing-key-fda-safety-experts/ https://floridianpress.com/2025/06/rep-wasserman-schultz-sla... [2]: https://fortune.com/2025/02/16/trump-cuts-fda-layoffs-food-safety-medical-devices-tobacco/ https://fortune.com/2025/02/16/trump-cuts-fda-layoffs-food-s...
- soangry 1y agoThe issue I described existed before the administration change. Neither's parties people wants to be poisoned.
- komali2 1y ago> Neither's parties people wants to be poisoned. Voters for one party keep taking horse medicine and we can't seem to stop them when they experience negative side effects, and we couldn't get them to get vaccines even as their friends and loved ones were dying begging for it at the last minute. There's definitely a party divide here.
- Loughla 1y agoI have no opinion on ivermectin. I don't think it's a miracle cure, but I also have no idea about the actual research in that space. But. My assistant at my last job was all in on it during COVID. It cures everything, according to her. The moment when her cognitive dissonance hit its peak was when she gave her husband ivermectin for a cold, and was absolutely astounded that he ended up in the emergency room with diarrhea and dehydration. She was convinced it was "vaccine injury" and that he did a sneaky and got the COVID shot without her knowing. Spoiler; he did not get vaccinated. It really was pretty funny at the time, but also sad. She was sort of my bellwether for nuts behaviors. When she started spitting Q-anon talking points, as a middle aged woman completely disconnected from anywhere that should exist, I knew we had problems.
- kgujdtjof 1y agoManufacturing drugs in India is like manufacturing them in Haiti. Why would anyone think that would be a good idea?
- Arkhadia 1y ago[dead]
- barbazoo 1y agoCare to explain?
- quickthrowman 1y ago150 million people still shit in the open in India. Is that a sufficient explanation? It’s substantially better than it used to be. FWIW I believe the people of India deserve to have proper sanitation.
- barbazoo 1y ago> 150 million people still shit in the open in India. Yet they landed on the moon [1], how about that. I assume they're theoretically capable of producing medicine. https://en.wikipedia.org/wiki/Chandrayaan-3 https://en.wikipedia.org/wiki/Chandrayaan-3
- quickthrowman 1y ago-Who funded the moon mission? What are their incentives? -Who owns the pharmaceutical plants? What are their incentives?
- barbazoo 1y agoAnd who is moving these goalposts around?
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- cowpig 1y agoI 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.
- dantheman 1y agoThe majority of medical care and expenses are not emergency.
- ASalazarMX 1y agoThe parent comment never implied that every medical interaction is an emergency. I can see why they mention it, as emergencies are usually the most expensive medical transactions by far. Was that the only thing you got out of it?
- tacitusarc 1y agoI completely agree with your points about medical services, but I think it’s important to point out the US does not have, and never really has had, a meaningful market economy when it comes to healthcare.
- jmyeet 1y ago[flagged]
- dantheman 1y agoMedicine is one of the most regulated and least capitalist markets.
- deleted 1y ago[deleted]
- jmyeet 1y agoCapitalism cannot exist without regulation. There is no such thing as a "free market". Capitalism relies upon regulation to enforce the enclosures it builds. Regulations are a direct product to protect profits. For example, Medicare is prohibited from negotiating prices with drug companies for most medications. A few exceptions were carved out with the IRA passed under Biden. The VA can it pays a lot less. Why is Medicare forbidden from negotiating? Because the pharma industry lobbied for it. Also, cheaper generics are banned from being imported even though you can buy the exact same thing for a 95%+ discount in Canada. To see this regulation in action, you can pretty accurately predict what courts and the government will do by simply asking "what do the capital owners want?". Just this weekend, we had an actual domestic terrorist in Minnesota kill a state lawmaker (and her husband) and attempt to kill at least one other. So far he's been charged with second-degree murder and some federal charges [1]. Now compare this to Luigi, the alleged shooter of UHC CEO Brian Thompson where the AG and US attorney immediately came out calling for the death penalty and laying first-degree murder and terrorism charges on him. Now maybe the federal or state charges will be upgraded to first-degree but there's none of the same rhetoric about an actual terrorist. Ask yourself why. [1]: https://www.cbsnews.com/minnesota/news/vance-boelter-fbi-details-charges-suspect-minnesota-lawmaker-shootings/ https://www.cbsnews.com/minnesota/news/vance-boelter-fbi-det...
- vanillax 1y ago"Capitalism cannot exist without regulation. There is no such thing as a "free market". Capitalism relies upon regulation to enforce the enclosures it builds. Regulations are a direct product to protect profits." - Source?
- idopmstuff 1y agoFor 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.
- ls612 1y agoMy mom was a hospital pharmacist when she was still working and was beating the drum on this all my life as far as I can remember. All it accomplished was getting her called racist and xenophobic and losing friends :(
- deleted 1y ago[deleted]
- idopmstuff 1y agoGood for her - I'm just astounded that I didn't know any of this. Even the fact that generics only have to be within something like 20% of the active ingredient of the non-generic was surprising to me; I thought they were basically identical. But the quality of manufacturing stuff is just unbelievable. You take for granted that our medications are highly regulated and it turns out to not be remotely true...
- deleted 1y ago[deleted]
- Arkhadia 1y ago[dead]
- raincom 1y agoAsk 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.
- soangry 1y agoIf it's worth anything, I keep telling Sam's Club managers to hire more staff. I also tell the employees at Dillons to unionize. I'm pretty sure I'm going to get banned from their stores soon.
- AbstractH24 1y agoI 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.