The problem of fraud in the generic drug industry is the topic of the book "Bottle of Lies" by Katherine Eban[0]. She joined Peter Attia for a fantastic episode of his podcast[1]. It isn't often I burst out laughing while listening to a healthcare podcast, but I did several times with that episode. Attia and Eban are imagining the situation as the naive new employee from the U.S. drug manufacturing industry is presenting a report to the board of his new Indian generic drug company how their fraud has been working, and how to fix it.

All those patients who can't get their generic drugs: How many of them were getting fraudulent drugs before that had little or no effect on their disease?

One U.S. startup tried to make a business model out of analyzing every batch of drugs they sold. [I'm sorry, did you think every batch of the drugs you take was verified as the real thing between you and the (foreign) manufacturer?] Valisure is a startup that bought drugs in bulk and actually tested samples, using mass spectroscopy, to verify they were the real thing, then sold them on to U.S. patients. Alas, their business model does not seem to be working out so far. But they did detect massive contamination in Zantac which lead to its recall five months later by the FDA.[2]

[0] https://www.amazon.com/Bottle-Lies-Inside-Story-Generic/dp/0...

[1] https://peterattiamd.com/katherineeban/

[2] https://peterattiamd.com/davidlight/