For greater than a dozen years, the Meals and Drug Administration quietly allowed substandard overseas factories to proceed delivery medicines to america even after the company formally banned them from doing so due to harmful manufacturing failures.
ProPublica uncovered the little-known follow in June. The FDA mentioned the selections to exempt sure medicines from import bans have been made to fend off drug shortages and that guardrails have been in place to make sure the merchandise have been secure, reminiscent of requiring the banned factories to do additional testing on the medicine earlier than they have been despatched to People.
However the company itself didn’t often check the medicine or proactively monitor studies filed by docs and others that described medicine with a foul odor, irregular style or residue, or customers who had skilled sudden or unexplained well being issues. The FDA cautions the outcomes described within the complaints might don’t have any connection to the medicine or may very well be sudden unwanted side effects. However drug security specialists say that with out additional research, it’s unattainable to know whether or not individuals have been harmed or what number of.
The FDA saved the exemptions largely hidden from the general public and has by no means launched a complete listing of the medicine allowed into america from banned factories. ProPublica is publishing that listing right now.
The listing supplies the names of the medicine or components that ProPublica has recognized as having been exempted from an import ban since 2013 and the names of the producers that made them. The product names are written as they appeared on the FDA’s import alert listing. Many of the factories on this listing are now not banned, so their medicine are coming into the nation by regular channels. The FDA lifts bans after amenities make all the required fixes.
A number of the factories are nonetheless banned — and are nonetheless allowed to ship exempted medicine to the U.S. These are highlighted in yellow.
All informed, ProPublica recognized greater than 150 exempted merchandise, largely from factories in India. One manufacturing unit in China and one manufacturing unit in Hungary additionally obtained exemptions. A number of of the factories make components for medicine, that are then despatched to the producers that produce tablets, capsules, tablets or injectables.
To compile the listing of exempted medicine and components, reporters pulled historic data from the web and used Redica Programs, a top quality and regulatory intelligence firm with an enormous assortment of company paperwork.
In finalizing its evaluation, ProPublica counted all of the medicine and components that have been exempted from every banned manufacturing unit. Typically, the identical product was exempted from a number of factories and was added to every manufacturing unit’s complete. In a handful of circumstances, the FDA exempted a number of formulations — reminiscent of a pill, capsule or injectable — of the identical drug. ProPublica counted these completely different kinds as distinct medicine.
For this listing, ProPublica solely included every drug as soon as for every producer.
Generic medicine can have many producers, and it may be troublesome to know based mostly on info offered on drugs bottles the place medicine have been made or by whom. Typically bottles listing the names of repackagers or distributors reasonably than the drugmaker itself. Pharmacists and probably well being care suppliers can present extra details about the supply of prescribed medicines.
This listing is present as of Aug. 4. The FDA can add or take away exempted medicine at any time.
Firm Responses
ProPublica reached out to all of the drugmakers listed right here. Most didn’t reply.
Apotex didn’t reply to requests for remark. After the inspections that led to the import bans, the corporate informed the FDA that it will launch corrective actions and produce on a third-party marketing consultant, amongst different issues. The factories are now not banned.
Divi’s Laboratories didn’t reply to requests for remark. In its response to the FDA on the time, the corporate mentioned it employed third-party consultants and different specialists to resolve the FDA’s considerations. The corporate additionally mentioned it had taken corrective actions on the facility. The manufacturing unit is now not banned.
Emcure Prescription drugs didn’t reply to requests for remark. In its response to the FDA on the time, the corporate mentioned it will revise procedures, present coaching and interact consultants, amongst different issues. The manufacturing unit continues to be banned however now not has exemptions.
Glenmark Prescription drugs didn’t reply to requests for remark. On the time of the ban, the corporate mentioned it will interact with the FDA to resolve the considerations. The manufacturing unit continues to be banned however is now not receiving any exemptions.
GPT Prescription drugs didn’t reply to requests for remark. In its response to the FDA, the corporate defended the standard of its merchandise and mentioned it had introduced on a marketing consultant to audit the operation. The manufacturing unit is now not banned.
In an announcement to ProPublica, Pfizer, which owns Hospira, mentioned it submitted a complete response to the FDA, paused manufacturing on the website after which offered the ability to a different firm in 2019. “We’re dedicated to working our manufacturing websites on the highest high quality requirements,” Pfizer mentioned. The manufacturing unit is now not banned.
Intas Prescription drugs, whose U.S. subsidiary is Accord Healthcare, mentioned in an announcement that the corporate has invested thousands and thousands of {dollars} in upgrades and new hires and launched a companywide program targeted on high quality. Exempted medicine have been despatched to america in a “phased method,” the corporate mentioned, with third-party oversight and security testing. Intas additionally mentioned that some exempted medicine have been by no means shipped to america as a result of the FDA discovered different suppliers. The corporate wouldn’t present particulars. “Intas is nicely on its approach in direction of full remediation of all manufacturing websites,” the corporate mentioned. The 2 Intas factories are nonetheless banned and nonetheless receiving exemptions.
Ipca Laboratories didn’t reply to requests for remark. On the time, Ipca mentioned it was working to resolve the problems at a number of factories. “The corporate is dedicated to its philosophy of highest high quality in manufacturing, operations, methods, integrity and cGMP tradition,” Ipca mentioned, referring to “present good manufacturing practices,” a typical phrase within the trade. The factories are now not banned.
Jubilant Generics didn’t reply to requests for remark. On the time, the corporate mentioned it will “interact with the company to resolve the import alert on the earliest and guarantee cGMP compliance.” The manufacturing unit is now not banned.
Shilpa Medicare didn’t reply to requests for remark. In a media assertion on the time, the corporate mentioned it deliberate to resolve the FDA’s considerations. “We uphold high quality and compliance with utmost significance and are dedicated to sustaining cGMP and high quality requirements throughout all Shilpa amenities.” The manufacturing unit continues to be banned and considered one of its medicines continues to be exempt.
Sri Krishna Prescription drugs didn’t reply to requests for remark. The corporate on the time informed the FDA that it was utilizing a marketing consultant to audit operations and help in assembly manufacturing necessities. The manufacturing unit continues to be banned however is now not receiving exemptions.
In an announcement to ProPublica, Solar Pharma mentioned that adherence to high quality requirements “is a prime precedence for Solar, and we keep a relentless concentrate on high quality and compliance to make sure the uninterrupted provide of medicines to our clients and sufferers worldwide. We proceed to work proactively with the US FDA and stay dedicated to attain full decision of any FDA regulatory points at our amenities.” The manufacturing unit continues to be banned and nonetheless receiving exemptions.
Teva Prescription drugs didn’t reply to requests for remark. The corporate mentioned in an announcement on the time that it was working to keep away from drug shortages “whereas we concentrate on resolving regulatory considerations, as sufferers are all the time highest precedence.” The manufacturing unit continues to be banned however now not receiving exemptions.
Wockhardt didn’t reply to requests for remark. In a convention name with reporters on the time of the import ban, in keeping with Reuters, the Wockhardt chairman mentioned the corporate was “making every kind of effort to fulfill” FDA good manufacturing requirements on the manufacturing unit. The factories are nonetheless banned, however in July, Wockhardt introduced that it will now not make generics for the U.S. market.
Zhejiang Hisun Pharmaceutical didn’t reply to requests for remark. In keeping with a report in Bloomberg, Hisun mentioned on the time that it takes high quality severely and has complied with necessities. The manufacturing unit is now not banned.
Mylan/Viatris mentioned in an announcement to ProPublica that it instantly labored to resolve the FDA’s considerations. “Affected person security stays our main and unwavering focus,” the corporate mentioned. The manufacturing unit continues to be banned and nonetheless receiving exemptions.
A lawyer for Madhu Devices informed ProPublica in an e mail that the corporate has mounted all the issues recognized by the FDA and is cooperating totally. The manufacturing unit continues to be banned however now not has an exemption.
Brandon Roberts and Irena Hwang contributed knowledge reporting.
