The cost of medicine is exploding. The U.K. is no exception compared to what is happening round the globe.

As the NHS is struggling to keep expenses under control, providing substitute generic medication instead of costly branded medication is a way to put some relieve on the rising unbudgeted pressure.

But are generic medicines as good as promised? This question is increasingly important since prices of generic medicine are now on the rise as well and an American journalist made some shocking revelations.

Branded medicines are medicines mostly marketed under the name given by the company that developed them. Generic medicines are often copies produced in countries with low labor cost.

As protection rights after 20 years expire, companies and pharmacists are free to copy medicine. They can manufacture and sell the medication under its own generic name mostly at a lower price.

In 2016 and 2017, the NHS spent over £4.3 billion on generic medicines. This is more than 28% of total medicine expenditure.

As the cost of branded medication soars, generic low cost alternatives are increasingly popular.

But according to Katherine Eban, an American journalist who wrote the book “Bottle of Lies”, generic medication might not be as safe and effective as we generally believe.

Mrs. Eban investigated the pharmaceutical industry for a decade and focused on generic medication produced in the Far East and sold in the U.S.

She came to the appalling conclusion that at least the American Food and Drug administration, was misled and manipulated. Plant owners in India and China cheated FDA inspectors many times.

She revealed that it is very easy to manipulate data.

Weeks in advance, overseas companies in the Far East producing the generic medication get an announcement of scheduled inspections.

Thanks to this information, plants in China and India are well informed that the FDA inspectors are coming.

This allows factories where the substitute generic medication is made, manipulate data and results.

In her book she writes: “I discovered overseas drug companies that altered documents, shred them, invent them and in some cases even steaming them overnight to create the impression that they are old”

The FDA dismisses claims that it is easy to mislead. “We conducted a number of unannounced inspections at foreign plants over the past several years”

But Mrs. Eban is convinced that in some cases, at least in the U.S. generic medicine becomes available without proper vetting.

She says that the FDA is overwhelmed and under resourced in its duty to ensure the safety of overseas drug production.

She also produced evidence about inspectors that were poisoned with contaminated drinking water to undermine inspections.

Mrs. Eban: “The investigators were poisoned in the course of their inspections with tainted water from the tap, which you can’t drink in India. They felt sick during inspections. I mean, this was a way of running out the clock”

In one instance, an investigator had his hotel room bugged.

In other cases manufacturers tried to scan passenger lists in airports to try to determine exactly who was coming and when. There were elaborate measures that the plants took to try to protect against bad inspections.