| Darin Okuda grew worried reading Bottle of Lies by Katherine Eban. The book, which I highly recommend, details fraud in the generic drug industry that led to low-quality and even potentially dangerous medications of all kinds. Okuda is a neurologist who specializes in multiple sclerosis at the University of Texas Southwestern Medical Center in Dallas. He had noticed the number of generic medications to treat MS were growing and wondered: Were his patients being harmed? He found six women being treated at the medical center for relapsing remitting multiple sclerosis who had experienced instances of worsening symptoms when they were switched from Novartis AG's Gilenya to its generic, called by its active ingredient fingolimod. He and other researchers were able to test the generic fingolimod that three of the women had taken. Recent results published in the journal Therapeutic Advances in Neurological Disorders showed the patients had been given pills that didn't contain enough of the drug to be considered effective. One of the women had received pills with only 72.56% of the fingolimod the drug was supposed to have. Relapse symptoms can include a lack of coordination, numbness or tingling and weakness. They can last a few days to a few months. Additionally, about half of all relapses leave lingering symptoms, according to the MS Society. So it's vital to avoid such an episode. Each of the drugs Okuda and his colleagues had tested were made by a different manufacturer, though the study doesn't reveal which ones. No one is supposed to get a subpotent drug. People with neurological conditions like MS or epilepsy can be particularly sensitive to changes in their treatment. Okuda notes in the study that doctors don't often associate a patient's worsening symptoms to a potential problem with the drug they're taking. Instead, they just assume the patient needs a higher dose, increasing the risk of side effects, or a completely different drug altogether. The US Food and Drug Administration insists that generic drugs work the same as the brand versions they aim to copy. In reality, it would be helpful, Okuda wrote, if patients and doctors were armed with the information to look out for potential differences and help them make better treatment plans. — Anna Edney | 
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