Keveme,

Before earning my Ph.D.,  worked for the US  FDA as a Food and Drug Chemist. We did  Quality assurance testing of drugs, which included large and small drug companies.

One small company had an excellent formulations chemical engineer/chemist  who made tablets that easily met the specification of product potency and uniformity.  FDA inspectors however observed the laboratory testing facilities and found them woefully lacking.  Kept taking samples and our lab kept finding an excellent product.   The problem is/was that if the formulations person retired or quit or got sick and someone made a mistake,  their laboratory would be totally incapable of detecting that an error had been taken place.  No different in some ways with the question on pollution control measurement in VW cars.   If their software cannot detect whether their car is polluting, and if the owner of the car cannot detect if the car is polluting, then this is totally untenable. 

It is not enough to make an excellent product;  one needs 1) to have in place verifiable testing procedures by the manufacturer,  2) to have a verifiable paper trail of analytical results to be able to trace back if and when a mistake happens to have been made where and when it occurred [so only the known defective lots needs to be recalled, and  3) the public needs unambiguous confidence in the [regulatory] system.   Trust betrayed is something very difficult to overcome, and deceit and/or even non-transparency can be a "poison pill" to any large or small pharmaceutical company.  The impact of anti-cancer drugs that are ineffective because of improper formulation and/or quality control is that the patient is not getting the medicine that could save her or his life.  Every health care person's impact [from pharmacist to physician to physical therapist] is undermined when the quality of drugs available to the consumer is not verifiable.

Walter.

Dear Louison,

One simple answers are,

1. Pharmaceutical companies have turned out as a business alone.

2. They have ignored their role in health care.

3. Governance on pharmaceutical companies are not appropriate.

I can answer as a neurologist. There is an increasing number of large pharmaceutical companies that distribute generic brands. These brands are not cheaper in many cases, and their quality makes you use more doses and have more adverse effects. So far, no real benefit to patients.

I strongly agree to Dr. Ramalingam Peraman, indeed, the establishment of Large Pharmaceutical industries have ignored their role in health care.

The super sizing of the pharmaceutical companies has resulted in less innovation from them to the detriment of drug development.  This is partially offset by the smaller pharma and biotech companies who do much of the innovative work to day.