[JamesBarney]

While this is true of some drugs this isn't true of insulin. Insulin that doesn't work would be noticed very quickly.

[rtkwe]

It would be hard to notice if it were adulterated with something else with long term harmful effects though. Say something that increases the potency or allows the effect to last longer (so I'm not strawmanning a The Jungle style willfully negligent corp) but is ultimately harmful over long term or combination with other medicines?

[JamesBarney]

Yeah, and those risks are why we have so much regulation which is why we have such high costs. It's a tough problem.