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by ihattendorf 2423 days ago
Honest question, how do you know you're actually getting the correct drug and that it isn't contaminated or cut with something else?
3 comments

You could send it to a chemist and ask them to do an NMR and have a pretty good idea (provided it’s just one molecule)
You can test it yourself, but many times the same manufacturer in the USA is the same abroad.

I would say India for Drugs is not a bad idea - if you're worried it's "from" China.

> I would say India for Drugs is not a bad idea - if you're worried it's "from" China.

Then again:

https://peterattiamd.com/katherineeban/

> The story of Ranbaxy: An Indian drug company whose business model was fraud and deceit [40:45]

Good link. On his podcast, Peter has also talked about generics vs. name brand differences. He had a chemist on who started a pharmacy selling generics where some statistically significant amount of each batch of drugs is tested for chemical verification.
"You can test it yourself" : If you die, just make sure to leave a bad review on Alibaba. Do your bit to prevent survivor bias.
I meant by a reagent test. Not consumption.
I have not the remotest idea how I would test a cancer drug for myself to see if it was pure. I suppose I could hire a chemical laboratory, if I could figure out what kind of one would do that kind of work...
> I have not the remotest idea how I would test a cancer drug for myself

As someone with only a high school level of chemistry training I would check the melting temperature.

Although seriously get it professionally tested. The delta between USA prices and India/China prices is so high a lab test will barely change the margins.

The first thing to do would be look up the Scientific Discussion or Monograph as filed with the FDA for the brand name product. With the details obtained from there, you'd know what to test for.

The first steps would be assay and impurity tests for the active pharmaceutical ingredients (API). If you bought tablets you'd probably want to do dissolution as well.

If everything looked fine after that, I'd still be concerned about uniformity. If you just performed dissolution on half a dozen tablets, how do you know all the tablets are the same from the whole supply?

Next question is then stability. What happens to the API over an extended time period? Does it deteriorate due to climate or poor storage conditions?

The main issue is quality control. Even an approved generic has to file with the FDA (or equivalent of wherever you are) concerning processes, batch sizes, critical quality attributes etc.

> if I could figure out what kind of one would do that kind of work

Open up the phone book. I'm sure you can find one within a day.

Chemists like money. Especially when it's not even a controlled drug.

Probably the best way is to use a mass-spectrometer.
Hopefully they don't send you an inactive enantiomer!

Or an insoluble polymorph.

Realistically, a lot of cancer drugs are injectables, ramping up the risk of something going awry when you inject the powder you will have to handle.

I'm guessing the people who can afford a mass spectrometer can already afford the drug (or at least better insurance)
Heh, well if the drug is $4k a month and you can get the equivalent 5 year supply for $100 that leaves quite a bit of money left over for testing.

There are lab services that will run samples through a mass spec and report the results.