Not specific to CLL but India is one of the leading countries in the world making generic drugs and this issue, in my opinion, is a cause for concern and why I always buy branded over the counter drugs when I need to.
Incidentally, there are allegedly the same issues in China where the FDA theoretically oversea some drug production but they are obfuscated from inspecting production and QA records
It’s worth noting that Ibrutinib will be coming off patent soon and may be manufactured in India.
The article from the UK Daily Telegraph reports that:-
"The World Health Organisation (WHO) has issued an alert over an Indian-manufactured cancer drug circulating in Lebanon and Yemen which was found to contain life-threatening levels of toxic bacteria.
Pseudomonas aeruginosa was discovered in an injectable chemotherapy agent and immune system suppressant called methotrexate, which is manufactured by Celon Labs, a biopharmaceutical company based in the southern Indian city of Hyderabad. The methotrexate injections were only found to be contaminated after children administered with the drug reported adverse effects.
India is known as the “pharmacy of the world” as its factories manufacture 20 percent of the globe’s generic drugs and 50 percent of vaccines. However, the sector has long been plagued by safety concerns and regulation breaches.
Last year, Indian-made cough syrups were linked to the deaths of over 300 children in Gambia and Uzbekistan. In October and November 2022, approximately five per cent of the 2,767 drugs and medical devices tested by the Indian government’s regulator were found to be spurious, not of standard quality, adulterated or misbranded. More than 80 companies who failed quality testing stated on their website that they sold their products abroad, including two firms who export to the United Kingdom.
In February, Global Pharma Healthcare, an Indian pharmaceutical company based in the southern Indian city of Chennai, recalled its Artificial Tears Lubricant Eye Drops. The product, which was distributed in turn by two American pharmaceutical companies, was linked to an outbreak of pseudomonas infections and three deaths in the United States.
According to Prashant Reddy, a co-author of the book “The Truth Pill: The Myth of Drug Regulation in India”, some Indian companies and regulators do not adequately quality test their active pharmaceutical ingredients (APIs) or finished products before export, while corruption is also rife,“
The Indian government pats itself on the back as the pharmacy of the world – it is one of the country’s few big success stories so there is no incentive to really crackdown,” adds Mr Reddy.“It is a systemic issue. The implementation of standards and enforcement by drug regulators is sporadic across different Indian states and many drug labs do not do comprehensive testing of their products and only do a small subset.”
telegraph.co.uk/global-heal...
Jackie