| The pills in American medicine cabinets are built on a bargain: profits in return for trust. Drugmakers make heaps of money on medicines they invent. Then their patents lapse and more patients get the fruits of innovation for pennies thanks to generic drugs. But what if the cheaper pills don't work, or harm people? What if a system meant to reward risk-taking and spread scientific breakthroughs breaks down? There are signs that the makers of America's generic drugs aren't holding up their end. The small cadre of FDA inspectors in India and China—where many generics are made—have found filthy factories and efforts to conceal worrying quality checks. The FDA insists generics are as safe and effective as the medicines they mimic. But the agency has also overseen the recall of a heart pill taken by millions after it was tainted with a cancer-causing chemical. Two foreign companies that will produce new supplies of the pill have had problems of their own. There are hairline cracks in the grand generic-drug contract. What happens if they widen?—Drew Armstrong Here's what else you need to know: Mental block. Most health insurers nominally cover mental-health care, but when the time comes to actually use the plans, many patients have run into obstacles, including "ghost networks" and treatment limits. Precision promise. A new Roche gene therapy has been successful in treating some of the most difficult child tumors, including on the brain. All 12 patients who got the drug in a small trial responded to the treatment. Bankruptcy watch. Insys Therapeutics warned investors that it could soon file for Chapter 11. The opioid maker, whose former CEO was convicted of racketeering early this month, has been hemorrhaging cash. Listen up. Season two of our podcast is all about what happens when we hand over our health data to companies and governments. Download it here on Apple devices, and here on Android.  Got this newsletter forwarded to you? Sign up to get it every Thursday by clicking here.
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