Also, here is one manufacturer, whom we never heard of, along with a citation of a handful of others, whom we also never heard of, who were afraid of reputational blowback from being blamed for spurious product. They are small. Probably they are right to fear. The major manufacturers, the ones we have heard of, do not share that fear.

Between my wife and I, we have now encountered at least three situations where generic drugs from one manufacturer were effective, from another manufacturer ineffective. Our doctor says that this is now a commonplace problem. Fewer and fewer pharmacies are willing to place special orders from specific manufacturers other than their supplier's default. And it was not so long ago that we learned that "turmeric" is now a euphemism for lead chromate. Think about what would be involved in enforcing quality control, and immediately it becomes obvious that it is not being and cannot be enforced.