These days, we know where almost everything comes from. Everyday items like food, clothes and pens all carry labels listing where things are grown, manufactured or even designed.
So why is it so hard to find where prescription drugs are made?
That question set off a 14-month investigation into where our medications are made, how the FDA polices drug manufacturers and what happens when inspectors report issues inside factories.
The vast majority of prescriptions filled in the United States are for generic drugs, which are often far cheaper than brand-name alternatives.
For years, Congress, doctors and watchdog groups have questioned the quality of generic drugs made overseas. India produces about half of all generics used in the U.S., but the labels on pill bottles often don’t list where a drug is manufactured. Inspection reports describe unsafe manufacturing conditions at generic drug factories, but the Food and Drug Administration redacts the names of the medications made in those factories. That means if drugs made in errant factories wind up in your medicine cabinet, you’d have no way of knowing.
To better understand how the FDA regulates the generic drug industry, Debbie Cenziper and Megan Rose interviewed current and former factory inspectors, tested medications in a lab and sued the federal government for critical documents.
Here’s what they found:
- Birds defecated on boxes of sterile equipment. Inspectors reported finding dirty labs, mold and foul water at factories. Records referenced vials of medication that were “blackish” from contamination. Inspectors found what appeared to be metal shavings on equipment.
- Drug manufacturers manipulated and destroyed drug-testing records. At one factory, an analyst poured acid on records stuffed in a trash bin. At another, inspectors said in a report that records were “routinely manipulated” to cover up the presence of particulate matter — which could include glass, fiber or other contaminants — in generic drugs.
- A lifesaving generic drug contained a lower amount of a key ingredient. We worked with an independent lab to test generic versions of tacrolimus, used to prevent organ rejection. We found some pills contained a lower amount of the key ingredient in the drug. Doctors and experts said that underdosing can leave patients vulnerable to organ rejection.
- The FDA allowed generic drug imports from banned factories — and didn’t inform the public. The agency gave some manufacturers a special pass to continue to ship drugs made in factories whose manufacturing practices were so bad they had been banned from the U.S. Over a dozen years, the FDA exempted at least 150 drugs or their ingredients from banned factories.
- A transplant patient’s lungs failed after she took generic versions of tacrolimus. Hannah Goetz had a double-lung transplant as a teenager and had to take tacrolimus twice a day. Her lungs failed in 2023, and she died at 21 years old, after years of relying on the generic drug made by two manufacturers with documented problems. Lawyers told Goetz’s mother that it was impossible to draw a straight line from Hannah’s death to a generic manufacturer, but her mother said she wonders if her daughter would still be alive if she took a different brand of tacrolimus.
In a response to ProPublica, a spokesperson for the FDA said in a statement that the exemptions given to banned factories are “thoroughly evaluated through a multi-disciplinary approach” but declined to say exactly what those evaluations entailed. The agency also said it requires manufacturers to conduct additional quality checks with third-party oversight before sending drugs to the U.S. The agency did not respond to questions about how it can know that generics are safe without a more robust testing program.
In statements to ProPublica, drug companies said that they take patient safety seriously, adhere to quality standards and are committed to working with the FDA on any regulatory issues.
ProPublica’s investigation, which went on to be a finalist for the Pulitzer Prize for investigative reporting, published in 2025.
Use our tool to find where your prescription drugs were made.
ProPublica’s Brandon Roberts and a team of data journalists made a tool called Rx Inspector that will show you the facility that manufactured your generic prescription drugs and any inspection reports, warning letters and import bans we have from the FDA.
The data isn’t perfect; it’s possible the FDA hasn’t published everything it knows about a given facility, for example. Also, one company may have acquired another or moved the factory somewhere else. This tool also isn’t meant to provide you with medical advice: If you find something troubling, it doesn’t necessarily mean that your drug is compromised. Doctors and pharmacists advise that you not stop taking your medications. Instead, you should talk to your healthcare provider about any concerns.
Step 1: Enter the name of your prescription drug, as well as the company name found on your pill bottle or drug label.
Step 2: If there are multiple matches in our database, you can narrow your search using the markings found on a pill, for example.
Step 3: When you click on a drug, we’ll show you any manufacturing facilities we’ve been able to connect to it. Click on a facility to see any information we have from the FDA.
FDA inspections come with compliance outcomes, such as import alerts or warning letters. The best possible outcome of an inspection is “acceptable state,” which means the FDA took no compliance action and ProPublica found no issues documented by inspectors. Search your prescription here.
ProPublica described Rx Inspector and the methodology used to build it to the FDA, which did not comment. The agency previously told ProPublica that it doesn’t reveal where drugs are made on inspection reports to protect what it deemed to be confidential commercial information.
Read more of Cenziper, Rose and Roberts’ reporting from their series Rx Roulette or watch their video explainer.
