2013-09-03nytimes.com

``The economic root cause is simple: the purchasing organizations have squeezed manufacturers' operating margins to razor-thin levels. By awarding select suppliers exclusive contracts in return for exorbitant (and undisclosed) "administrative," marketing and other fees, they have reduced the number of suppliers to just one or two for many generics. Further, they've crimped investment in maintenance and quality control, resulting in adverse F.D.A. inspections and plant closings. ''



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