Medicine is an interesting area because all of the incentives lean towards incremental, long-term subscriptions for small-but-measurable gains. So if your fraud is an improvement by 2.5% instead of 2.45%, it's both unlikely to get a lot of attention and quite likely to get incorporated into the new drug development pipeline. All of the players except for the general public seem to have reached their goals here. Even if the fraud is detected during drug production it's probably small enough not to warrant a scandal, and who wants to shut down their next great drug production pipeline for what might or might not be a fraud and even if it was doesn't amount to very much?