Points Bookshelf: “Bottle of Lies” by Katherine Eban

Editor’s Note:  Today’s post comes from contributing editor Brooks Hudson, a PhD student in history at Southern Illinois University. As part of our Points Bookshelf series, he reviews Bottle of Lies: The Inside Story of the Generic Drug Boom (Ecco, 2019). 

Screenshot 2019-08-07 at 4.49.07 PMKatherine Eban previews Bottle of Lies: The Inside Story of the Generic Drug Boom with shocking statistics on the state of pharmaceuticals: “Roughly 40 percent of our generic drugs are manufactured in India. A full 80 percent of the active ingredients in all our drugs, whether brand-name or generic, are made in India and China.” China is the sole source for many of America’s essential medicines, including those used in anesthesia and the treatment of cancer and HIV/AIDS. It is the world’s only source for antibiotics. One drug importer explained to her that “without products from overseas, not a single drug could be made.” 

Bottle of Lies’s popularity and positive press stems from Eban asking what appears, at first blush, to be a naïve set of questions: What are generic drugs? How are they made? Where are they made? And what are the consequences? If you surveyed the American people’s knowledge of what a generic drug is, they would probably say something to the effect of “generic drugs are the cheaper version of the name-brand.” “Patients” Eban writes, “tend to assume that their generic drugs are identical to brand-name drugs in part because they imagine a simple and amicable process: as a patent expires, the brand-name company turns over its recipe, and a generic company makes the same drug, but at a fraction of the cost.”

It doesn’t happen this way. Instead companies, “erect a fortress of patents around their drugs, sometimes patenting each manufacturing step—even the time-release mechanism, if there is one. At any point, they can tweak a drug “declare it new, to add years to their patents, a move known as ‘evergreening.’” Whatever generics hit the market, they arrived there “not with help from brand-name drug companies, but in spite of their efforts to stop them.”

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