LftS: Bottle of Lies: Inside the Generic Drug Boom

Earlier this year a bomb dropped as Katherine Eban released the culmination of roughly a decade of research and investigative work on the Generic Drug Industry, and the explosion should be huge.  In this Episode of Lessons from the Screen we are going to be taking a look at Bottle of Lies: Inside the Generic Drug Boom by Katherine Eban.

The book starts out introducing us to an FDA Inspector that ends up in a foot race down a hallway chasing a pharmaceutical plant manufacturing worker who is trying to destroy paperwork.  This sort of cat and mouse game is basically the narrative of the entire book and thus the narrative of what has been happening between the FDA and overseas generic drug manufacturers since the boom of the industry.  Which this book manages to tie to Gandhi as he leads the resistance against British colonialism and advocated for Indian corporations.  2 students, in particular, heeded his direct call and birthed the generic pharmaceutical industry.  While Gandhi wanted cheaper, high-quality drugs from Indians what ended up happening was lower quality drugs for India and the rest of the developing world in favor of profits.  

The point of profit over quality is especially clear with regards to AIDS medications in Africa at the onset of the AIDS global epidemic.  At several moments in the book, it is alleged that a very dismissive behavior was given to the fact that the drugs weren’t working in Africa because “they were just Black People,” which is a sentiment that probably also filter down through Gandhi.  These poor quality medications are mentioned as a potential reason why the AIDS epidemic in Africa never came under control like it did in other countries.  It speaks to those in Africa that tried to start legitimate pharmaceutical companies to supply high-quality drugs to the continent only to find that high quality, low cost was the biggest lie in the pharmaceutical industry and the entire generic drug sector was built on that lie.  In one occasion mentioned in the book, an African Drug Company wanted to purchase active ingredients for medications only to be presented with the option to by low-quality ingredients at the “African” rate.  A segment of these low-quality goods was regularly being set aside to sell to those making drugs for African Nations.  

But far from just being focused on the underprivileged, the book also takes a look at the impact of generic drugs on wealthy countries such as the European and Western Nations of the World.  While those implications have been minimized to an extent by the ability to create and pay for brand drugs, it details how the growing trend of resistant diseases could actually be attributed, in part, to substandard generics.  The concept of substandard generics causing treatment-resistant bacteria is a new development but evidence is quickly being amassed to prove the case.  As the generic drug industry continues to grow and expand, plants founded in corrupt areas of the world are also selling active ingredients to other manufacturing plants lowering the quality of the drugs made in potentially safe plants.  

The book spoke passively to the fact that well-meaning activist where being used to place the FDA in a tough position.  The public largely sees generic drugs as a lower cost version of brand drugs and as such demands and champions generics.  Unfortunately, this is far from the case and the book makes this point over and over again.  But the FDA is not treated as the victim, they are in a lot of ways treated as an accomplice to what is happening and in a lot of ways they are an encouraging accomplice but so is the uninformed populace.

Most of the story is told from the perspective of Ranbaxy and Dinesh Thakur, the whistleblower that ended up getting $48 million from the $500 million dollar settlement Ranbaxy agreed to with the FDA.  It veers off into necessary and informative tangents where necessary, quickly coming back to the main story after a tangent has been sufficiently explored.  Like all books, this one is another must read. I actually struggled with what to share and what not too because I wanted to share everything.  What I settled on is that next week's show will be on Generic vs. Brand drugs.  So get ready.  

Data manipulation, governmental politics, dirty plants, compromised drugs, villains, heroes, evil schemes with deadly consequences it's all here and it’s all real.   It’s hard to read this book and believe that drugs are drugs.  But reading this book and understanding that drugs aren’t drugs is something that I believe all people must do.  

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