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Bottle of Lies: The Inside Story of the Generic Drug Boom

by Katherine Eban

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24413116,788 (4.2)2
"Many have hailed the widespread use of generic drugs as one of the most important public-health developments of the twenty-first century. Today, almost 90 percent of our pharmaceutical market is comprised of generics, the majority of which are manufactured overseas. We have been reassured by our doctors, our pharmacists and our regulators that generic drugs are identical to their brand-name counterparts, just less expensive. But is this really true? Katherine Eban's Bottle of Lies exposes the deceit behind generic-drug manufacturing--and the attendant risks for global health. Drawing on exclusive accounts from whistleblowers and regulators, as well as thousands of pages of confidential FDA documents, Eban reveals an industry where fraud is rampant, companies routinely falsify data, and executives circumvent almost every principle of safe manufacturing to minimize cost and maximize profit, confident in their ability to fool inspectors. Meanwhile, patients unwittingly consume medicine with unpredictable and dangerous effects. The story of generic drugs is truly global. It connects middle America to China, India, sub-Saharan Africa and Brazil, and represents the ultimate litmus test of globalization: what are the risks of moving drug manufacturing offshore, and are they worth the savings?" -- Dust jacket.… (more)
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Everyone knows the lack of ethics in India. Corruption pervades the public and private sectors, and even the most conscientious of citizens can barely escape this now-routine fact of our lives.

I had always assumed that certain sectors might still be sacrosanct because of their very nature of their existence. Right now though, after reading this book, I'm terribly depressed and worried and have lost almost all hopes about reform in this country.

Bottle of Lies is an exposé by US investigative journalist Katherine Eban about the generic drug industry, its boom and its flaws. Ranbaxy is its primary _target, viewed through the eyes of Dinesh Thakur, the whistle-blower who made public the deep-rooted unethical corruption within the company.

Though the book primarily focuses on Ranbaxy, the list of companies Eban has named with actual instances of malpractices contains the who's who of the Indian Pharmaceutical sector: Dr. Reddys, Zydus Pharma, GSK Pharma, Wockhardt, Glaxo Smithkline, Cipla. Glenmark, Aurobindo, Sun Pharma... The names and the malpractices perpetrated leave you astounded.

Eban's narrative is fast-paced and leaves you breathless. You feel like you're reading a scary dystopian thriller instead of some boring documentation of a whistle-blower's experience. All tactics used by the Indian cheats are mentioned: repairing instead of replacing faulty equipment, falsification of data, shifting employees temporarily to a department to show the adherence to minimum required staff numbers, lack of testing as per norms, circumventing the truth constantly by using loopholes, lack of documentation, making different versions of the same drug for different markets,... Things that you wouldn't ever expect of reputed multinational companies! She even mentions "Jugaad" and "Chalta Hai" as two inherent problems in Indian corporate mentality because of which companies work around a problem rather than working on it. (A small part of me was even waiting for "Jhol" to make an appearance, but I was disappointed by its being missed out!)

Obviously, Eban also focuses on FDA and the struggles it faces wrt lack of understanding of medical jargon, low number of agents willing to travel abroad for checks and their need to balance US Congress requirements of cheap medical availability with medicinal integrity. The first half is almost panegyric of FDA. But the second half of the book reveals even their problems of corruption and bureaucracy. (That was a teeny saving grace: to know that even American institutions struggle with bureaucratic pressures and delays.)

If I have to nitpick, I can say that the book does have a lot of white supremacy, especially in the first half. American FDA investigators are portrayed in the veil of ethical cowboys out to (metaphorically) kill the bad generic pharma guys. The Indian culprits are openly criticised. But the Britisher Brian Tempest, who was the Ranbaxy CEO during the debacle, is only mentioned by name and without any character flaws detailed. Additionally, there are too many physical descriptions of the Americans, right down to the colour of their eyes, which to me was unnecessary and distracting.

A slightly bigger irritant for me was the complete lack of acknowledgement of the problems that even Indian citizens face with these cheap drugs dumped here. About 90% of the book is totally about the US citizens and their rights, with one chapter focusing on Africa. Still, I suppose this is partly understandable as both Eban and the FDA are American and their loyalties would obviously lie there.

These, however, are just trivial issues coming from the heart of a disgruntled and shamefaced Indian. The above flaws don't take away anything from this masterful eye-opener.

A caveat though: Read the book at your own risk. You'll never look at medicines the same way again. The book will create depression and enhance pessimism.

Rating : 4.75/5




*********************************************
Join me on the Facebook group, "Readers Forever!", for more reviews and other book-related discussions and fun. ( )
  RoshReviews | Jul 30, 2024 |
5 stars

Bottle of Lies is the story of the generic drug boom of the early 2000s, specifically that caused by the increasing availability of cheap generic drugs from India and China. It follows the history of one specific Indian drug company, Ranbaxy, and the attempts by a whistleblower, certain contingents of the FDA, and FDA inspectors to bring attention to its widespread issues. In doing so, it exposes the consequences of globalization on the generic pharmaceutical industry as a whole.

This book was genuinely frightening. Eban's writing style is very engaging; it doesn't read like nonfiction. In fact, I spent most of the book wishing it was as I looked suspiciously at the pill bottle full of generic medication next to me. I would say it is one of the best pieces of investigative journalism I've ever read. ( )
  abcace | Apr 2, 2024 |
Sobering look at the generic drug industry and the FDA that is supposed to be protecting us ( )
  corliss12000 | Mar 16, 2024 |
I did not finish this book because I found the language to be too "othering." The third strike was at 15% and I returned it to the library. ( )
  Greenfrog342 | Jan 22, 2024 |
This book is fairly limited in its scope, but it points out important issues that affect pretty much everyone because pretty much everyone, at one time or another, uses prescription medication. The main focus here is on a company in India and the government regulation of that company, but the issues raised go well beyond the "star attraction" of this book. There are "bad" people and bad companies and bad regulators and bad oversight of those regulators...and bad understanding by the average prescription drug buyer of how bad everything is. Many of us badly need to read this. ( )
  larryerick | Feb 11, 2023 |
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"A lie has speed, but truth has endurance."
--Edgar J. Mohn
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For my mother, Elinor Fuchs, and my father, Michael Finkelstein, the first and best writers and editors in my life.
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"Many have hailed the widespread use of generic drugs as one of the most important public-health developments of the twenty-first century. Today, almost 90 percent of our pharmaceutical market is comprised of generics, the majority of which are manufactured overseas. We have been reassured by our doctors, our pharmacists and our regulators that generic drugs are identical to their brand-name counterparts, just less expensive. But is this really true? Katherine Eban's Bottle of Lies exposes the deceit behind generic-drug manufacturing--and the attendant risks for global health. Drawing on exclusive accounts from whistleblowers and regulators, as well as thousands of pages of confidential FDA documents, Eban reveals an industry where fraud is rampant, companies routinely falsify data, and executives circumvent almost every principle of safe manufacturing to minimize cost and maximize profit, confident in their ability to fool inspectors. Meanwhile, patients unwittingly consume medicine with unpredictable and dangerous effects. The story of generic drugs is truly global. It connects middle America to China, India, sub-Saharan Africa and Brazil, and represents the ultimate litmus test of globalization: what are the risks of moving drug manufacturing offshore, and are they worth the savings?" -- Dust jacket.

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