Generic: The Unbranding of Modern Medicine

Overview

Generic drugs are now familiar objects in clinics, drugstores, and households around the world. We like to think of these tablets, capsules, patches, and ointments as interchangeable with their brand-name counterparts: why pay more for the same?And yet they are not quite the same. They differ in price, in place of origin, in color, shape, and size, in the dyes, binders, fillers, and coatings used, and in a host of other ways. Claims of generic equivalence, as physician-historian Jeremy Greene reveals in this ...

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Generic: The Unbranding of Modern Medicine

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Overview

Generic drugs are now familiar objects in clinics, drugstores, and households around the world. We like to think of these tablets, capsules, patches, and ointments as interchangeable with their brand-name counterparts: why pay more for the same?And yet they are not quite the same. They differ in price, in place of origin, in color, shape, and size, in the dyes, binders, fillers, and coatings used, and in a host of other ways. Claims of generic equivalence, as physician-historian Jeremy Greene reveals in this gripping narrative, are never based on being identical to the original drug in all respects, but in being the same in all ways that matter.

How do we know what parts of a pill really matter? Decisions about which differences are significant and which are trivial in the world of therapeutics are not resolved by simple chemical or biological assays alone. As Greene reveals in this fascinating account, questions of therapeutic similarity and difference are also always questions of pharmacology and physiology, of economics and politics, of morality and belief.

Generic is the first book to chronicle the social, political, and cultural history of generic drugs in America.It narrates the evolution of the generic drug industry from a set of mid-twentieth-century "schlock houses" and "counterfeiters" into an agile and surprisingly powerful set of multinational corporations in the early twenty-first century.

The substitution of bioequivalent generic drugs for more expensive brand-name products is a rare success story in a field of failed attempts to deliver equivalent value in health care for a lower price. Greene’s history sheds light on the controversies shadowing the success of generics: problems with the generalizability of medical knowledge, the fragile role of science in public policy, and the increasing role of industry, marketing, and consumer logics in late-twentieth-century and early twenty-first century health care.

Johns Hopkins University Press

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Editorial Reviews

Publishers Weekly
08/11/2014
Greene (Prescribed: Writing, Filling, Using, and Abusing the Prescription in Modern America) turns the concept of generic as “ho-hum” on its head with this jam-packed survey of the effects culture, medicine, and politics have exerted on today’s ubiquitous generic drugs for the last 50 years. Painstakingly documented and researched, Greene, an associate professor of medicine at Johns Hopkins School of Medicine, infuses plenty of drama into the tale of American consumers’s shift from suspicion to support for drugs that are “the same but not the same” as brand-name medicines. From black-market medicines controlled by the mafia to the risk-taking pioneers of “generic enterprise” to the intense resistance of pharmaceutical producers—and doctors—to the rise of consumer rights and a patient’s “right to know what he is buying and how much it costs,” Greene laces this history with intrigue, ambiguity, and scandal. Students of the history of medicine will be intrigued, but his message is farther-reaching. In coming to grips with the future of our health care, the past, Greene writes, “helps to orient us to the present,” and the concept of “same but not the same” can also help us better understand biomedical innovation as well as the “risks and rewards of debranding.” (Oct.)
Somatosphere - Stefan Ecks

Greene's brilliant book is the first full-length monograph to trace the history of how Americans think about generics, and it is going to be the key reference for many years to come.

Somatosphere - Joseph Dumit

Jeremy Greene's Generic: The Unbranding of Modern Medicine fascinates because the very meaning of the key term "generic" is so unstable. Every time the reader thinks they have a handle on its dimensions, another four open up.

Somatosphere - Todd Meyers

Greene's book is a dizzying historical-political-social-cultural account of the forms generic drugs have taken over past several decades.

History Wire - Where the Past Comes Alive - Stephen Goddard

Fascinating and thought-provoking.

P&T Community - Miriam Reisman

Dr. Greene's gripping and eye-opening accounts of the scientific, social, and political debates that happened along the way keep the reader hooked and engaged... [He] is both scholar and storyteller, interspersing fascinating historical narratives with complex scientific discussion.

Library Journal
10/15/2014
Greene (history of medicine, Johns Hopkins Univ.; Prescribing by the Numbers) reviews how the generic drug industry came into being in the United States, with some information about the development of generic drugs in India and Brazil, and how governmental regulation has affected the development of generic pharmaceuticals. As with many aspects of modern society, the part played by generic products has been driven by economics. Greene carefully details how various interests, traditional drug developers, generic drug companies, insurance companies, consumers, and doctors have shifted the role of generic medicines in society. It is important to know that these drugs are only similar to, not identical to, their brand-name components, a factor that adds significantly to the difficulty of regulation and oversight. The author also describes the emerging role of "me too" drugs, created when multiple manufacturers produce similarly purposed medicine to gain market share. VERDICT This is an excellent and recommended history of how the generic drug market came to be, but it is missing information about the current situation, which may be better addressed in Greene's previous work.—Eric D. Albright, Tufts Univ. Lib., Boston
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Product Details

  • ISBN-13: 9781421414935
  • Publisher: Johns Hopkins University Press
  • Publication date: 9/25/2014
  • Pages: 368
  • Sales rank: 376,767
  • Product dimensions: 6.00 (w) x 9.10 (h) x 1.20 (d)

Meet the Author

Jeremy A. Greene, M.D., Ph.D., is associate professor of medicine and the history of medicine and the Elizabeth Treide and A. McGehee Harvey Chair in the History of Medicine at the Johns Hopkins University School of Medicine. He is the author of Prescribing by Numbers: Drugs and the Definition of Disease and coeditor of Prescribed: Writing, Filling, Using, and Abusing the Prescription in Modern America, both published by Johns Hopkins.

Johns Hopkins University Press

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