Generic: The Unbranding of Modern Medicine

Generic: The Unbranding of Modern Medicine

by Jeremy A. Greene
     
 

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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

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.

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.

Health Affairs - Elizabeth Richardson
As Jeremy Greene lays out in his excellent book, the story of the generic drug industry is is far more complicated—and far more interesting than most of us might guess... [Greene] provides readers with a useful framework for understanding how we got to where we are and how we might apply the lessons of the past to the challenges we face today.

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.

History Wire - Where the Past Comes Alive

Fascinating and thought-provoking.

P&T Community
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.

Health Affairs
As Jeremy Greene lays out in his excellent book, the story of the generic drug industry is is far more complicated—and far more interesting than most of us might guess... [Greene] provides readers with a useful framework for understanding how we got to where we are and how we might apply the lessons of the past to the challenges we face today.

Bulletin of the History of Medicine
... recommended reading for anyone interested in postwar developments in U.S. health care and for scholars and analysts of contemporary pharmaceutical politics.

History Wire: Where the Past Comes Alive
Fascinating and thought-provoking.

Lancet
Greene should be congratulated for bringing this subject to life—with a mix of anecdote, scholarship, and elegant prose.

Medical Anthropology Quarterly
... Generic is an excellent example of how to intelligently construct a modern material history, grounded in the logics of the everyday.

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

The Midwest Book Review
Generic: The Unbranding of Modern Medicine comes from a physician and historian who offers a history of not just the development of generic drugs, but how they differ from the original. Within his examination are important insights on how drugs are made, what parts of a pill really matter, issues of therapeutic similarity and difference, and more. It's a wide-ranging history that embraces ethical, scientific, health, and economic issues and it provides insights on the history of generic drugs in America and the problems associated with scientific and medical changes in the public eye. The result is a survey that belongs in any health collection and many a general-interest holding.

Journal of the History of Medicine and Allied Sciences - Nicolas Rasmussen
This fine, stimulating, and entertaining book offers much food for thought.

Chemistry World - Phillip Broadwith
Well written and informative... bring[s] to life a tangled web of competing interests.

Sociology of Health and Illness - Debra Swoboda
A theoretical and empirical primer that explains the success and failure of generics and what it means to choose between generic and brand name drugs. Extensively researched and documented, Generic is the first book to chronicle the development of generics, and will probably be the key reference on the topic for some time... A book that should be read by anybody with a serious interest in contemporary healthcare.

Studies in the History and Philosophy of Science - Scott H. Podolsky
The generic drug industry... has been glorified as the antidote to exorbitant drug prices, and vilified as the purveyor of poisonous (or at least less effective) counterfeit drugs. Yet in Generic, Jeremy Greene has a far more nuanced, and far more interested, tale to tell... Greene's vitally important book... explicitly asks us to consider how much the tensions concerning times and places examined in the book are the same as those we face today... or at least similar enough in ways that we should find relevant. The answer is, very much.

Choice
Physician/historian Greene provides a thoroughly researched discussion about generic products derived from innovative or brand-name drugs, focusing on their "social, political, and cultural history"... Greene ably argues for generic by providing inside details about the drug approval process.

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.

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

Product Details

ISBN-13:
9781421414935
Publisher:
Johns Hopkins University Press
Publication date:
09/25/2014
Pages:
368
Sales rank:
747,322
Product dimensions:
6.00(w) x 9.10(h) x 1.20(d)
Age Range:
18 Years

Related Subjects

What People are saying about this

Susan Strasser
Jeremy Greene brings his knowledge and wisdom as both historian and physician to bear on the economics and politics of branding, marketing, and consumerism in health care. Most intriguingly, he asks fundamental questions about what it means to say one drug is the same as another. Fascinating and eye-opening.

Siddhartha Mukherjee
An enlightening and passionately written work, Generic opens the 'black box' of the pharmaceutical world. This book will deeply impact the way we imagine and practice medicine in the future.

João Biehl
Generic is a gem. Original, multi-layered, and powerfully narrated, the book unearths the history and value of generic drugs. While illuminating the dynamic interface of medicine, public health, and the marketplace in the US and beyond, Greene has crafted a vital compass that can greatly help us to understand and navigate the pharmaceutical present.

John P. Swann
The story of generic drugs is rife with intrigue, deceit, complex scientific debate, legislative wrangling, backstabbing, internecine warfare among health professions and government regulators, under-the-table deals worth billions of dollars, headline-grabbing prison sentences for trusted officials, and power struggles among monied interest groups. But Jeremy A. Greene’s Generic is not just a lurid story: it is also rich with lessons in the negotiating of health policy, the brokering of legitimate scientific disputes to craft the best possible regulatory decisions for the public health, the struggles to make health care more affordable for as many citizens as possible, and the transformation of the global pharmaceutical marketplace. A provocative, thoughtful, and comprehensive look into an industry that took on big pharma and organized medicine.

Charles E. Rosenberg
An extraordinarily timely and important contribution to our understanding of health practice and public policy. The status of generics is a significant subject in itself, and also a tool to think with, linking physiology and policy, business history and clinical options. Generic is a book that should be read by anyone with a serious interest in contemporary health care.

Meet the Author

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

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