Generic: The Unbranding of Modern Medicine
The turbulent history of generic pharmaceuticals raises powerful questions about similarity and difference in modern medicine.

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.

1119462102
Generic: The Unbranding of Modern Medicine
The turbulent history of generic pharmaceuticals raises powerful questions about similarity and difference in modern medicine.

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.

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Generic: The Unbranding of Modern Medicine

Generic: The Unbranding of Modern Medicine

by Jeremy A. Greene
Generic: The Unbranding of Modern Medicine

Generic: The Unbranding of Modern Medicine

by Jeremy A. Greene

Hardcover

$32.95 
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Overview

The turbulent history of generic pharmaceuticals raises powerful questions about similarity and difference in modern medicine.

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.


Product Details

ISBN-13: 9781421414935
Publisher: Johns Hopkins University Press
Publication date: 10/27/2014
Pages: 376
Product dimensions: 6.00(w) x 9.10(h) x 1.20(d)
Age Range: 18 Years

About the Author

Jeremy A. Greene is an associate professor 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 Generic: The Unbranding of Modern Medicine and coeditor of Prescribed: Writing, Filling, Using, and Abusing the Prescription in Modern America, both published by Johns Hopkins.

Table of Contents

Acknowledgments ix

Introduction. The Same but Not the Same 1

I What's in a Name?

1 Ordering the World of Cures 21

2 The Generic as Critique of the Brand 39

II No Such Thing as a Generic Drug?

3 Drugs Anonymous 53

4 Origins of a Self-Effacing Industry 64

5 Generic Specificity 77

III The Sciences of Similarity

6 Contests of Equivalence 93

7 The Significance of Differences 110

IV Laws of Substitution

8 Substitution as Vice and Virtue 137

9 Universal Exchange 155

V Paradoxes of Generic Consumption

10 Liberating the Captive Consumer 173

11 Generic Consumption in the Clinic, Pharmacy, and Supermarket 191

VI The Generic Alternative

12 Science and Politics of the "Me-Too" Drug 211

13 Preferred Drugs, Public and Private 231

14 The Global Generic 243

Conclusion. The Crisis of Similarity 261

List of Abbreviations 277

Notes 279

Index 343

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."

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.

From the Publisher

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.
—Siddhartha Mukherjee, Assistant Professor of Medicine, Columbia University, author of The Emperor of All Maladies: A Biography of Cancer

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.
—Charles E. Rosenberg, Professor of the History of Science and the Ernest E. Monrad Professor in the Social Sciences, Harvard University

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.
—Susan Strasser, Richards Professor of American History, University of Delaware, author of Satisfaction Guaranteed: The Making of the American Mass Market

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.
—João Biehl, Susan Dod Brown Professor of Anthropology, Princeton University, author of Will to Live: AIDS Therapies and the Politics of Survival

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.
—John P. Swann, author of Academic Scientists and the Pharmaceutical Industry: Cooperative Research in Twentieth—Century America

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.

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