From an award-winning journalist, an explosive narrative investigation of the generic drug boom that reveals fraud and life-threatening dangers on a global scale-The Jungle for pharmaceuticals
Many have hailed the widespread use of generic drugs as one of the most important public health developments of the twenty- first century. Today, 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 overseas, and do they outweigh the savings? An investigation with international sweep, high-stakes brinkmanship, and big money at its core, Bottle of Lies reveals how the world's greatest public health innovation has become one of its most astonishing swindles.
Table of Contents
Author's Note xi
About the Reporting xvii
Important People and Places xix
Prologue 1 (8)
PART I SHIFTING GROUND
Chapter 1 The Man Who Saw Further
9 (8)
Chapter 2 The Gold Rush
17 (14)
Chapter 3 A Slum for the Rich
31 (10)
Chapter 4 The Language of Quality
41 (16)
Chapter 5 Red Flags
57 (12)
PART II INDIA RISES
Chapter 6 Freedom Fighters
69 (12)
Chapter 7 One Dollar a Day
81 (10)
Chapter 8 A Clever Way of Doing Things
91 (10)
Chapter 9 The Assignment
101 (20)
PART III A CAT-AND-MOUSE BUSINESS
Chapter 10 The Global Cover-Up
121 (16)
Chapter 11 Map of the World
137 (12)
Chapter 12 The Pharaoh of Pharma
149 (12)
PART IV MAKING A CASE
Chapter 13 Out of the Shadows
161 (8)
Chapter 14 "Do Not Give to FDA"
169 (10)
Chapter 15 "How Big Is the Problem?"
179 (16)
Chapter 16 Diamond and Ruby
195 (12)
Chapter 17 "You Just Don't Get It"
207 (14)
PART V DETECTIVES IN THE DARK
Chapter 18 Congress Wakes Up
221 (12)
Chapter 19 Solving for X
233 (12)
Chapter 20 A Test of Endurance
245 (14)
Chapter 21 A Deep, Dark Well
259 (14)
Chapter 22 The $600 Million Jacket
273 (20)
PART VI THE WATERSHED
Chapter 23 The Light Switch
293 (18)
Chapter 24 We Are the Champions
311 (10)
Chapter 25 Crashing Files
321 (16)
Chapter 26 The Ultimate Testing Laboratory
337 (20)
PART VII RECKONINGS
Chapter 27 Flies Too Numerous to Count
357 (20)
Chapter 28 Standing
377 (18)
Epilogue 395 (16)
Acknowledgments 411 (4)
Glossary 415 (6)
Notes 421 (42)
Index 463