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Generic

The Unbranding of Modern Medicine

Jeremy A. Greene

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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...

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.

Reviews

Reviews

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.

An excellent and recommended history of how the generic drug market came to be.

Fascinating and thought-provoking.

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.

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

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Book Details

Publication Date
Status
Available
Trim Size
6
x
9
Pages
376
ISBN
9781421421643
Illustration Description
8 halftones, 9 line drawings
Table of Contents

Preface to the 2016 Edition
Acknowledgments
Introduction. The Same but Not the Same
Part I. What's in a Name?
Chapter 1. Ordering the World of Cures
Chapter 2. The Generic as Critique of the Brand
Part II

Preface to the 2016 Edition
Acknowledgments
Introduction. The Same but Not the Same
Part I. What's in a Name?
Chapter 1. Ordering the World of Cures
Chapter 2. The Generic as Critique of the Brand
Part II. No Such Thing as a Generic Drug?
Chapter 3. Drugs Anonymous
Chapter 4. Origins of a Self- Effacing Industry
Chapter 5. Generic Specificity
Part III. The Sciences of Similarity
Chapter 6. Contests of Equivalence
Chapter 7. The Significance of Differences
Part IV. Laws of Substitution
Chapter 8. Substitution as Vice and Virtue
Chapter 9. Universal Exchange
Part V. Paradoxes of Generic Consumption
Chapter 10. Liberating the Captive Consumer
Chapter 11. Generic Consumption in the Clinic, Pharmacy, and Supermarket
Part VI. The Generic Alternative
Chapter 12. Science and Politics of the "Me- Too" Drug
Chapter 13. Preferred Drugs, Public and Private
Chapter 14. The Global Generic
Conclusion. The Crisis of Similarity
List of Abbreviations
Notes
Index

Author Bio
Jeremy A. Greene
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Jeremy A. Greene

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.