Bottle of Lies: The Inside Story of the Generic Drug Boom Paperback – 23 Jun. 2020

‘Bottle of Lies’ takes us into a world where generic drugs are designed and manufactured. Generics, through reverse-engineering, are produced to act like the parent, brand drugs from which they are derived. They are not identical to these, but are meant to be bio-equivalent.Katherine Eban’s investigation, guided by a handful of intrepid and determined whistleblowers and inspectors, brings us to places where deception and fraud are the norm. Where unapproved materials and unregistered active ingredients are substituted for genuine ones as secret changes are made in formulation. Unfavourable test results are concealed. Data is manipulated. Everyone working for the company is a participant, enjoying gaming the regulations, or simply trying to earn a living under duress. The Indian drug firm, Rambaxy, after an investigation lasting for several years, pleaded guilty to criminal charges and, in May 2013, was fined $500 million by a court in the US.The consequences of a market flooded with inferior drugs are worst for countries like those of Sub-Saharan Africa, where regulation is weakest, but can be found anywhere on Earth. Antibiotics not potent enough to destroy bacteria have resulted in the deaths of children. Vials of insulin, meant to be sterile, but contaminated with microbes have been released on to the market. Adulterated heparin from China, inadvertently given to patients on dialysis, caused around 100 deaths in the US. A generic antidepressant from Israel lacking the time release mechanism of its branded parent brought numerous complaints of severe side effects, including suicidal thoughts.‘Bottle of Lies’ is about the drug companies, but it is also about the ineptitude of the American Food and Drug Administration. Conscientious and hard working employees, focussed on patient safety, found their efforts undermined by an organisation which gave priority to ensuring smooth trade with countries like India and China, and a smooth flow of drugs, however defective, to American patients.Katherine Eban has written an outstanding and necessary book. Perhaps the next question that needs to be asked is ‘Why have we become so dependent on drugs, and thus so vulnerable to exploitation?’

Do you buy into the empirical dogma that generics and brand name drugs are the same? If so, dialectically challenge yourself and buy this page-turning book...

Katherine's exposé of dangerously substandard generic drugs and the horrors of Ranbaxy is a veritable life and death warning to us all. I applaud her investigative journalistic skills to present the truth in such exquisite and painstaking detail.Thank God for people like Dinesh Thakur, he is a hero and a martyr. Bravo Dinesh! The honesty and integrity of some rare souls is an example to us all and gives hope in a world where profit is the false god to be worshipped by sacrificing every vestige of ethical sensibility and moral conscience.Excellent book. Heartfelt thanks to the author for exposing the hideous greed and hypocrisy of these profit-driven companies who have no regard for human life and suffering.

An interesting read. Quite a gripping detective story, in fact, and maybe worth a 3-star rating on that basis. But the cover blurb which led me to buy the book suggests a global overview of the generic drugs industry and its possible malpractices, when in fact it is largely the story of the fraudulent practices of one outfit based in India. A large outfit, to be sure, but only one. Should the whole industry be tarred with the same brush? I haven't quite finished the book,but so far that question hasn't even been mentioned. It looks like the "global" aspect of the title was designed to lure in a wider audience for what is largely the history of an isolated case.

Good book

The book was rather spoiled for me by the breathless personalisation of so many of the events described. Far too many pages are wasted on the background of many of the people involved, their education, their family lives, the impact on them of ongoing involvement with the production of generic drugs.This is a common failing among journalists writing business books, but Eban’s approach is more irritating and obtrusive than most.Which is a pity, because there is a lot in the book to admire, a really important story well researched. It could have been a five starrer.I had no idea that bio-equivalence was such a broad target, that even properly manufactured generics could legitimately be so different in effect from the drugs they are copying, particularly when time lapse tolerances are taken into account. I did not know (tho probably could have guessed) that constraints on FDA inspections in countries such as India and China present opportunities to game the system that are not available to US manufacturers.I learnt that Generics that fail the standards required to be sold in Europe or the US find their way to India and other Asian countries, and that drugs so poorly made that they would even fail regulatory requirements in these countries are dumped in Africa.Eban’s analysis is powerful and convincing. I would thoroughly recommend anyone with an interest in the subject to read this book. Just be prepared to skip over the tiresome padding.

Interesting insights into the generic drugs business, enjoyable and thought-provoking read.