Generic: The Unbranding of Modern Medicine

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.)