An eye-opening exposé on generic drugs.

Given the greed of pharmaceutical companies, writes investigative journalist Eban (Dangerous Doses: How Counterfeiters Are Contaminating America’s Drug Supply, 2005), cheap generics are essential to money-strapped consumers—and that just may be a death sentence. There are many players and levels in this excellent book, a solid mix of the history of generic drugs, whistleblower tale, and pharmaceutical detective story. The whistleblower in question is a young executive and systems engineer from India, lured home after being educated in the United States to work for a huge pharmacological concern that specializes in making generic drugs. There’s a fortune to be made there, Eban writes, especially for the first to market, who can enjoy a brief monopoly. The margins are further improved by eliminating key steps in the quality-control process—and then cooking the books when investigators from the Food and Drug Administration come to inspect. The executive in question sounded the alarm, his charge backed by on-the-ground evidence from an FDA investigator. However, he faced prosecution, not least on the part of the FDA and U.S. attorney Rod Rosenstein. “My reporting,” writes Eban early on, “led me into a web of global deception”—and, she makes clear throughout this long but tightly narrated book, that deception may well prove fatal to medical consumers. This is especially true in the developing world, she writes, for if substandard drugs are regularly shipped from plants in India, China, and elsewhere to the U.S. and Europe, the really ineffective, dangerous stuff is headed for markets in Africa, South America, and Asia: EpiPens, AIDS cocktails, cures that may turn out to be poisons. For all the efforts of that FDA inspector, writes the author, the new antiregulatory FDA now gives foreign companies advance warning of inspections, allowing the deception to grow and flourish as suspect drugs continue to roll in, “including a crucial chemotherapy drug for treating leukemia and breast and ovarian cancers.”

An urgent, alarming work of health reporting that will make you question every drug in your medicine cabinet.

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