Episode 104: Katherine Eban talks about the dangers associated with relying on generic drugs manufactured overseas
// Mar 10, 2020
Today’s interview is with Katherine Eban, an investigative journalist who uncovered the widespread fraud that goes on overseas in the manufacturing of U.S. generic drugs.
With the outbreak of the deadly coronavirus, which originated in China but is now spreading across the globe and United States, today’s interview is especially timely. Katherine’s recent book, “Bottle of Lies,” reveals that nearly 80 percent of the active ingredients of all brand-name and generic drugs as well as almost all of our antibiotics in the U.S. are made outside of the country, mostly in China and India. Today’s interview highlights the dangers Americans face in outsourcing the quality and safety of its brand-name and generic drugs to overseas manufacturers.
Katherine is an investigative journalist who has written award-winning stories that range from pharmaceutical counterfeiting to gun trafficking to even coercive interrogations by the CIA. Her first book, “Dangerous Doses: A True Story of Cops, Counterfeiters and the Contamination of America’s Drug Supply,” was named one of the Best Books of 2005 by Kirkus Reviews.
“Bottle of Lies: The Inside Story of the Generic Drug Boom” is a New York Times bestseller that came out in 2019 and was named one of the top 100 notable books of 2019 by the Times.
Show notes:[00:03:16] Dawn opens the interview mentioning Katherine’s appearance on Peter Attia’s podcast. [00:04:30] Ken asks how Katherine how she ended up living just three subway stops from where she grew up in Brooklyn. [00:05:01] Katherine talks about how despite her talent and interest in writing, she at one point joined the circus in high school and considered going to clown school after she graduated. [00:06:02] Dawn asks how Katherine ended up in Rhode Island to attend Brown University instead of going to Florida to attend the Ringling Brothers Clown College. [00:06:47] Katherine talks about her time at Brown University editing the school’s literary magazine. [00:07:24] Ken Asks about Katherine’s time at Oxford University as a Rhodes scholar. [00:08:37] Dawn asks how Katherine, a woman who holds a Master’s degree in 17th Century English Epic Civil War Poetry, became a journalist. [00:10:23] Dawn asks about Katherine’s first big story, which also happened to be her first story. [00:11:49] Dawn asks Catherine long she worked at the New York Times. [00:13:07] Katherine explains how she came to write her first book, “Dangerous Doses: A True Story of Cops, Counterfeiters and the Contamination of America’s Drug Supply.” [00:14:56] Dawn mentions that after the publishing of “Dangerous Doses,” Katherine spent a decade investigating the generic-drug industry, an investigation sparked by a phone call from a colleague who asked for her help. [00:16:17] Ken asks about the difference between a generic and brand-name drug, and what is involved in the process of reverse-engineering a drug. [00:17:43] Dawn asks about the series of interviews Katherine conducted with patients sharing their experiences with generic drugs, which led to a story she wrote for “Self” magazine in 2009. [00:20:15] Ken mentions that in the “Self” magazine article, Katherine wrote about Dr. Kesselheim, an instructor at Harvard Medical school who reviewed data from 47 clinical studies. He found no evidence that patients on brand-name cardiovascular drugs had outcomes superior to those on generics. Given this study is now 10 years old, Ken asks if anyone has revisited this analysis. [00:21:25] Katherine tells the story of her anonymous informant that contacted her about a month after the “Self” magazine article, who went by the pseudonym “4 Dollar Refill.” [00:22:38] Dawn mentions that over the following five years, Katherine wrote a series of articles about generic-drug quality, which culminated in a 10,000-word article titled “Dirty Medicine” published in Fortune Magazine in 2013. [00:24:03] Dawn mentions that a reason that generic drugs account for 90% of the drugs in the U.S. is that generics are so much cheaper than brand names. She goes on to ask about how in “Bottle of Lies” Katherine explains why the low cost of manufacturing in India and China has created issues for the American consumer. [00:25:08] Dawn asks about the Carnegie Fellowship Katherine received in the midst of working on “Bottle of Lies.” [00:26:42] Ken asks Katherine how many interviews she had to do for her book. [00:27:11] Katherine talks about how the plan to help Africa during the AIDS epidemic laid the groundwork for some of the corruption she laid out in “Bottle of Lies.” [00:29:14] Katherine tells the story of Harry Lever, a cardiologist at the Cleveland Clinic, who started noticing his patients suffering from low platelet count after taking heparin, which raised his concerns, and led him to discover that heparin had been contaminated in China. [00:30:10] Ken asks what the average person can expect if they tell their pharmacist that they do not want the generic version of a drug that their doctor prescribed. [00:31:26] Dawn asks if this problem is being substantially driven by insurance companies. [00:31:56] Ken asks what it was that caused generic drugs to make up 90% of the drug supply today, when in 2009 they only made up 60%. [00:33:16] Dawn asks about Peter Baker, a young FDA investigator, who ended up in New Delhi looking into Indian drug manufacturers. [00:34:17] Ken asks about the obstacles Peter Baker faced. [00:36:47] Katherine explains what the protocol is when an FDA investigator finds contamination. [00:38:18] Dawn asks about Peter Baker’s investigation into the Wockhardt plant. [00:41:22] Ken asks Katherine to tell the story of Ranbaxy, India’s largest drug company. [00:44:27] Katherine how Dinesh Thakur became a whistleblower. [00:45:51] Ken asks what happened to Ranbaxy. [00:46:29] Katherine explains why Peter Baker eventually left the FDA despite the good work he was doing. [00:48:18] Dawn mentions that in light of Baker’s and other FDA investigators’ discoveries of fraud and corruption in China and India, stronger regulations are needed in order to protect consumers. She asks if Katherine has a sense of what direction the FDA is headed in that regard. [00:49:39] Ken asks if we should start producing more of our own drugs in the U.S. [00:50:30] Katherine explains the resource on her website titled “A Guide to Investigating Your Own Drugs.” [00:52:21] Dawn asks about Valisure, a mail-order pharmacy that tests every drug that they dispense to ensure quality. [00:54:18] Dawn mentions that Katherine was recently in India to do some talks and book signings, but that she had concerns about the reception because the Modi Government had put out a statement saying that it was going to take action against her book. [00:55:39] Ken asks if Katherine is working on any new projects at the moment. [00:56:13] Ken asks if Katherine is still in touch with Harry Lever at the Cleveland Clinic, or “4 Dollar Refill.” [00:56:47] Dawn closes the interview asking about Katherine’s 187-pound dog Romeo.