Life Threatening Dangers of Generic Prescriptions with Katherine Eban

DR. MIKE MORENO: Welcome to Wellness Inc. I’m Dr. Mike Moreno. Taking a deep dive into the big business of wellness. After 25 years of practicing medicine, I am fascinated with the booming wellness industry. I’ll be exploring apps, gadgets, and discoveries. Everything new to help us all get and stay well.

Our guest today is an award-winning investigative journalist for Forbes and Vanity Fair and author of the critically acclaimed book “Bottle of Lies.” This book spans a ten-year journey to uncover fraud, lies and deceit in overseas generic drug plants. While we’ve been reassured that generic drugs are identical to their brand name counterparts but less expensive, today’s podcast will explore why this isn’t always true. Ultimately, the goal being to help you choose generic drugs wisely, to protect your health and your well-being. I want you to get ready to hear some shocking stuff from my guest, Katherine Eban. Katherine, thank you so much for being here.

KATHERINE EBAN: Thanks for having me. Great to be on with you.

DR. MIKE MORENO: Really, I have to tell you, the book is fascinating. After practicing medicine for 20 years, as I read through the book, I have to ask this first question, which was at the very beginning, when you talk about being in India, China, and Mexico City, where they were watching you. I mean, it had to be a little scary doing this stuff.

KATHERINE EBAN: You know, it was actually. Some of the reporting felt pretty harrowing because I was out there on my own. I was meeting with sources. I knew that the generic drug industry sort of had their eyes on me and I thought, you know this could go any which way, but on the other hand, you know, I felt really compelled to tell this story because I felt if I don’t tell this, I’m not sure this information will ever be exposed.

DR. MIKE MORENO: Right. Well, I along with many other people in this world, thank you particularly in our country. When I read that line, I got chills. I’m thinking, oh my gosh, you know, it’s always sometimes scary when you’re in another country as it is, but you should be doing this kind of stuff. I was like this is a brave woman. So, I, along with everybody else thank you. So, let’s dive into this. Can you give us and the audience a little bit of kind of a history of the FDA? I think it’s fascinating and I don’t think a lot of people really know.

KATHERINE EBAN: Yeah. So, you know today we just all take for granted that our drugs, if they’re approved by the FDA and they have to be to be sold here, that those drugs are safe and effective, that every pill that we take from a bottle is going to be the same as any other. It’s going to work identically, but there was a time in America where that absolutely wasn’t true. There was essentially no FDA. Companies did not have to prove that their drugs were safe or effective in order to market them. There’s one quote in my book, you know, that companies would just sort of throw things together and so long as they didn’t explode, they were put on sale.

DR. MIKE MORENO: It’s amazing. You bring up in your book as well that the FDA regulates and I found this fascinating as well, a fifth of the U.S. economy. That’s big, I mean, the US economy, if you think about how much we’re talking about and you talk about 20 percent of that, it’s absolutely incredible. So, talk about how the US was able to dodge this bullet by not approving a drug that was causing all these side effects and all of these things in birth defects and all these other things that we’re going on, like how do we maneuver through this?

KATHERINE EBAN: Yes. So, this was back, I think you’re referring to the Thalidomide chapter.

DR. MIKE MORENO: Exactly.

KATHERINE EBAN: This was back in the 1960’s and there was a drug called Thalidomide. I think Kevadon was the brand name of it, and it was being widely dispensed in Europe to pregnant women who were having trouble sleeping. Well, there was an FDA reviewer named Frances Kelsie and she just didn’t buy what the company was telling the FDA. She kept asking for more safety studies. The company executives would not provide that information. She did not approve the drug. She didn’t rubber stamp and really a whole generation of mothers and children owe her a debt of gratitude because that drug Thalidomide, was linked to horrible birth defects. Babies who were born with flippers instead of arms. Because Frances Kelsey held the line, the only birth defects linked to it were samples that were dispensed. 17 cases in the US as opposed to thousands. So that was a bullet that we dodged and that actually led to more stringent regulation.

One of the things reporting this book that is so clear, no matter what any of your listeners may think of regulation and regulators and they’re so fussy and it’s so onerous, but the truth of the matter is that those regulations are absolutely critical to ensuring health and safety.

DR. MIKE MORENO: What was another shocking thing was how the FDA inspections take place here vs in other countries. It’s like having the answers to the test. You know, it was crazy.

KATHERINE EBAN: Well, this is the thing, the system that we have here is problematic. It’s full of holes, but there is a time where we didn’t even have this flawed system and people were getting medicine with mercury in it and going blind and hair falling out and getting radium poisoning from all kinds of drugs. So, our system now is way better than nothing and it needs to be way better than it is.

DR. MIKE MORENO: Yeah, there’s no doubt and it was really shocking to see that when they do their investigations or when they do their inspections of the US and our production company and our lineage and how that works, they can just knock on your door essentially and say, hey, we’re here. If you have a heads up and you know exactly which things need to be buttoned up and taken care of and if that’s what’s going on in other countries and then we’re getting these medications from other countries, it’s a real cause for concern. I get it.

KATHERINE EBAN: Yeah. I mean, so the two big things that the book exposes is systematic fraud in the overseas plants that are making most of our low-cost medicine. Manipulation of data to make these substandard drugs look better than they are, but then this crazy system whereby the FDA gives overseas plants two months of advance notice coming. So, some of these plants even have data falsification teams that go in in advance of the FDA and alter documents, invent documents. In one instance, a company even steamed documents overnight in a sauna like room to make them look old, so it’s mind boggling.

DR. MIKE MORENO: Like I said at the beginning, it is like a Tom Clancy novel reading this book, because it really it’s fascinating. I had to stop myself several times. I’m like, is this like a novel or is this actually happening? Yeah, it was fascinating. It was mind boggling that this stuff is happening. So, I’m going to remind you guys, if you have not read this book, trust me, it is an amazing read. It is not just these facts. It is a beautifully told story and something that, again, we thank you for doing. So, let’s dive into this a little bit. Let’s talk about generic drugs and how did they begin and how did they get into our system and the whole landscape of modern medicine? How did this happen?

KATHERINE EBAN: Right, so with brand name drugs, which are developed by so-called “innovator companies.” Right? They invent the molecule. They market the drug. They have a patent. So, they have intellectual property protection. So, when the patent lapses or when a generic company feels that it has a legal argument that it can make the drug, that matter usually winds up in a court. And generic companies if they prevail what they have to do is reverse engineer the drug. It’s not as if the brand company says, “hey here’s the recipe and here’s how you make it.” The generic company essentially has to go through a scientific process of guessing how to make the drug. They have to invent their own time release mechanism. They have to break it down in a lab. So, the resulting generic has to use the same molecule as the brand name drug, but a lot of other things about it can be different. So, it is not an exact copy. It is a version of that brand name drug. In fact, there can be a sort of a wide range in the amount of absorption into the blood. It can be quite different.

DR. MIKE MORENO: So as a physician, I cannot tell you how many times, you know going through the science, and I don’t want to turn this into a biochemistry discussion, but you can take a simple molecule that may represent a pharmaceutical drug and you could sort of tweak a carbon level or add a hydroxy group or just to alter it just a little bit, but I don’t think that you can assume that that minor alteration, however, maybe it doesn’t affect the active portion of the molecule, can be an issue for a lot of people.

KATHERINE EBAN: Right, and so especially for patients who are taking medicine where precise dosing is super important. So those are called narrow therapeutic index drugs for cardiologists, urologists, endocrinologists. They find that when their patients are getting switched from brand to generic or generic to generic, often a patient who was stabilized becomes unstable.

DR. MIKE MORENO: So, to give an example like Coumadin. Coumadin is something a lot of the anti-seizure medications, Dilantin, and things like that monitor levels. I can’t tell you how many times over the years do you say, listen, all of a sudden the level goes up or down or whatever it may be, it changes, and you say to yourself maybe this patient’s not taking the medication or they’re taking it wrong or whatever and it turns out that maybe something like what you’re speaking of that can cause these problems.

KATHERINE EBAN: Absolutely, and the thing is, most patients don’t realize you know, if you take a monthly medication, you go to a pharmacy you may not realize that you’re the manufacturer of that drug has been changed. So, you can have a change from month to month and you wouldn’t necessarily know, and your doctor does not know.

DR. MIKE MORENO: Right. I think important, I think I know the answer, but I’m going to defer to the expert. But when we talk about how long these people can hang onto these patents, it is years and years and years and then they can file for extensions to extend their patent. And unfortunately, it comes down to a big dollar sign for a lot of big pharmacies. It’s frustrating because, again and I said at the beginning, we’re talking about human lives and we’re talking about whether it’s from this country or another. We’re talking about people who are ingesting something, and they trust the process that people have gone through to obtain this medication. I mean we all probably would, and it can be really harmful.

KATHERINE EBAN: Absolutely. So, you know as an example, there could be a ton of political pressure on the FDA to get a generic approved. A good example of that is Lipitor. You know, senators were writing to the FDA saying, what are we going to get generic Lipitor? The problem was, the generic company that had gotten approval for Lipitor was completely fraudulent, called Ranbaxy. It was an Indian generic drug company. A whistleblower had come to the FDA with documents, this is a big story in my book, to say this company has committed fraud on a massive scale. The FDA knew that and yet this company was first in line to make generic Lipitor. It was a big Indian company, Ranbaxy.

DR. MIKE MORENO: Wow.

KATHERINE EBAN: The FDA ended up approving that company to make the first version of generic Lipitor.

DR. MIKE MORENO: I think it’s important to point this out. I’m going to do it now and I’m going to do it again to remind people who are listening. You’re not someone who’s just completely against generic drugs. I know that from reading, but you’re someone who wants people to understand and know the facts, but I think it’s important to make that clear. You’re not some cowboy out there saying all generic drugs are bad. It’s that we just need to be consumer where we need to kind of make sure we know what we’re taking and where it’s coming from in the process.

KATHERINE EBAN: Absolutely right. I take generic drugs myself and we need them. We absolutely need generic drugs. Most of us can’t afford brand name drugs, but we need them to be of high quality. So, one of the issues is, generics come on the market and the price drops through the floor. Then the question is, what is the incentive for a company that is operating in India say, with minimal scrutiny from the FDA to not cut corners and to not falsify quality data?

DR. MIKE MORENO: Right and especially, like you said, when the FDA lets, you know, two months ahead of time, hey, we’re going to be coming over and you may want to know, here’s the day, here’s the time. Make sure you have everything taken care of so that we can make sure this is all okay and approve everything. That’s a scary, scary thought, I got to tell you.

KATHERINE EBAN: Yeah, so the FDA did this little experiment for about a year and a half where they said okay, we’re going to stop the advance notice for manufacturing plants in India was called the India Pilot Program. And we’re just going to give them a couple hours advance notice and we’re going to show up. Wow. When they did that, they found crazy stuff like, for example, a sterile manufacturing plant. It has to do microbial testing of its air, its water, its surfaces. There was a plant that had perfect sterility data. The only problem is they weren’t testing anything. All of the data was fake. They had perfect paperwork corresponding to no samples.

DR. MIKE MORENO: Wow. So, they knew exactly what they needed to do and presented that and said, here you go, we’re all good.

KATHERINE EBAN: That’s right. Another thing that some of these unannounced inspections have turned up during that pilot program, infestations of monkeys, of snakes, of pigeons. I am totally pro animal, but not in a sterile manufacturer.

DR. MIKE MORENO: I’m with you. I have two cats and I love them dearly, but I would not want them around Lipitor. That would be unthinkable.

KATHERINE EBAN: Right or open vials of injectable drugs.

DR. MIKE MORENO: Yeah, you know, it’s interesting because I’ll tell you when I talk to my patients and it just goes to point out a quick fact that as physicians out there and I’m hopefully some physicians out there listening, listen to your patients, hear what they say, because I think there’s a lot to be said and you pointed this out earlier, that there are subtle differences and patients will tell you listen, I don’t know what it is, but I don’t feel the same. I don’t think it’s just coincidence that it happened to be when you’re transitioning from a brand name to a generic. So, it’s super important to hear your patients out for the physicians out there listening to this. There are some things a lot of people say well, it’s all about just in their head and this and that and they know it’s generic, I think there’s some truth to that, but I also think we need to take time to listen to our patients and hear what they’re saying.

KATHERINE EBAN: I have had a number of doctors come up to me after reading my book and say you know, I thought that my patients were just sort of being whiners and complaining. Saying oh my drugs aren’t working, and it turned out low and behold that they were right.

DR. MIKE MORENO: Absolutely. Like you said, it’s not all generics. I think if things are done properly, as you said, we need generics. We get it when we talk about costs of medical care in this country and the costs of drugs and big pharma, you know the list goes on and on. We need these generics, but I don’t think it’s a lot to ask that they’re done properly.

KATHERINE EBAN: Oh absolutely. So, then the question is how? You know, now starting in about I mean, this is really an issue of globalization, because starting in about 2004 the FDA suddenly had more manufacturing plants to inspect overseas than they did within the US. So suddenly this domestic agency became this global watchdog, this global policeman. Really, how are they supposed to do all of that?

DR. MIKE MORENO: Right. And I remember in the book, it said they were supposed to do it on a certain time frame, and it would be two or three or sometimes more years before they got to the plant to inspect it.

KATHERINE EBAN: Oh absolutely. In fact, until relatively recently, some plants would go a decade without being inspected and then they would give them months of advance notice. And is one of my sources said to me, you know these plants, they will do whatever they have to do to pass an FDA inspection because millions of dollars are at stake. So, give them a weekend, they can put up a building.

DR. MIKE MORENO: Exactly. Now, I want to get into this a little bit because this was also fascinating. Tell us a little bit about the FDA inspector who uncovered a lot of this fraud that was going on.

KATHERINE EBAN: Yeah, so he’s an important character in the book. His name is Peter Baker, and he was a young, energetic inspector who was very unsatisfied with the two months of advance notice showing up at the plant, getting the dog and pony show in the welcome ceremony and the video and all of that. So, what he did is he started looking, not just saying, can you printout this data for me? What he did is he looked inside the company’s computer systems. And once he did that, what he uncovered was a completely hidden world of secret testing.

Which means that these companies were pre-secretly prescreening their drugs to sort of forecast what the test results would be and then figuring out if the drugs were not going to pass, how to alter the parameters of their testing and then running the tests again on the official system that the FDA was going to look at. What he found was metadata that was left over from this trail of deleted tests and that’s how we piece together a really remarkable amount of fraud. So, over the course of four years, he inspected about 86 drug manufacturing plants in India and China, and he found data fraud in 67 of those plants. Like four fifths of those plants.

DR. MIKE MORENO: So now the question everybody has is what happened as a result of him making these findings?

KATHERINE EBAN: Well, one of the things that happened, you would think he would have been steadily promoted and now he’s the FDA commissioner. Well, this story doesn’t go like that.

DR. MIKE MORENO: That’s why I’m asking. I love it.

KATHERINE EBAN: Yeah. So essentially, he went to his supervisors and he was like look, let me train the other FDA inspectors to find this stuff. Right? Instead, what the FDA, his supervisors and bureaucrats were doing back at FDA headquarters in Maryland, is they were downgrading some of his findings. So, he would uncover horrible fraud, he’d recommend serious sanctions, and they would essentially let these companies off the hook. Then they basically kind of reduced the number of inspections he was doing and essentially forced them out of the agency.

DR. MIKE MORENO: I mean, it’s unbelievable. It’s like you said, you would think he would be promoted, and he would be sitting on this grand office with everything going for him. It’s terrible. So, we talked. Let me ask you this, Kathy. We talked a little bit about Lipitor. I think a couple of other ones that really come to mind. I’m thinking of my population of patients and probably a lot of people out there, Accutane.

KATHERINE EBAN: Oh, yeah. So, Accutane is an acne drug that was given to a lot of teenagers. The big problem with Accutane is that it created a spark suicidal tendencies. So, the drug is a scary drug that’s effective, but scary drug. It was given what’s called a black box warning, which is very significant, where the FDA is flagging, his is very serious set of circumstances. It has to be monitored closely. Well, this company, Ranbaxy, they were selling a generic version of Accutane. It was called Sotret, and they discovered that the drug, their version was dissolving improperly. So scary.

DR. MIKE MORENO: So that’s a big deal. I mean, for people listening that just think, well, so it dissolves, you’re still ingesting it. It’s going where it’s supposed to go. But the medication dissolving in your system and how it’s distributed is a big, big deal.

KATHERINE EBAN: Yeah. And of course, I mean all bets are off as to the reaction, it could be toxic. All kinds of consequences can result from that. So, you know under the rules what they were really required to do is say to the FDA, we have this problem and we’re going to pull the drug off the market. We’re going to try to fix it and we’ll come back to you, but they didn’t do that. So, what they secretly did, they buried their findings, and they kept the drug on the market and then they secretly went back into their lab while it was being dispensed to American patients and tried to solve the problems.

So fast forward about four years. There’s a whistleblower inside Ranbaxy that’s come to the FDA. Dinesh Thakur, a very brave man. The FDA ends up serving a search warrant at Ranbaxy headquarters and they find this document, which is the secret report about all of the problems with Sotret, and the cover page says in big, bold letters “Do Not Share With FDA”.

DR. MIKE MORENO: I remember that. Listen, guys, like I said, this reads like a Tom Clancy novel. It’s amazing. I was in the first chapter. I was like, what is going on? I was still taken back by the whole, when you were in an airport or something and it said, we are watching you. You got a message on your cell or something. And I was like oh God. So, let’s transition a bit. Let’s just ask the question, how much has changed since your book has come out?

KATHERINE EBAN: My book got a lot of attention and there have been a number of congressional hearings. In Congress, at this point is really focused on this very broken FDA system, but now we’ve got coronavirus on top of it, so this is just now we’ve got this huge disaster on top of the old disaster. One of the things that this pandemic has done is exposed the unbelievable hazards and national security risks of being so dependent on drugs from China and India. Of course, in the midst of all of this, our own inspectors couldn’t even travel to India or China to do inspections. So suddenly our whole drug supply is running on an honor system. Right? I mean, the FDA put out this document that was supposed to reassure us saying well, we can’t go to these plants right now, we’re suspending our inspections, but don’t worry everybody because we’re accepting data from these companies. Right? So, for people who understand how broken this is we’re like oh my God… You know, there’s no there’s no verification. Zero.

DR. MIKE MORENO: So, I mean, since you transition to coronavirus and I think it’s on the top of all of our minds, let’s talk about some of the shortages. It’s all over the news. We see it all the time. Let’s talk about the shortages that we’re seeing because of this pandemic. Talk to us on that whole thing. It’s going to put us at greater risk.

KATHERINE EBAN: Yeah, I mean, the shortages really have been serious out of the gate, and they have actually led to a further decrease in standards. So as an example of that, When President Trump was talking up hydroxychloroquine from the White House podium, saying the drug was a game changer. Suddenly the drug was in short supply all over the world. So, everybody on planet Earth wants this drug and it’s an old malaria drug.

DR. MIKE MORENO: That’s been around for a long time.

KATHERINE EBAN: Yeah, and patients who have lupus and arthritis also use it. So, the FDA’s given this mission to go find any bit of hydroxychloroquine anywhere on planet Earth. Look under every bush and tree. They get a donation of chloroquine phosphate, but basically a similar drug which is made in a plant in Pakistan that has never, ever been inspected by the FDA or any of our regulatory partners. No one except for Pakistani regulators has ever set foot in this plant and we’re suddenly taking millions of pills from this plant, sight unseen.

DR. MIKE MORENO: Yeah, it’s I remember when all of this coronavirus started a good friend of mine who’s the orthopedic surgeon in New York City, obviously they were devastated by this whole thing initially and it’s slowly made its way, but I remember having a conversation with him and he was like you know, orthopedic surgeons don’t generally deal with hydroxychloroquine, of course, me as a primary care guy does. He’s like what is this drug hydroxychloroquine, and can you get me some? And I was like, listen get a hold of yourself. So, and then as times gone on over the last several months, we’re finding that it’s not this magical thing that we thought it was.

KATHERINE EBAN: Right. And the thing is, there are ways there are scientific methods for figuring out what drugs work for what disease they’re called clinical trials. They are important. I mean, these are standards that are important. You don’t just throw them out the window because we’re in the middle of a massive crisis which we are of course.

DR. MIKE MORENO: So, you know, so let’s talk about what everybody wants to know which is. All right so I hear what you’re saying, I hear all of this stuff. They’re probably shocked that this stuff is actually going on. So, if we’re dependent on these cheaper generics, like what can we do as a consumer? Like, give us some nuggets for people listening. Like what should I insure like how do I know they’re safe? And what are some steps? I mean, you obviously can’t have every answer, but what are some things you’d recommend people to do?

KATHERINE EBAN: Yeah, so this is the number one question that I’ve gotten from readers of the book and concerned consumers. So, what I ended up doing is creating a guide to investigating your own drugs, which is on my website, www.KatherineEban.com. The number one first step is to actually pay attention to who is making your drug. When we when we go to pharmacy, most of us never even look at who the manufacturer is.

DR. MIKE MORENO: No never.

KATHERINE EBAN: And the reason we don’t is because the FDA has reassured us that it’s all the same. Right? There’s no difference.

DR. MIKE MORENO: I think people are handed a stack of papers with a list of ten thousand side effects, potential side effects, which they’re like looking through this. I mean it’s like a PDR that they’re handed with your medication, it’s ridiculous.

KATHERINE EBAN: Right. So, nobody pays any attention to that, but actually, the first thing that consumers need to do is pay attention to that, especially if they’re on a monthly medication. So, if that drug is working and you’re not having side effects, it’s effective, you feel fine. You want to stay on that manufacturer, and you can’t do that unless you know who made it. If you suddenly feel funny, you feel strange. You’re having side effects. You want to get off of that manufacturer’s version. So, in a lot of cases, you can request a certain generic manufacturer and I do it all the time.

DR. MIKE MORENO: How about this, because I know a lot of people are going to wonder: Over the counter drugs. I mean over the counter drugs, so many supplements, so many things that you can now just walk into a grocery store buy or you can get online. It’s shocking what you can now just get online with. It’s insane, right?

KATHERINE EBAN: So that’s a great question. I mean, I could have written a whole separate book about over the counter drugs. You know the short answer is be very afraid. If you go into a CVS or a Walgreens or a Duane Reade, that you will have access to the drugstore version of cough syrup, Pseudoephedrine medicine. Usually, those drugs are made by these very low-cost Indian manufacturers who are operating under contract with those pharmacy chains. Those auditing contracts are terrible, like CVS says okay, we have the right to inspect you once every five years and we have to give you two months of advance notice. The FDA looks at the over the counter drugs a lot less than they do the prescription drugs. So, it’s dodgy.

DR. MIKE MORENO: You know, I tell my patients all the time because people assume if you can just walk into a drugstore and buy something or get it online, that it must be completely safe. So, there’s one element of you know, where is this drug coming from and where is it being manufactured? Then there’s the other thing about really knowing the drug interactions and what is a quality product. And so, for my own knowledge and I can’t wait to get your answer, I’ve always gone by and I shouldn’t say always, but I’ve I put a lot of worth into the GMP products, which is a good manufacturing practice. My understanding it’s a third party that inspects that makes sure that what you’re getting in that bottle is actually in that bottle. Tell me about GMP a little bit. I think that’s a helpful thing for people to know because you’re going to see that on a lot of labels and if you don’t, I think it’s time to be suspect.

KATHERINE EBAN: Right well so you know, any product that is sold in the United States that is regulated by the FDA has to be manufactured using good manufacturing practices. The FDA inspections basically check for those. Right. Is that company, is that brand complying with those regulations? So, then there’s this whole separate subset of products that are really minimally regulated by the FDA, like supplements. A lot of those companies will make all kinds of claims about quality, many of which are just not true at all. So, I basically feel just for me, for my family, as broken as the FDA system is, I do not want to be taking anything that has been made in a plant where the FDA hasn’t inspected. Some of the pictures that I have seen out of these plants in India where they’re making over-the-counter drugs, they are just ghastly conditions, you know, bathrooms with no drainage piping. Nightmarish things and then you think about actually ingesting something.

DR. MIKE MORENO: That’s the point I was just going to get you. I’m like we’re not talking about rubbing like a bomb on our skin guys. We’re talking about ingesting this and having it absorbed in our bloodstream run through our body. I think there’s just a lot of like we just trust people, you know. I don’t think there’s an intent here that someone wants to do harm. You know, we take a Hippocratic Oath when we graduate from med school and that oath says do no harm. I don’t think by and large, for the most part, we are all trying to do the best that we can. Again, I want to point out that you’re not on some tirade against big pharma. That’s not your point. Your point is more let’s educate people. Let’s make people aware because, listen, it’s 2020.

I’m an old school guy, you know, I’m 52 going on like 82, but the world just went and got itself in such a hurry and we were just trying to keep up. So, a lot of these things will slip by us. Your book and your work is critical. Again, this is not about money although, you know I won’t even get into that discussion, but this is about the safety of individuals of a human life and it’s really, really amazing the work that you’ve done. One other thing I had to bring up was when you brought up going back to the in the book with the AIDS epidemic in Africa. Stunning 5,000 people a day dying. The orphans. I mean, I read that passage several times and I thought, my gosh… The orphan population was just substantially growing. 5,000 people a day. I mean, that’s amazing to me. Ridiculous to think.

KATHERINE EBAN: To the extent that the biggest industry in many African nations was making coffins.

DR. MIKE MORENO: Oh gosh.

KATHERINE EBAN: You know, so fast forward to these companies and what a number of these generic companies do and it’s pretty shocking is they engage in a practice called dual track production. They make one level of quality for the more regulated markets. So those are the markets in which they think they can get caught, right? Then they make another level of quality for minimally regulated countries like African countries where are assuming that nobody’s checking the quality of the drug. They are really dumping their worst ingredients, the most shortcuts into the drugs for those countries now. Your listeners might think well, that’s terrible, but it doesn’t affect me but actually it affects all of us. Yeah, because those substandard drugs and some potent drugs are actually contributing to drug resistance and that’s spreading all through the world. So, because of these low-quality generics it’s actually reducing the effectiveness of all of our drugs.

DR. MIKE MORENO: Yeah, and we’ve been talking about antibiotic resistance since I came out of medical school 24 years ago. It’s still present and it’s still a problem and it’s still a concern when you talk about superbugs that are out there, they’ve seen everything. When you bring it up and I got to be honest with you, I didn’t think of it in this way. I think of it more as a clinician and in my practice, but when you bring it up this way it’s even more of a concern. I can I get it. I mean I totally get it.

KATHERINE EBAN: Yeah, so it’s really, if you like basically under dose an entire continent of people you’re really messing with the effectiveness of some of the few weapons we have against these infectious diseases.

DR. MIKE MORENO: Right. I tell my patients about supplements and I share this with all of them. The thing I want to know about supplements is that it’s doing what it’s supposed to do, that it’s not harming you and that it’s not breaking the bank. I think those three things for those of you out there, let your doctor know, let them know what you’re on and be informed. I think the whole point and again, you have to get this book “Bottle of Lies”. You have to give this a read. It’s amazing. It was not, I got to tell you, Katherine, it was not what I expected and as I got into it, we all have a lot of time these days. I was riveted. It was like I was reading a novel and it was fantastic. I can’t thank you enough for it, for everything and for spending time with me and with the listeners. I think this information is so valuable. You know, any last words? What would you say to people out there listening with all of the work and all of the years that everything you’ve done, if you could just sort of give a finishing sentence to people and let them take away one thing, what would that be?

KATHERINE EBAN: I guess what I would say is it’s unfortunate that we have to be Sherlock Holmes when it comes to our own medication. It shouldn’t be that way, but I think once people become aware of what is going on than the path forward becomes clearer. For example, we need more information about our drugs. You know, why don’t we get country of origin labeling for our drugs, drug ingredients? You know my sort of my job as an investigative journalist is to turn on the klieg lights so we can all see what’s going on. See what scurries out from under the rock, essentially, but that’s those are the changes that we need. And so there needs to be a lot more transparency. I think the more patient that are aware of these issues, the closer we get to a consumer revolution on this.

DR. MIKE MORENO: Right, ask questions, be informed. You don’t need to become a biochemist or an expert, but a takeaway is, know what’s the country of origin. After talking to you, that seems like the one thing you want to know.

KATHERINE EBAN: Yeah, and at the moment, consumers, you really have to be an investigative journalist to find it out because that that information is not offered to consumers.

DR. MIKE MORENO: And with the danger you put yourself in, I’m going to leave that work to you. I’m not particularly interested in doing that. Katherine, where are people going to find you? Give us your social media. Give us a way for us to get to you, because I’m sure this was not even near enough information and people are going to want to reach out to you. So how can we find you on social media?

KATHERINE EBAN: Absolutely. So, I’m very active on Twitter @KatherineEban. You can contact me through my website, which is www.KatherineEban.com. I always love to hear from readers. Happy to interact.

DR. MIKE MORENO: Awesome. Katherine Eban, “Bottle of Lies”. You need to get this book. You need to read this book. Thank you guys. Katherine, I cannot thank you enough. Fascinating book. Amazing work. I got to tell you even after practicing as long as I have practiced, I was this opened my eyes. So, I want to thank you personally and professionally for the work you’ve done and for the listeners out there, this is going to be really helpful stuff for us moving forward.

KATHERINE EBAN: Thank you so much. Really appreciate the time to chat.

DR. MIKE MORENO: Thank you. So, everybody, thanks for joining us. I hope you got as much out of that as I did. Katherine Eban, really, really amazing work. I want to remind you guys to subscribe and download and listen to Wellness, Inc. with me, Dr. Mike Moreno. Have a great afternoon, evening, morning. Whatever it may be. We’ll see you very soon. Thanks. The Wellness, Inc. with Dr. Mike Moreno podcast is for informational and entertainment purposes only and is not intended as a replacement or substitution for any professional, medical, financial, legal, or other advice, diagnosis, or treatment. This podcast does not constitute the practice of medicine or any other professional service. The use of any information provided during this podcast is at the listeners own risk for medical or other advice appropriate to your specific situation, please consult a physician or other trained professional. Thank you.

About This Episode:

In this episode Doctor Mike Moreno talks to an award winning investigative journalist for Forbes and Vanity Fair and author of the acclaimed book “Bottle Of Lies”, which spans ten years and looks into issues with overseas generic drug manufacturing plants.

Americans have been re-assured that generics really are identical to name brands but this isn’t always true.

Today’s podcast is going to help you become informed about the realities of generic prescriptions so you can protect yourself and your loved ones.

Get ready to hear some shocking truths about generic prescriptions from today’s guest Katherine Eban.

Connect with Katherine Eban:

https://www.katherineeban.com/
https://www.facebook.com/Katherineeban
https://twitter.com/KatherineEban