The Chris Voss Show - The Chris Voss Show Podcast – Bottle of Lies: The Inside Story of the Generic Drug Boom by Katherine Eban

Episode Date: September 16, 2020

Bottle of Lies: The Inside Story of the Generic Drug Boom by Katherine Eban KatherineEban.com A NEW YORK TIMES BESTSELLER New York Times 100 Notable Books of 2019 New York Public Library Best Books of 2019 Kirkus Reviews Best Health and Science Books of 2019 Science Friday Best Books of 2019 New postscript by the author From an award-winning journalist, an explosive narrative investigation of the generic drug boom that reveals fraud and life-threatening dangers on a global scale—The Jungle for pharmaceuticals Many have hailed the widespread use of generic drugs as one of the most important public-health developments of the twenty-first century. Today, almost 90 percent of our pharmaceutical market is comprised of generics, the majority of which are manufactured overseas. We have been reassured by our doctors, our pharmacists and our regulators that generic drugs are identical to their brand-name counterparts, just less expensive. But is this really true? Katherine Eban’s Bottle of Lies exposes the deceit behind generic-drug manufacturing—and the attendant risks for global health. Drawing on exclusive accounts from whistleblowers and regulators, as well as thousands of pages of confidential FDA documents, Eban reveals an industry where fraud is rampant, companies routinely falsify data, and executives circumvent almost every principle of safe manufacturing to minimize cost and maximize profit, confident in their ability to fool inspectors. Meanwhile, patients unwittingly consume medicine with unpredictable and dangerous effects. The story of generic drugs is truly global. It connects middle America to China, India, sub-Saharan Africa and Brazil, and represents the ultimate litmus test of globalization: what are the risks of moving drug manufacturing offshore, and are they worth the savings? A decade-long investigation with international sweep, high-stakes brinkmanship and big money at its core, Bottle of Lies reveals how the world’s greatest public-health innovation has become one of its most astonishing swindles. About Katherine Eban Katherine Eban, an investigative journalist, is a Fortune magazine contributor and Andrew Carnegie fellow. Her narrative, deeply reported articles on pharmaceutical counterfeiting, gun trafficking, and coercive interrogations by the CIA, have won international attention and numerous awards. She lectures frequently on the topic of pharmaceutical integrity. Bottle of Lies: The Inside Story of the Generic Drug Boom, which she worked on for five years and reported on four continents, is her second book. Educated at Brown University and Oxford, where she was a Rhodes Scholar, she lives in Brooklyn with her husband, two daughters and Newfoundland dog Romeo.

You wanted the best. You've got the best podcast, the hottest podcast in the world. The Chris Voss Show, the preeminent podcast with guests so smart you may experience serious brain bleed. Get ready, get ready, strap yourself in. Keep your hands, arms and legs inside the vehicle at all times. Because you're about to go on a monster education roller coaster with your brain now here's your host chris voss hi folks this is voss here from the chris voss show.com the chris voss show.com hey we're coming here with another great podcast we certainly appreciate you guys tuning in be sure to see the video version of this at youtube.com for just chris voss hit that

bell notification button so you get all notifications of all the amazing authors we have i gotta tell you the publishing companies have me booked solid like i even had to just cap it at two a day they're just flooding me with all these brilliant great authors writers journalists reporters we're even getting co-editors, CNN anchors, just all the most brightest, brilliant people on the planet, the people who have all the great data information that can just make you so smart and better looking. And we've got one of those authors here today as well, and we'll be talking about that. Also, you can see all the wonderful books that we have interviewed so far, some that are pending on the schedule.

You can go to Amazon.com forward slash shop forward slash Chris Foss. That way you can, you know, just you can peruse everyone you've heard on the Chris Foss show, buy their books, support them, and all that good stuff. Today we have Catherine Eban on the show, and she is an investigative journalist. She is Vanity Fair's contributing editor and Andrew Carnegie Fellow. Her articles on pharmaceutical counterfeiting, gun trafficking, and coercive interrogations by the CIA have won international attention and numerous awards. Her first book, Dangerous Doses, A True Story of Cops, Counterfeits, and the Contamination of America's Drug Supply, was named one of the best books of 2005 by Kirkus Reviews and was a Barnes & Noble Discover Great New Writer's Pick. She lectures frequently on the topic of pharmaceutical integrity.

And today we're going to be talking about her second book. It's called Bottle of Lies, The Inside Story of the Generic Drug Boom. And this baby came out. It's a New York Times bestseller and New York Times 100 notable book of 2019. She uses in it a decade of reporting and reveals the endemic fraud and dire conditions in the overseas manufacturing plants where the majority of our low-cost generic medicine is made. You're going to find out a lot of stuff. She's educated at Brown University in Oxford where she was a Rhodes Scholar. See what I told you. We have the most brilliant people on. And she lives in Brooklyn with her husband, two daughters, and her Newfoundland dog, Romeo. Welcome to the show. How are you doing, Catherine? I'm great. How are you doing? Awesome sauce. So we've got your new book. In fact, my mom, she's, my mom's always been kind

of into, well, you know, she's older, so there's a lot of prescription stuff that she takes. And so I had her read your book and she loved it. She's all through here too as well. So give us your.com so people can take and look you up on the interwebs. Absolutely. So you can find me at CatherineEvan.com on Twitter at CatherineEvan. So I'm easy to find and love to hear from readers. Sounds good. And give us an overview of why you wrote this book and what

it's about. So in 2008, I got an unusual phone call from a radio show host. He has a program on NPR called the People's Pharmacy. His name is Joe Graydon. And he contacted me because he knew my work. He said that he was getting flooded with phone calls from patients who were having trouble with their generic drugs. Either they had side effects or the drugs didn't seem to work as well as their brand name. And he, given the volume of phone calls and letters, he believed the patients. And he took their complaints to the FDA. And officials there basically said to him, well, you know, it's probably psychosomatic. You go to a pharmacy, you get switched to a different drug. And, you know, it looks different. And so patients have a

psychosomatic reaction. In other words, it's all in their head. And Joe did not believe that. And he posed this question to me, what is wrong with the drugs? That was a hard question to get out of my head. And I began to look into it. And that's really where my 10 year reporting journey began. And so you've, I mean, this is a huge book when you really look at it. Look how thick this book is, people. It's a giant book. And you tell the story of the generic drug boom, basically how it started, I guess. And I believe it was in the Ronald Reagan era or it was Orrin Hatch or some other folks that helped start this generic sort of industry to begin? So, you know, I sort of look at two different origins for the generic drug boom.

One was in the U.S. There was a law that was passed, a bipartisan law, the Hatch-Waxman Act. And what that did is it told generic drug makers, in order to get your drugs approved by the FDA, you're not going to have to do the same massive clinical trials that the brand name companies do because we know that the molecules have already been approved. They're safe and effective. What you need to do is some tests to show us that your drugs are bioequivalent, that they work similarly in the body to the brand name drug. So you have to do some studies, you have to submit some data, you have to test it on a dozen or so more volunteers. And we'll review that. And then we're going to take a look at your

manufacturing plant and make sure you know, you're not just making this in some outhouse somewhere. And then you get approval to sell your drugs. But at the same time, well, actually, decades earlier, what was very interesting was something I found out about Mahatma Gandhi in India. He was fighting for independence from the British. And it was in World War II. And the British came to him and said, they were occupying India. And they came to him and said, look, we know you want your freedom. We need pharmaceuticals because drugs from Europe have completely collapsed here in India. If you can get the Indians to start making active ingredients for drugs, we will help you in moving towards freedom from British rule.

And that set off a chain of events that led to a kind of revolution in generic drug making in India. And basically those two trajectories collided and led to not just a generic drug boom here, but in ultimately the importation of a lot of low cost medicine from India, where a significant portion of my book takes place. Wow. And you tell the story as you go through the book of a gentleman who's trying to fight his way through the system and what's going on and stuff like that. Give us a rundown of what's going on with that gentleman's plight. So the lead character in the book is a young engineer named Dinesh Thakur. And he worked at Bristol Myers Squibb in New Jersey. And he was Indian by birth. So he gets recruited to go work at India's largest drug company, Rambaxi. And at the time, and this was in about 2004,

Rambaxi was the fastest growing generic drug company in the US. So for your listeners, if you were one of the first people to take generic Lipitor back in 2011, and you were so psyched to be taking that drug, that was made by Rambaxi. So you've probably taken a drug made by that company, even if you don't realize it. So Dinesh Thakur went over,

moved his family to India, starts working at this company, and he begins to notice that things are really different there than the way things work in the U.S. Um, there seemed to be very little transparency, very little sort of the high standards that he had encountered in the U.S. And at one point his boss says to him, I'm concerned about the integrity of the data that the company is submitting to regulators around the world, I want you to take your team, research all of the applications Rambaxi has submitted worldwide to get approval for its drugs, like the bioequivalence data it submits to the FDA, and find out, is the data real or fake? Dinesh Thakur ends up uncovering this terrible dark secret of Rambaxi, which is that for over 200 drug products in more than 40 countries,

it submitted fake data. Holy moly. Yeah. He uncovered nothing short of a global crime. This was data that was just invented, or they would take brand-name drugs and test that and submit the data as though they were testing their own drugs. So, of course, the data was perfect.

It looked great. He put together a PowerPoint, and that gets shared with the board of directors, and they decide they're going to cover this up. They want to bury the data. They want to bury Tucker's findings. They want to destroy even the computer on which he put together his findings. And eventually, Tucker gets forced out of the company.

But he keeps thinking about all of these poor patients around the world, particularly those in Africa who are taking HIV drugs made by Rambaxi. Oh, wow. That are, you know, potentially useless, dangerous. He ends up going to the FDA as a whistleblower. His back and forth with the FDA sparks an eight-year investigation, at the end of which Rembaxy finally pleads guilty to a felony for faking data. So I tell this very dramatic story in the book of what happened with Tucker. But the other question that I explore in the book and ultimately get an

answer to is, was Rambaxi an outlier or the tip of the iceberg, right? When Joe Graydon gave me that tip and asked, what is wrong with the drugs? Well, I had figured out what was wrong with Rambaxi's drugs, but what about other companies' drugs? And that is when I began to look really deeply at this whole system we have of getting our low-cost medicine from overseas manufacturing plants that are poorly regulated and that get advanced notice from the FDA that we're going to show up and take a look. And what I discovered is endemic fraud in these distant manufacturing plants. Wow. It's just incredible to think about. And like you say, I didn't even think about people that might be taking HIV or other different drugs to keep them alive. And if this stuff

isn't working, they're just taking placebos and going to die. One thing that was surprising to me that my mom didn't know and I didn't know, she handles the care for two of my sisters who are in care centers, and so she oversees their medications as well. But what we didn't know is how the generic approval process worked and what they have to do to reverse engineering, if you want to expand on some of that. Well, sure. You know, so a lot of people just think, well, the patent ends on the brand name drugs and then the brand name companies just hand over their recipe to the generic drug companies. But in fact, it's anything but that. It's really a kind of warfare where the brand companies are trying to

prevent the generic manufacturers from coming to market. The generic drug makers have to litigate against the brand companies. And also what they have to do, because they're not given the recipe, they have to take the drugs, break them down in a laboratory and try to reverse engineer them and create a different set of manufacturing steps to try to get to the same result at the end. But the result is not identical and the FDA recognizes that. So what the FDA says is, we'll approve your generic if the absorption into the blood is at not more than 25% above or 20% below the absorption into the blood of the brand name drug.

Now think about that. That is a big range. So let's say you take a monthly medication. You go to the pharmacy, you get your prescription, and one month you're on Oribindo's thyroid medicine, and the next month you're on Lupin's thyroid medicine. You might be, let's put it, if the drug is made without falsehoods, deceit, lies, you might be 25% above one month and 20% below the next.

So if your listeners are wondering, why do they feel different with a manufacturer change, that can be why. Wow. That just blew my mind. And my mom was like, holy crap. I mean, like you say, we literally thought that they had the recipe to them and go, here you go, have fun with that. We made our bucks.

And I think there's another factor of who races first to market for generic that ends up affecting quality and stuff. Can you expand on that? Yeah. So, again, another really surprising thing. So when the Hatch-Waxman Act passed, the generic drug makers were saying, hey, we're going to have to sue the brand name companies. That's a lot of cost.

You know, we're going to have to reverse engineer this in a laboratory. We have no idea if we're going to wind up with approval. So what can you do to make this more profitable and less risky for us? So what was incorporated into that piece of legislation was something called first to five. And basically it said, if you as the drug maker are the first one to put down your application at FDA headquarters and you're approved, you will get six months of generic exclusivity on the market before we let your competitors come in. And then in that six month period, you can price the drug at like, you know, 20% below the brand name price. So you think, well, you know, it's just six months, maybe it's not so lucrative. In the case of generic Lipitor

for Rambaxi, for example, that six month exclusivity was worth $600 million. This was big money and it set off this absolute race to be first. So it turned out that generic drug companies were lining up in the FDA parking lot weeks in advance of when a drug would go off patent. They would bring their executives in in limousines, and they would take turns sleeping and waiting in line. They pitched tents in the parking lot. I literally got a memo about this that the FDA created. All to be first. Fist fights broke out. Serious?

Yeah. Sounds like a Van Halen ticket line. Totally. Yeah, yeah. With limos, though. healing tickets line totally yeah yeah it's like the hottest ticket in town to be first to launch you know whatever generic val sarton um and but but this resulted in a quest that the generic companies had to be first so if you want to be first in the FDA parking lot, and you have to go through all these steps to develop a generic drug, then you test it in these small pilot batches in a laboratory. Those are easy to control, so your data usually looks good. Then you're supposed to scale it up to an exhibit batch, then scale it up to a commercial batch. Well, wait a second.

If you want to cut some time off that timeline so you can be first, what if you take your little easy to control pilot batches and you make them look like they're your commercial batches? You use that easy to control data. You make it look like you did it on a commercial scale, and then your data's great, and you're first in the FDA parking lot. So that's what these companies were doing in a race to be first, is they were slicing time off of their testing and production and falsifying their data. Wow. I can see that encouraging a lot.

Yeah. Let me just say this, which is if you, so, so you, you know, you might have listeners who are saying, well, they're just faking a little data. Here's what faking the data means. It means the data that they're submitting to the FDA that shows the drug is the same as the brand, that shows that it's safe, that shows that it's stable and dissolves correctly in the body, that's fake. And what's the truth? Well, we don't know what the truth is because they didn't fully test the drug.

So that means that once that drug with fake data gets approved by the FDA, we're taking a kind of mystery medicine, right? We're all like guinea pigs because the drug hasn't been fully tested. It sounds like the Russian coronavirus. There's something going on. But yeah, I can see how that would just create a system that's fraught with people that want to cut corners and cheat and everything else. And it's just extraordinary. I love that you're getting this data out to people because people have no idea. And then I believe my mom was telling me that the Medicare encourages

or pushes you towards generic. Oh, absolutely. And for my sister's medicine and stuff, they say, no, you've got to go with generic. And so then you kind of have to wonder, like, I mean, after reading your book, you're like, holy crap. Yeah, yeah, that's right. I mean, even if you swore that you were never going to take another generic, which a lot of people do after reading my book, let's say your doctor helped you and wrote a do not substitute prescription, right?

There's no guarantee that your insurance company is going to pay for a brand when a generic is available. So we've all been sort of herded into this low cost medicine, which is often low quality and fraudulent, you know, through no choice of our own. How much in your research of how much fraud and faking of results and stuff, especially in like overseas, like India, I guess, is a large provider of this. How much, what percentage would you say you found there was issues with? Yeah. So, I follow one of the characters in the book is a young FDA inspector who started going over to these overseas plants to inspect the plants. and he figured out something really incredible, which is instead of just asking the companies at the manufacturing plants

to print out data, he started looking inside the computer systems instead. And once he did that, he found that the companies were routinely pre-screening their drugs to figure out if they were going to pass the tests. And if they wouldn't pass, then they would tamper with the parameters of the test to get a passing result. And they delete all the evidence of these pre-tests. But he figured out they were doing this because he was able to track these pre-tests through the metadata that was left in the system. So, yeah, it was incredible. So over the course of four years, of the many dozens of manufacturing plants that he inspected of all kinds.

I think it was 86 plants in India and China. He found evidence of fraud in four-fifths of them. Four-fifths, holy crap. Yeah, so that I think on its face is telling you that this is a very widespread problem. That's roughly 80 plus percent, give or take yeah that's right and it's in why do we rely on i mean i know the start in india with uh mahat uh gandhi um is do do we just keep doing that over there with those folks because it's low cost and you know they've they've got they've got an infrastructure set up for that yeah so you

know what happened it started this sort of um offshoring of our drug manufacturing really started with antibiotics where the chinese started making very low cost antibiotic salts so those are kind of the underlying ingredients um And, you know, the plants here started closing. There is a So, you know, Western companies start our own companies started buying up manufacturing plants in India, hey, we can get market approval in the U.S. to come in and sell. And actually, one of the ways that this began to happen was because of the HIV crisis. So George W. Bush announced a program called PEPFAR, which was to address the AIDS crisis. And what that basically said is, charitably, U.S. taxpayers will pay Indian drug companies to supply HIV drugs for Africa, right? Great global innovation, this sort of figuring out the global marketplace to help solve a terrible problem. But then everybody was like, well, if we're using U.S. taxpayer dollars, how do we know that these drugs are real or fake?

We don't want to be sending counterfeit HIV medicine to Africa. So then there was this effort to say, all right, these drugs that we buy and send to Africa have to get FDA approval. The Indian company started getting FDA approval, and everybody was like, well, wait a second. If it's good enough to get FDA approval to send to Africa, we can take it too. So we can have all these cheap drugs because nobody can afford brand name drugs. And that is one of the ways that the indian companies started coming into our market holy crap so is there unintended consequences that seems to be the american way from all the stories that we hear uh we we seem

to have a lot of those here in america So is, and I think in your book, you talk about some pending legislation that at the end of your book was coming about. Has that had a momentum or everything's dying under Mitch McConnell? So I don't know if anything. Oh yeah. Well, you know, this issue, once my book came out,

this issue started getting a lot of attention. And there have been a number of congressional hearings about the fact that we're dependent on India and China. This is for our drugs. This is a national security risk. And then, oh my God, coronavirus came along and is like, yeah, this problem is so serious, it's even worse than we thought. Because now, India and China want to save all their drugs for their own populations. What if we're like, just pharmaceutically cut off, right? And we need to be able to make our own drugs pronto. So that has led to a movement, which some people refer to as reshoring, which is how can we bring back drug manufacturing into the U.S.? Can we bring it back effectively,

safely, cost effectively? So that is sort of where we find ourselves right now. Because I know, I think the Trump administration already like put a down payment or a contract with all the major drug manufacturers that prospectively may be bringing a vaccine to market like they've reserved them for us and basically bought it up to to say this is for us but i know there was a lot of problems for a while with just anything coming from uh china with fentanyl in it and it was like killing people and stuff i mean you know this is really uh the dark side of globalization you know that is what we are looking at which is, you know, the problem of how to control quality and get supplies in a globalized world. I mean, fentanyl is an interesting question, actually, because you need it for

patients on ventilators. There was a tremendous fentanyl shortage in the U.S. because of all these COVID patients who were ventilated. So, you know, basically the bottom line is if you don't control your own life-saving supplies, you're in a very vulnerable situation. That's why I keep a sock of amoxicillin in the back. No, I'm just kidding. So what can consumers do to, you know, advocate for themselves? Yeah. Okay, so first of all, obviously they should read my book so they know what's going on.

But once they know what's going on. But once they know what's going on, patients need to know who's making their drugs, right? Most of us, we go, we fill a prescription, we get it at the pharmacy, we have no idea who the manufacturer is. We never look at it. One of the reasons we don't look at it is because we all believe what the FDA is telling us, that there is absolutely no difference, right? It's like, if we approved a drug, it's safe, it's good. The brand's the same as the generic. The generics are interchangeable, right? So once consumers understand that that isn't actually true, then when they get their drugs, they need to look at who the manufacturer is

for two reasons. If the drug is effective and working, you want to stay with that manufacturer. You don't want to get switched by your pharmacy. But if the drug is not working or gives you side effects, you want to switch. And so the first step is to know who's making it. On my website, I have a guide to investigating your own drugs because I was so inundated with questions from readers about what can they do and how can they protect themselves. What's the name of the tab on your website for that? It's under Bottle of Lies, and I think it's More Info. Okay. And then there is a guide it's More Info. Okay.

And then there is a guide to investigating your own drugs. Okay. Awesome sauce. This is really important to take and have. Because there's not like a Yelp review for drugs. No, and we need that. So I've been in a lot of discussions with different players in

the sort of pharmaceutical world. How could you do that? How could you put some of the, some of this information into consumers' hands? You know, if it's not a Yelp review, is it a kind of certification system? Is it a kind of, you know, I mean, what if, what if as a consumer, you knew that the manufacturer whose drug you were just given was busted by the FDA for faking its data? Yeah. Like, what if you knew that? Wouldn't that be helpful information? Can a consumer get to that data, or is that hidden behind FDA paywalls?

Well, no. You actually can get to that data, but it is, you know, you kind of have to be a Sherlock Holmes or an investigative journalist who wants to spend 10 years of their life figuring all this stuff out, how to connect all these dots. And it should be made for consumers. So there are people right now who are working on that issue. You have to pull a Woodward Bernstein deep throat in some basement of some Watergate hotel to figure out. Exactly, yes. Hang out in the garage and follow the money. Follow the money, which is probably true. Yes, it is. Actually, this totally is a follow the money situation. It is extraordinary how

when I look at everything that goes on with us as Americans. We just, sometimes we're just like treated like rats in a cage. It's like, let's throw that on them. They'll take it. And you're,

you're just like, and you know, we have this, we have this principled idea that like of American exceptionalism, like we're the greatest country in the world. You're just like, Oh, and imprisoning people maybe, but that's about it. You know, you look at, you look at the, the, the, so, you know, everybody likes to talk about how the FDA is the gold standard,

the world's gold standard, but look at the performance of the FDA in the middle of this pandemic. Sure. We're going to approve hydroxychloroquine for COVID, but you know, it doesn't work and you may have cardiac arrest. Whoops, that was a mistake. Let's take that back. You know, we saw the same thing with this convalescent plasma a couple of weeks back where the head of the FDA couldn't even state the known data correctly. So we're in a period. I'm pretty sure that my pillow guy is on to something, though. That might be, you know.

I mean, he used to do meth, so he's used to mixing chemicals. I'm pretty sure that my pillow guy has got something for us. Well, he does have something for us, but the FDA chose in its infinite wisdom not to approve it, thank God. But, yes, he did have something for us, but the FDA chose in its infinite wisdom not to approve it, thank God. But yes, he did have something for us. God, I'm so surprised. I mean, because, you know, pillows and meth, I mean, that's almost a pharmaceutical degree right there. Oh, my God.

Yeah. But, yeah, it's extraordinary, too. We had Seth Abramson on, and he talked about some of his collective data on how many people in the Trump, I don't know, what would you call it, regime or skeevy swamp. Swamp's probably the right word. The cabal. The cabal between the people on Fox News and everybody, and they all bought this hydroxychloroquine. They all invested in it. And what's really sad is they were shoving it on a lot of veterans at the VA even after it had been done.

And my understanding is, I don't know if it's, yeah, well, my understanding is for a couple years now or for a couple presidents, the FDA has kind of had some insiders working at the FDA, which is kind of maybe a conflict of interest. You'll have to correct me if I'm wrong. Maybe that wasn't the way at the FDA, which is kind of maybe a conflict of interest. You'll have to correct me if I'm wrong. Maybe that wasn't the way of the Obama, but pretty sure it was the way with Trump because every division has run that way.

Well, you're talking about like a revolving door between industry and FDA. Like basically the guys just go to work there that are in the industry, the lobbyists or whoever's ahead of last company. And, and, and you're just like, wait, that doesn't seem arm's length. There is absolutely a revolving door. So like, you know, going to work as a regulator at the FDA

is sort of like an audition for your hiring in that private sector. So, you know, you've had, and I have that in my book as well, you know, the head of the FDA's generic every American should care about what these regulators are doing. You know, at the same time, I will say this, which is, there are some amazing public servants who work at the FDA, like Peter Baker, in my book, the young inspector who was literally risking his life going into these manufacturing plants where people were following him, putting, you know, adulterated water in his water bottle. Holy crap. Oh, yeah.

Bugging his hotel room on, you know, because the stuff that he finds out is is is a multimillion dollar decision-making for these companies is having a huge market impact, you know? So there are, there are people there who are completely committed to helping the public. And then there are people there who are committed to doing what is best for themselves. And I think, uh, let me go down a list here.

A guide to investing in your own drugs you can find on your website. Find out who manufactures your drugs. Research the manufacturer. Find out or not where your drug was made. How to change manufacturers. Pay attention to symptoms and side effects. Oh, yeah, side effects oh yeah side effects holy crap i didn't think about that that switching might even amplify your side effects yeah oh yeah

educate your doctors and pharmacists um yeah it's interesting to me too the the you know we saw this with the opioid epidemic i don't know why i can't say that um but uh this whole you know it started with his advertising on tv which like i still have friends in other countries they're like we do not get what you're doing with the advertising of drugs on tv like that doesn't happen here like that's just we see what's extraordinarily wrong with that just on the face of it yeah and and then uh and then and then you have uh uh you know these you know sending doctors on trips and you know giving them commissions or i don't know about commissions but you know what i mean just graph speaking gigs and vacations and you know yeah absolutely it's just it's just insane and so you know't, you know, they're not sitting around going,

well, you know, we got to give this thing to the right people. And, yeah, I guess we just need a Yelp review for the. We got to crowdsource this stuff or something. But at least they can go to your website and they can download a print version. I can see here and get some other data from you. So this is just astounding, Catherine. I'm glad you put this out. My mom learned a lot and she's going to be advocating for herself and the drugs that she's going to get. And I would encourage everyone to read the book. Anything more we need to know about what's in here as we round out? You know, I guess I would say that the way that our drug supply is structured,

if the FDA approves it, it is okay to take. And everybody downstream of that decision assumes that, right? And so nobody tests the drugs. That was what was astonishing to me is that our drugs are really regulated on an honor system, approved on an honor system, and we're all kind of like big guinea pigs here. The FDA reviews company data, it announces its inspections in advance overseas. And then it doesn't actually test the drugs. So, you know, American consumers need to be vigilant. They need to know about this.

They need to alert their elected officials. And I would say we probably need a consumer revolution. Definitely, definitely. More legislation. Can you touch just a little bit on the legislation that's kind of being presented? Well, I mean, there's so there are a number of different pieces of legislation that have been proposed. Everything from, you know, Trump had a recent executive order to encourage government entities to buy American. But the problem is, you know, the drugs aren't being made here. So there isn't all that much to buy. There have been efforts by the administration

to sort of bring manufacturing plants back. But, you know, what, what really needs to happen is I think an comprehensive overhaul at the FDA, which basically changes how drugs are approved so that there are verifications built into this cozy honor system that is currently operating. Yeah, and especially after the people that Trump's put in there. Holy crap. Actually, another question I have here that's really good.

Are vaccines, you know, for just our normal stuff like measles and the different things, the booster shots we give to kids, are those made overseas? So this is a really good question. Many of them, not all of them, but many of them are made overseas. So the vaccines can be subject to some of the same problems that we see, you know, that I describe in Bottle of Lies. That said, you know, I am not an anti-vaxxer. I am a proponent of science. I stated on my website, I do think that there is a lower risk to a one-time vaccination than there is to the medicine that you're taking every day, every month, right, for years, which is this, you know, kind of medicine that we're all on,

maintenance medication, may present a much higher risk than a one-time vaccine. Definitely. Yeah. I was just like, I'm not an anti-vaxxer either, but I used to have a lot of friends on Facebook. Now I'm a friend of them. Yeah. But, yeah, and then COVID, if the COVID vaccine gets made, is it going to be made largely here, do you think,

or is it going to be made overseas? You know, I don't know the answer to that, but let me put it this way. I would be wary of any vaccine that is rushed out before November 3rd. Yeah. I'm pretty sure that he's just doing that for the mail-in ballots. He's just doing that to con people. There's not going to be anything on November 3rd. I mean, that is really the question.

That is a big question that people are watching right now. Maybe he'll get desperate and he'll have Putin sent some over, you know, he's, he just has to call president boot and say, Hey man, can you help me out? Yeah. And then I can stay your vice president for the next four years. Well, Catherine, it's been wonderful to have you on and definitely an eye opener. Holy crap. This didn't make you lose sleep at night. NPR said propulsive, astounding, and disturbing. So there you go with that one.

But definitely educate yourself. You want to advocate for yourself. You want to know what's going on. If you're on cancer medications, HIV medications, all these different medications, this is really important. Catherine, give us your website one more time so people can check that out. www.catherineeban.com. There you go, guys. Check out her book. You can pick it up at Amazon or other local booksellers

with you. It's hard to miss. It's got a bunch of blue pills on the cover it and a bottle of lies, the inside story of the generic drug boom. It's a New York Times bestseller, so that's always good to have. You can go to Amazon.com forward slash shop forward slash Chris Voss. You can see all the books of the wonderful authors. Pick up her book. You can also go to YouTube.com forward slash Chris Voss. See the video version of this. And you can subscribe there.

It's free, too, for a very unlimited time. Go before that unlimited time runs out. Subscribe. You can also go to thecbpn.com and tell your friends, neighbors, relatives. Thanks for tuning in and we'll see you guys next time. Thank you.