Both Hayden “Pharmaceuticals and the Politics of the Similar in Mexico” and Greenslit’s “Depression and Consumption” partly address how drug prescriptions give primacy to brand names over active substances.
Hayden reports how in 1998 the Ministry of Health in Mexico responded to a social-security crisis that drove up the cost of medicine by encouraging growth in the country’s generic pharmaceutical market. The Mexican government enacted a policy requiring public sector physicians “to prescribe the active substance of a drug, rather than simply a brand name” (478). The policy aimed to debase a “ ‘culture of the brand’, in which the foreign-made and expensive is seen as naturally superior” (478).
The qualities of being ‘foreign-made’ and ‘expensive’ reported by Hayden can be grouped with the dual titles and packagings of fluoxetine hydrochloride that Greenslit addresses. They all belong to what Baudrillard calls the “ ‘inessentials’ of advertised commoditities” (Greenslit 480). These qualities, superfluous to a drug’s physiological effects, might have beneficial effects for drug consumers: supporters of the Sarafem/Prozac distinction argue that a distinct and unique disease-drug relationship helps sufferers of PMDD psychologically by establishing a medical identity, and it seems equally plausible that selecting a more expensive, foreign-made drug over an equivalent, cheaper generic might lead a consumer to a better recovery because they believe they are receiving superior treatment.
This current emphasis on the inessential qualities of medicines, however, creates a climate where patients are informed more by marketing and politics than medical knowledge, where patients must be both a “savvy consumer and political activist.”
If doctors prescribed active substances rather than brand names, the climate would certainly change. Such a shift would make evident that few drugs are used to treat many diseases, and second, that our lack of finer, more specified substances reveals we sometimes know little about the interactions between drugs and bodies.
If diseases are no longer tied knee-jerk to a single drug in the public eye, it is possible this shift would slow down rather than speed up what Hayden calls the “pharmaceuticalization” of public health. Words are powerful. They become even more powerful when they represent the cures to our most intimate problems. If we remove the brand name mask, then a drug becomes just a chemical, and seen as such, we might be less likely to take it as an all-in-one solution, favouring instead a broader conception of treatment.