Joseph M. Gabriel, “Medical Monopoly: Intellectual Property Rights and the Origins of the Modern Pharmaceutical Industry” (U Chicago Press, 2013)

Commercial interests are often understood as impinging upon the ethical norms of medicine. In his new book, Medical Monopoly: Intellectual Property Rights and the Origins of the Modern Pharmaceutical Industry (University of Chicago Press, 2013), Joe Gabriel shows how the modernization of American medicine was bound up in the ownership, manufacture, and marketing of drugs. Gabriel unearths the early history of intellectual property concerns as they entered the domain of medical practice itself. Through his careful marshaling of evidence, he takes readers back to a time when the norms and legal structures of commercial capitalism in the U.S. were just as much at issue as those of the professionalization of medicine. This fascinating book serves as a pointed reminder that the sources of therapeutic rationale are just as much tied to the production and regulation of therapies as the collective decision-making on ethical practice. Along with my previous interview with Jeremy Greene, this discussion will hopefully make accessible a broad perspective on the development of medicine in the 20th century by focusing on its ties to industry.

Medical Monopoly charts the history of property rights over medicines at the dawn of the 19th century through World War I. The important broader transition here is that while before the Civil War–at least in medicine–patents were seen as tantamount to granting problematic monopoly, by the end of the 19th century they were understood as the best available regulatory mechanism for preventing more problematic imitation. Whereas patent medicines had previously been linked to quackery, the emergence and rapid expansion of the “ethical” pharmaceutical industry after the Civil War was due to its adherents advocating for more effective regulation of commerce within medicine. Rather than reverting to secrecy, firms began to circulate and publish information on new remedies and the results of studies to physicians. As the explosion of new medicines remained at pace with the boom of consumer goods in the late 19th century, patenting and corporate investment in monopolistic practices became understood as a mechanism to advance the public good. The expansion of laboratory science and norms of chemical manufacturing in the 20th century only bolstered this union further.Medical Monopoly is a fascinating and important read that people interested in medical policy should pay attention to.

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