The chapter opens with a testimonial from Hope Marcus, whose quality of life hinged on her access to mesalamine. The drug is “decades old” and is “the active component of an even older aspirin-related medicine” commonly prescribed for bowel conditions due to its mild side effects (87). In order to experience its full effects, the drug must come with a special coating and should be taken orally and rectally. Once Marcus was accepted to Medicare, she was able to find a plan that would cover generic medications with no copay. Unfortunately, she could not take advantage of this plan, as the patent for mesalamine was purchased by a new pharmaceutical company that re-marketed the drug under new patents. Patients were soon dismayed to find that there had been no real change to the drug, and that the old manufacturer’s pills were simply re-coated with a different material. Marcus eventually resorted to purchasing generic mesalamine from India for $55 a month. While Marcus was scared, she was willing to go any lengths for this life saving medication.

The modern pharmaceutical industry’s roots lie in the practice of selling tonics in the 19th century. Most were questionable, and “relied on a little bit of science and a heavy dose of marketing” (91).