A drug called BiDil is poised to become the first drug ever approved by the Food and Drug Administration (FDA) to treat heart failure in African Americans - and only African Americans. This article explores the story of BiDil and considers some of its broader implications for the use of racial categories in law, medicine, and science. It argues that BiDil is an ethnic drug today as much, if not more because of the interventions of law and commerce as because of any biomedical considerations. The article is, first, a retrospective analysis of how law, commerce, science, and medicine interacted to produce a distinctive understanding of BiDil as an ethnic drug, shaping which questions got asked at critical junctures in its development and orienting how they were pursued. Second, it is a prospective consideration of how the science and medicine thus produced may come to affect legal and commercial understandings of the significance of race in relation to biology. The development of BiDil has profound implications for health law and policy, first, because it may be distorting current efforts to address the very real health problems associated with heart failure in America; and second because it implicates federal agencies in inappropriately giving the imprimatur of the state to conceiving and using race as a biological category.
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