The coronavirus has exposed the United States’ dangerous dependence on China for pharmaceutical and medical supplies.
The coronavirus we are currently seeing came to our shores and aside from becoming one more source of friction between politicians of both sides, has pointed out the potential for drug shortages since so many of our drugs are imported from foreign countries.
Jen Christensen, writing for CNN, on Feb. 28, “As of 2018, China ranked second among countries that exported drugs and biologics to the U.S. and ranked first for medical devices according to the FDA.”
Those numbers do not match up with those I have obtained from the FDA which when I called showed finished drug products from China imported to the U.S. and APIs or active pharmaceutical ingredients at lower levels, although still higher than most would like.
Janet Woodcock, director of the FDA’s Center for Drug Evaluation and Research, testified before Congress “that the United States has become a world leader in drug discovery and development, but is no longer in the forefront of drug manufacturing.”
Marsha Blackburn, writing for STAT, on Feb. 14, 2020, “Woodcock identified as a key health and security concern the cessation of U.S. manufacturing of active pharmaceutical ingredients, APIs, the basic building blocks of medication. She testified that 72 percent of API manufacturing takes place outside of the U.S. and that the number of facilities making APIs in China has more than doubled since 2010.”
Gary Cohen, a former chief economist to President Trump, argued against a trade war with China by invoking a Department of Commerce study that found that 97 percent of all antibiotics in the United States came from China.
China is the only maker of key ingredients in a class of decades-old antibiotics known as cephalosporins, which treat a range of bacterial infections, including pneumonia. Who remembers “Keflex”?.
The year was 2018. Fast forward, the Wall Street Journal on Feb. 28 reported “factory shutdowns across China because of the new Coronavirfus and have exposed an uncomfortable health care reality.”
Many medicines sold here rely on raw materials that are made in that country. The FDA just told us that one drug has already gone into shortage because of difficulties obtaining a raw ingredient from a site affected by the virus. It did not disclose which drug or manufacturer.
Politico reported that China accounted for 95% of U.S. imports of Ibuprofen, 91% of U.S. imports of hydrocortisone, 70 percent off U.S. imports of generic Tylenol, acetaminophen, and 40 percent of imports of heparin. These numbers come from the Commerce Department data.
Another example of an API is the starting material needed to make doxycycline, the recommended treatment for anthrax exposure. Another example of raw materials coming from China and India is azithromycin, known as a Z-Pak,
A single factory in China made the active ingredient for a common blood pressure medicine, Valsartan, that was found to contain a cancer-causing chemical that has been used to make liquid rocket fuel.
Cohen was quoted as saying,” if you’re the Chinese and you want to really just destroy us, just stop sending us antibiotics,”
Doug Palmer and Finbarr BerminfghAm, writing in Politico, say there are not enough FDA personnel conducting on-site-inspections in China, adding to the worries of many in Congress. ut a shortage of some critical medicine has prompted the FDA to allow the sale of some Chinese made drugs that could pose a safety risk, rather than be caught without any supply.
While the Department of Defense only purchases a small quantity of finished pharmaceuticals from China, about 80% of active pharmaceutical ingredients are said to come from China and other countries like India.
“Our biggest vulnerability is our over-dependence and single source of supply” said Mike Wessel, a long time member of the U.S.China Commission. China, directly or indirectly, is the major or potentially sole supplier of these products to the U.S.
The question I must ask as I write this article is, “Would you be willing to pay what would probably be a higher price for many if not all of the prescription drugs you are now using if you knew they were manufactured here, in the U.S.
This question that I ask has usually drawn a definite no from those I have asked. They do want quality products that they can depend on but are not really willing or able to pay a higher price for.
The additional emergency funding under new legislation hopefully being passed by both parties this week will help solve that question.
Bert Drachtman
Great Neck
