A popular blood thinner now costs U.S. Medicare patients and insurers more than $5,000 a year. This drug, which has amassed sales of more than $10 billion, uses Rivaroxaban as the main ingredient – a compound available from 26 manufacturers in China.
When you check prices for Rivaroxaban for sale in the U.S., the cost of a 10, 15 or 20 mg tablet is virtually identical, so the product quantity is not an issue. Rivaroxaban tablets sold in America, by the way, are so small they are almost impossible to cut in half to make a 20 mg tablet into two tens. Wonder why?
Since the price of materials is obviously so low (two for the price of one), it would seem that where it is manufactured is not very important, but to pencil-poking plutocrats, a penny saved is a salivating savings event of graphite proportions.
But what is the danger from manufacturing our drugs in China?
Brand name medicine chemicals made in China by Chinese companies, and sold in the United States, include antibiotics, antidepressants, drugs for Parkinson’s, Epilepsy, Alzheimer’s, high blood pressure, even HIV. This is just the beginning, as factories are also opening to supply generics.
Author Rosemary Gibson said recently that China plans to become the pharmacy to the world – a title currently held by India:
They make thousands of active ingredients for many of our medicines that we find in our home medicine chest and in hospitals all over the country. Many people that we spoke to, both former government officials and some industries, said that if China shut the door on exports, within months, pharmacy shelves in the United States would be empty. And hospitals would cease to function.
With China threatening “conflict” in the South China sea, how dangerous is it for us to depend on them for our drugs? With the world’s second largest military budget and hundreds of millions of soldiers available with the banging of a gong, can we be too careful dealing with the world’s largest economy and population?
Gibson recalled the dangers of controlling drug supplies:
In 2004, the New York Times reported the last penicillin manufacturing plant in the United States was about to shut down. That was the Bristol-Myers Squibb Syracuse, New York plant.
Prices soared as competitors were driven out of business from what became known as the “Penicillin Cartel.” Product was dumped. Monopoly cartel was formed, and prices shot up for consumers. In recent years penicillin shortages in many countries have been alarming; one reason is the drug is the only cure for syphilis.
The drug companies knew they couldn’t end deregulation in the U.S. by the FDA, so they accomplished their goal by moving production overseas.
United States was the gold standard, and we were told to expect high quality medicine. Every pill, every time. We are now effectively outsourcing the manufacturing of our medicine to countries that have few, if any standards, Gibson said.
In 2007, some of you might remember news reports of the Chinese equivalent of the FDA in China was taking bribes. They replied (apologized?) we are in the very early stage of being able to manufacture high quality medicine.
The market did not stop moving to a place where technology had very few standards – a really remarkable transition. The other thing fascinating and again about the lack of transparency, it even turns out we have a trade deficit with China in pharmaceuticals
Chinese reduction of drug supplies would require us to rapidly build factories for production in the U.S., but in the meantime, prices would become more astronomical than currently. It is somewhat like only being able to buy bullets from your enemy.
Health is always an issue, as well as working conditions and safety, Gibbons explained:
…a major U.S. company, the FDA went to their plant in China. Inside of the plant, it had no hand-washing facilities, no place (for workers) to wash hands, and the chore was an open pit in the floor. This is what happens when the outsourced production from a country with the highest standards in the world moves to a place that is still on a growth trajectory.
For those of you with good memories, recall we were told by the Bush and Obama administration that any drug importation by citizens to save money was dangerous, because only strict standards were used in the U.S. In short, if you imported drugs they were dangerous.
Penalty for importing drugs by patients is one-year imprisonment and a $100,000 fine by the DEA. On the other hand, drug companies do it every day for free and sell the medicines to the same folks that would be fined. Globalization – what a wacky world, unless you’re sitting on top of it.