With Coronavirus Pandemic, an Over-Reliance on China Is Bad Medicine

As local governments race to close schools and quarantine thousands and major conference organizers cancel events to halt the spread of the coronavirus, the bigger threat to Americans’ health is the dwindling access to life-saving medicine.

Today, 97 percent of the antibiotics prescribed in the United States come from China, as do 14 percent of the raw materials to make our drugs. Replenishing our emergency stockpile of life-saving medicine for local emergencies will be tough as 85 percent of those drugs rely on some component that comes from China.

Renewed efforts to address our reliance on China are important because — as Chinese factories cope with the aftermath of closed facilities due to cumbersome policies and a reduced workforce, and as the United States faces further anticipated drug shortages and quality surveillance challenges due to coronavirus — the lives of millions of patients who rely on antibiotics, generics and some branded drugs without alternatives are at risk.

The Food and Drug Administration’s decision to remind drugmakers to communicate about anticipated shortages is an important step in the right direction, especially given its recent announcement of the first drug shortage linked to coronavirus. That is on top of an already struggling health care supply chain that today tallies more than 100 drugs in shortage. A wake-up call about drug shortages is in order. 

Without lifesaving drugs on hand, health care providers are forced to delay medically necessary care or substitute therapies that may be less effective, which can increase overall health care spending. For instance, just one shortage of norepinephrine was associated with greater mortality among patients with septic shock and added $13.7 billion in costs to the U.S. health care system.

The good news is one root cause of drug shortages — a lack of incentives for manufacturers to produce less profitable drugs — can be addressed through collaboration across the pharmaceutical ecosystem. 

For example, group purchasing organizations that traditionally negotiate discounts with manufacturers by aggregating purchasing volume are also poised to create stability by giving manufacturers assurances to make the necessary investments for a consistent, long-term supply of medicines. 

ProvideGX, a program derived from an alliance of health system owners devoted to increasing the supply of shortage generic drugs, has taken insights from more than 1,600 hospitals to anticipate volume needs of more than 150 drugs that are or have been recently designated as shortage drugs to guarantee manufacturers profitability and hospitals access. A recent partnership between Pfizer and the program to supply a childhood cancer treatment that until last month was on the FDA shortage is a timely example of the importance of predicting and alleviating shortages through technology-enabled predictive solutions.

However, in addition to these improved dynamics between the pharmaceutical ecosystem that flows from drug manufacturers, regulators, hospitals, purchasers and patients, a permanent fix requires diversified sourcing of medicines and raw materials used to make them as well as incentives for drug manufacturers to stay in the marketplace.

As the coronavirus outbreak inspires renewed bipartisan efforts to alleviate our reliance on China for access to medicine, we must make solutions to curb drug shortages a priority.

Michael J. Alkire is president of Premier Inc.

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