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Workers at a medical manufacturer’s factory in Beijing in December. Drug shortages in the United States may worsen as China battles its Covid-19 surge. Photo: China Daily via Reuters

US drug shortages could worsen in coming months because of China’s health crisis, expert says

  • US Food and Drug Administration lists about 120 medical treatments in short supply, citing ‘manufacturing quality issues’ and supply chain difficulties
  • Even with US efforts to encourage alternative supply chains, ‘we are nowhere near the type of capacity at scale and quantity that we have in China’, one expert says

Pharmacies across the US have been running low on some key generic and prescription drugs for months now.

While healthcare providers point to increasing demand due to a “tripledemic” of respiratory viral infections- flu, Covid and RSV – as the immediate reason, the shortages go beyond seasonal infections.

And experts say that the situation could get worse due to the Covid crisis now roiling China, one of the biggest US suppliers of generic drugs and pharmaceutical ingredients, but that “nearshoring” – doing business with manufacturers in other countries much closer to the US – won’t help any time soon either.

According to the US Food and Drug Administration, some 120 treatments – including albuterol inhalers, morphine, lidocaine anaesthetics, chemotherapy drug fludarabine, even adderall, used by patients with attention-deficit/hyperactivity disorder, are currently in short supply.

The Food and Drug Administration lists roughly 120 treatments in short supply in the US. Photo: AP

Annual national shortage figures published by the American Society of Health-System Pharmacists shows that at least 160 new drug shortages were identified last year, compared to 129 in 2020 – when Covid-19 first ripped through the US.

Though the shortages are down from December, they are still close to the 2020 level.

The FDA cited “manufacturing quality issues” and supply chain difficulties as the main culprits, saying the agency has asked “manufacturers to evaluate their entire supply chain, including active pharmaceutical ingredients (API)”.

Sumit Vakil, chief product officer and a founder of Resilinc, a California-based global supply chain mapping and monitoring firm, said that the pharmaceuticals industry has been experiencing shortages “largely due to a dependence on China for these materials”.

Even before the pandemic, Washington called the US reliance on China for drug imports a potential national security concern. The US-China Economic Security Review Commission noted in 2019 that the US imports more than 80 per cent of API from overseas, a “substantial portion of US generic drug imports come either directly from China or from third countries like India”.

US firms seek factory ‘backups’ to China as zero-Covid accelerates reshoring

Then, with the onset of Covid-19, supply chain breakdowns and export restrictions exposed serious limitations in the medical supply chains.

A 2021 White House report found that while overseas manufacturing of API “helped reduce costs by trillions of dollars in the past decade” such offshoring now “has left the US healthcare system vulnerable to shortages of essential medicines”.

Vakil noted that even though many companies were looking to Indian pharmaceutical suppliers for manufacturing, “an additional risk that must be acknowledged” was that “these suppliers are still dependent on China for ingredients”.

According to New Delhi, India imports about 68 per cent of its API from China.

Moreover, reports suggest China is now enduring its own shortage of key drugs due to an unprecedented spike in Covid infections after it abruptly relaxed its zero-covid policies in December.

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Dental clinic gives away fever tablets amid medicine shortage in China

Dental clinic gives away fever tablets amid medicine shortage in China

Only 28 per cent of API used in the US are produced domestically, and there have been numerous discussions about building up supply chain alternatives to China. To encourage domestic drug manufacturing, a bipartisan group of US lawmakers are backing the American-Made Pharmaceutical Act, which would require Medicare, Medicaid and other federal health programmes to give preference to such drugs.

Even so, Vakil said, despite a rebalance in the origin of manufacturing, “we are nowhere near the type of capacity at scale and quantity that we have in China”.

He added that there are almost 50,000 factories in China that support a global network of companies and millions of raw and intermediary parts which can “disrupt any and all supply chains”.

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