OPINION:
“We are starting to have that conversation: ‘If we get to dire straits, how are we going to ration cancer care to patients?’”
Those aren’t words you expect to hear from a pharmacy manager in the world’s greatest economy. But America increasingly looks less like the center of global innovation and more like a civilization in decline.
Last fall, parents lived in fear as common antibiotics such as amoxicillin went out of stock. Now, our nation is experiencing another dangerous supply chain shortage. We aren’t just talking about empty shelves of ibuprofen. We’re talking about shortages of drugs that make the difference between life and death. Medication for breast cancer and leukemia, adenosine used to treat heart disease, and critical antibiotics are all in short supply.
Our stores haven’t run dry just yet, but the shortages are already leaving a mark. The American Cancer Society and the Society of Gynecologic Oncology have issued dark warnings of “worse outcomes” for future patients. Meanwhile, more older adults are delaying or skipping their medicines, in large part because of restricted availability.
The core problem is a familiar one: Our leaders spent decades encouraging the industry to consolidate and offshore. They told us that this was an unavoidable outcome of globalization and that the jobs lost by Americans would be more than offset by greater economic efficiency and lower consumer costs. They were wrong.
Today, about 70% of generic drug production and about 90% of generic active pharmaceutical ingredient, or API, production takes place overseas. The vast majority of that production is traceable to China. Meanwhile, widespread consolidation and integration of pharmaceutical intermediaries, such as wholesalers and group purchasing organizations, has enabled just a few actors to dictate drug prices. Together, these factors have hollowed out what should be one of our strongest industries.
A strong, resilient American economy depends on securing access to lifesaving drugs. We cannot leave our sick and older people at the mercy of the Chinese Communist Party and fragile international supply chains that could break in an instant. The pandemic highlighted this issue, but we have yet to fully learn our lesson. We desperately need to restore a robust generic drug manufacturing market on American soil.
This requires encouraging manufacturers to bring every stage of drug production back to the U.S. We need to offer financial incentives and eliminate burdensome regulations to make America a competitive destination for this critical industry. We need to forge a robust supply of APIs and other chemicals. And we need to support the development of innovative technology and methods, like continuous-flow manufacturing, which could build greater redundancy into our supply chains.
Ultimately, if we want to pursue transformational change, President Biden and congressional Democrats must address the root causes of our drug shortage. Their current approach goes after only the symptoms of the problem, and it has done more harm than good.
Last August, I predicted that the drug price controls enacted by the Inflation Reduction Act would “remove the incentive to produce innovative therapeutics for patients in dire need” and that cancer patients would be among those hardest hit. Unfortunately, not only did innovation slow, but the law prompted “a ‘race to the bottom’ in price” that made expanding production “not economically viable.”
There is still time to get things right, though. We can start by passing the bipartisan Ensuring Timely Access to Generics Act.
We can also pass my legislation, which would encourage companies that currently produce medical and pharmaceutical equipment abroad to relocate to the U.S.
And we can repeal the Inflation Reduction Act’s deadly price controls.
If we want to prevent pharmacies from having to ration lifesaving treatments, if we want older people not to go without, and if we want to reverse our nation’s sad decline as an industrial power, then we need to strengthen our medical supply chains. We need to put the health and safety of Americans over profit. This is a national priority, and we need to treat it as such.
• Marco Rubio is an American politician and lawyer serving as the senior U.S. senator from Florida, a seat he has held since 2011.
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