Skip Navigation
Menu
Ideas and Opinions |18 December 2018

The U.S. Medicine Chest: Implications of Increased Reliance on China

Rosemary Gibson, MSc

Article, Author, and Disclosure Information
Author, Article, and Disclosure Information
This article was published at Annals.org on 11 December 2018.
  • The Hastings Center, Garrison, New York (R.G.)

    Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M18-2552.

    Corresponding Author: Rosemary Gibson, MSc, The Hastings Center, 21 Malcolm Gordon Road, Garrison, NY 10524; e-mail, gibsonr@thehastingscenter.org.

    Author Contributions: Conception and design: R. Gibson.

    Analysis and interpretation of the data: R. Gibson.

    Drafting of the article: R. Gibson.

    Critical revision for important intellectual content: R. Gibson.

    Final approval of the article: R. Gibson.

    Administrative, technical, or logistic support: R. Gibson.

    Collection and assembly of data: R. Gibson.

×
FULL TEXT
Public concern about the safety of medicines has been heightened with the recent recall of more than half of all valsartan products on the market in the United States and other blood pressure medicines. In the case of valsartan, the U.S. Food and Drug Administration (FDA) identified a probable cancer-causing chemical in the active pharmaceutical ingredient, which was made in China. Changes in the manufacturing process seem to have resulted in the presence of N-nitrosodimethylamine, which may be harmful at very low levels (1).
The recall shines a spotlight on the increased reliance of the United States on China to supply generic drugs, active pharmaceutical ingredients—the components that give a drug its therapeutic value—and the chemical building blocks and raw materials to make them. The case of antibiotics illustrates this dependence. The last penicillin fermentation plant in the United States closed in 2004 (2). China had invested heavily in building large-scale penicillin fermentation capacity. Its domestic companies began to sell products on the global market at below-market prices. Producers in the United States, Europe, and India went out of business because they could not compete. A dramatic price increase ensued (3). This experience suggests that when the United States loses control over the supply of its medicines, it can also lose control over prices.
The example of doxycycline highlights the ramifications of U.S. dependence during a public health and national security event. After the anthrax attacks in 2001, the U.S. government purchased vast...
FULL TEXT
PDF
Not Available
Citations
Citation

Gibson R. The U.S. Medicine Chest: Implications of Increased Reliance on China. Ann Intern Med. 2018;169:873–874. [Epub ahead of print 11 December 2018]. doi: https://doi.org/10.7326/M18-2552

Download citation file:

© 2019

×
Permissions

Published: Ann Intern Med. 2018;169(12):873-874.

DOI: 10.7326/M18-2552

Published at www.annals.org on 11 December 2018

©
2018 American College of Physicians
0 Citations

Related Articles
Geographic Variation in Prevalence of Adult Obesity in China: Results From the 2013–2014 National Chronic Disease and Risk Factor Surveillance
Annals of Internal Medicine; ():
Lost Evidence From Registered Large Long-Unpublished Randomized Controlled Trials: A Survey
Annals of Internal Medicine; 171 (4): 300-301
Characteristics of High Cardiovascular Risk in 1.7 Million Chinese Adults
Annals of Internal Medicine; 170 (5): 298-308
Cardiovascular Disease Risk Estimation in China
Annals of Internal Medicine; 170 (5): 340-341
View MoreView Less

Related Topics
Cardiology
Coronary Risk Factors
Hematology/Oncology
Hypertension
Nephrology

Cardiology, Coronary Risk Factors, Hematology/Oncology, Hypertension, Nephrology.

PubMed Articles
Genetic and epigenetic regulation of BHMT is associated with folate therapy efficacy in hyperhomocysteinaemia.
Asia Pac J Clin Nutr 2019;28(4):879-887.
Metabolic syndrome and risks of carotid atherosclerosis and cardiovascular events in community-based older adults in China.
Asia Pac J Clin Nutr 2019;28(4):870-878.
View More

Results provided by: PubMed

CONTINUE WITH LIMITED ACCESS
Annals of Internal Medicine
To receive access to the full text of freely available articles, alerts, and more. You will be directed to acponline.org to complete your registration.
×
acp link acp
silverchair link silverchair

Copyright © 2019 American College of Physicians. All Rights Reserved.

Print ISSN: 0003-4819 | Online ISSN: 1539-3704

Privacy Policy

|

Conditions of Use

This site uses cookies. By continuing to use our website, you are agreeing to our privacy policy. | Accept
×

You need a subscription to this content to use this feature.

×
PDF Downloads Require Access to the Full Article.
Annals of Internal Medicine
To receive access to the full text of freely available articles, alerts, and more. You will be directed to acponline.org to complete your registration.
×
Access to this Free Content Requires Users to be Registered and Logged In. Please Choose One of the Following Options
Annals of Internal Medicine
To receive access to the full text of freely available articles, alerts, and more. You will be directed to acponline.org to complete your registration.
×