Rosemary Gibson was a speaker at Made in America 2019. She is an award-winning author, speaker and advisor to organizations that advance the public’s interest in healthcare.
In this interview, Rosemary discusses her book, China Rx: Exposing the Risks of America’s Dependence on China for Medicine.
Jason Blount: What’s your background?
Rosemary: I’ve written several books before China Rx and they’ve all been about healthcare. The first book was about medical mistakes and the second was on unnecessary medical treatment. I’ve been an editor at a medical journal and also led a ten-year $250 million national strategy to bring palliative care in nearly 2,000 U.S. hospitals. Palliative care is an extra layer of support for patients when they have serious illnesses. Then, I worked with physicians, nurses and other healthcare professionals and consumer advocates to reduce the harm from medical mistakes.
Jason: How many years were you doing that?
Rosemary: I’ve been working on patient safety for more than 15 years and counting. I wanted to write another book on a topic of significance to our country and came across a serious health and national security concern: our dependence on China for many of our medicines.
Jason: What have you found out in your research that you’ve put into China Rx?
Rosemary: Millions of Americans are taking prescription drugs made in China and don’t know it, and neither do their doctors. We can’t make penicillin anymore in the United States. That happened after the US opened up free trade with China. It’s the steel story with a twist, Chinese producers sold it at such low prices and they drove out all U.S. and European producers. Once we stopped making penicillin, prices shot back up. Now, we’re hugely dependent on China for penicillin and other antibiotics including those for superbugs.
Jason: Manufacturing is slowly starting to reshore in some industries. Is this industry starting to turn things around as well?
Rosemary: When it comes to generic drugs which are 90 percent of the prescriptions that Americans get, it’s probably going in the opposite direction. Unless something is done, those jobs will not be coming back and there’s no one advocating to bring them back.
Jason: Is China the sole supplier to the U.S. or are there other countries producing drugs?
Rosemary: China is the sole supplier of some products. Mostly, it is the dominant global supplier for the U.S. and a lot of other countries. Even if we wanted to manufacture our drugs in the U.S., we would still have to buy the key ingredients from China. Other countries, like India, also depend heavily on China’s ingredients.
Jason: Are some non-generic drugs still being made here?
Rosemary: Yes, many non-generic drugs are made in the U.S. But the big concern is our generics as China is ramping up production very quickly. Here are some generics made in China by Chinese companies that Americans are taking: antidepressants, medicines for Alzheimer’s, Parkinson’s, HIV/AIDS, and epilepsy; birth control pills, chemotherapy for cancer treatment, and much more.
Jason: Say we could no longer get medicine from China…how quickly would we run out of penicillin and medicine in general?
Rosemary: Within a couple months. Pharmacies would be empty. The U.S. military depends on China for its medicines which has enormous implications for military readiness and national security.
Jason: Do you think that industry will ever thrive again here?
Rosemary: China’s price advantage appears to be diminishing because the government is cracking down on pollution. A lot of plants in China are closing down that can’t afford to invest in cleaner production. Still, China’s stated goal is to become the pharmacy to the world. The U.S. doesn’t have a goal or a plan. Without a goal and plan, we are at risk of losing a vital industry.
Jason: Are the Chinese products of good quality?
Rosemary: In 2018, the FDA banned pharmaceutical products from 32 companies in China. This was unthinkable years ago. An example is the recent recalls of blood pressure medicines because of carcinogens found in them. The worst culprit was a Chinese company that knew its product didn’t meet U.S. standards. It had the highest level of carcinogen of all the products recalled – 200 times the acceptable limit of carcinogen per pill. But it sold the medicine to Americans anyway. Chinese manufacturers assume no liability for their products. It’s buyer beware. It’s remarkable that we outsourced medicine making there.
Jason: Do you think advanced manufacturing will have the capability to create some of these active ingredients that we’ve lost to China?
Rosemary: The U.S. has developed advanced manufacturing to make some of the key ingredients in a much more cost-effective way. But uptake by companies has been very slow and I don’t expect generic companies to invest in this technology. Strategic public investment may be needed to take small-scale pilots to commercial scale. If we got this going, thousands of high-paying, high-tech jobs would be created and a dying generic drug manufacturing industry would be resurrected. This would be a huge boost to our economy and national security.
Jason: What’s the situation with drug prices?
Rosemary: For generics, a small number of companies buy 90 percent of all generic drugs. They hammer down on the price paid to manufacturers, buy cheap, and sell higher. You can hammer down on price only so much before the system breaks. And that’s what happened with the blood pressure medicines. The U.S. companies hammered down too much on price, drove production to China, and now we have carcinogens in them. Some hospitals are piloting a new way to buy drugs directly from manufacturers. This will save money, assure better quality, and perhaps drive manufacturing back to the U.S.
You can learn more in the book China Rx, available on Amazon