Over the years arguments have raged within both political parties about the safety of importing or reimporting drugs, generally from Canada. Sure, seniors could save some serious money from legitimate Canadian suppliers of popular prescription drugs, but are a few dollars worth the hefty risk? It was a Republican mantra for years as they protected the virtually unregulated profits from the U.S. market for their generous meds-making giant pharmaceutical donors. Canada puts a ceiling on how much the Pharmas can charge.
Let’s call this the greening of more than a few Politicus readers, especially seniors. Some of you already know what’s behind the window that I’m about to pop open so as to let the sunshine of truth bathe over your environs. Some of you will be taken by surprise.
Let’s start with a couple of corporate names; Aurobindo and Wockhardt. Never heard of them? Odd, for two companies that are keeping many of you alive. If you take any prescription meds, hundreds of thousands, maybe millions of you, have handled prescription bottles with those names embossed somewhere on the label. Aurobindo is the 5th largest entity in its specialized sector, the troubled Wockhardt is number 13.
Now here’s another snippet of information; 80% of the active pharmaceutical ingredients in medications sold here are manufactured elsewhere. You know where I saw that number? A Food and Drug Administration report, dear friends. That brings me back to Aurobindo and Wockhardt; India’s 5th and 13th largest drug ingredient and manufacturing facilities. Their plants make other pharmaceutical-related products as well. Over half of all medical devices some from over yonder.
There are about 600 such plants in China and around 300 in India. Most of your aspirin is made in China not to mention numerous other over-the-counter drug products. Aurobindo has 6 plants in India, 1 in the U.S. (Dayton, N.J.) and 1 in Brazil, mainly to serve Brazilian customers. Chances are at least two of your prescriptions came from one of the 6 plants in India considering costs for the huge pharmas are anywhere from 15 – 40% lower than in the U.S.
Maybe you’re gobbling up a Carvedilol or two per day. It’s a favorite generic prescription for those with high blood pressure and relatively mild congestive heart failure. The Zocor generic, Simvastatin, a drug that works to keep that nasty old cholesterol at a low, healthy level, is another Aurobindo favorite. Happy with the results? Drop the corporate office a line. Just send your note to Plot #2, Ameerpet, Hyderabad – 500 038, Andhra Pradesh, India. I’m sure they’d be glad to hear from you.
Lisinopril is another favorite of the high BP, heart attack and CHF crowd. It’s a generic ace inhibitor that’ll most likely keep you alive a few more years and its ingredients are most likely pieced together in one of Wockhardt’s 4 Indian factories. Maybe the one in Aurangabad, a city in Maharashtra. You can stay in the delightful Lemon Tree Hotel for the ridiculously low price of 4,300 rupees or about $80. You’ll want to upgrade a bit, but it’s still a hell of a deal with a super swimming pool. That $80 would likely eat up a month’s salary for the average Aurangabad plant worker. Take a little side trip to the Ellora caves while you’re there.
Another plant is on Plot # 87-A, of the Silver Industrial Estate in the village of Bhimpore, not very far from Surat and famous for its clear air and pristine sea water. You’re supposed to able to cure all manner of skin diseases just by sprawling out on the beach. I have no skin problems, but the sprawling part sure sounds appealing.
Enough of the travelogue. My point is that your meds are coming from India and China. They’re coming from people who are paid a pittance and in some cases, the ownership is troubled and hanging on by their fingernails. Wockhardt is a good example. The company has been around for nearly 50 years, but had recently fallen into deep debt problems and had difficulty repaying foreign currency convertible bonds. Shares collapsed on the Sensex Index (the Bombay Index before the name-change to Mumbai) and the company came within a whisker of liquidation. Things have improved in the ensuing years, but I’m not sure I’d want my meds coming from a company fighting brutal fiscal battles. I’d be afraid they’d take their eye of the ball of making sure the meds were safe and exactly as ordered.
How many times the factories have been truly inspected is open to speculation. A few that require special attention for whatever quality reasons, attract some attention. There are others that haven’t been seen more than once or twice a decade, if at all. Nearly 8 out of 10 generics are manufactured overseas by those low-paid workers in China (a buck or so an hour) and India and several other countries. Indian factory owners are currently in a vicious battle with unions that are actually demanding a living wage for workers in assorted industries.
As for Chinese manufacturers, their appeal to the huge pharmaceutical companies can best be summed up in this Internet statement from Panjin Dmso Chemicals Co. Ltd. in the Liaoning Province: “Our product’s qualities are the best in China, also their prices are the lowest.” The company is named after their home city.
The Republicans want to cut funding for everything that doesn’t go boom or isn’t Koch-connected. The FDA is in desperate need of inspectors to hold Chinese and Indian meds manufacturers feet to the fire to avoid another deadly debacle like the 2008 contaminated Chinese-manufactured (contracted to Baxter) blood-thinning Heparin batches that killed 81 Americans officially, though estimates run into the hundreds. After-the-fact FDA inspections found numerous violations by the Chinese. As worrisome is the fact that numerous players in this tragedy remain in the industry.
A rare piece of bi-partisan good news is a bill overwhelmingly passed a few months ago by congress (387-5 in the House, 92-4 in the Senate) that gives the FDA much wider latitude in inspecting overseas drug plants. In many cases that means going from zero inspections to at least one every other year or so. Of course, it’s one thing to pass a high-minded bill, quite another to fund it adequately. The money must be substantial and consistent.
There are simply services and agencies that cannot be underfunded or defunded and FDA inspections, domestically and internationally, are an absolute priority among them. I don’t mind saying that prescription meds that can kill you if the ingredients are just a hair off, should draw full-time attention from the FDA and, frankly, be manufactured right here in the good old USA with strict oversight. But Republicans reward pharmaceuticals for taking their manufacturing business elsewhere…and Mitt Romney thinks that’s just dandy.
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