Hastings center. Good morning. Guest good morning. Great to be here. Host tell us about drug shortages in the United States. What drugs are we talking about. What drugs are we short on . Guest in the United States of america, we have a shortage of really important medicines. This has been going on 20 years. Andave had hundreds hundreds. One of the medicines and shortage right now is a really important blood thinner that hospitals use every single day. There was an article in a local newspaper about a boston physician saying i do not know if we can do cardiac surgery two weeks from now if we do not have this product. We are walking on a very thin line. We have had shortages of chemotherapy to treat cancer in children and adults. We have had shortages and right now, there is a shortage of a really important antibiotic to treat a lifethreatening infection. These are life and death medicine. Sometimes, we cannot get them, and we are rationing. In therationing medicine United States of america. Really remarkable. Host is this hyperbole or is is a real, existing problem . In washington, we hear a lot of talk from a lot of Different Industries saying that scott is falling here, the sky is falling their there. Is is a real problem where peoples lives are endangered danger because these drugs are not available . Guest this is the real deal. I do not take money from industry. I have no conflict of interest that i was talking with a physician working to try to get medicines for children with Rare Diseases. These are not the new, innovative drugs needed. These are the old, mainstay medicines. Many, many children are dying from Rare Diseases because we do not have basic medicine. Host how did we get here . Guest that is a long story and we will get to that. 12 years ago, there were hundreds of americans who died from dialysis, others in the hospital, because there was a shortage of this blood thinner, heparin. That happened because there was a shortage, and we were getting it from china, and china did not want to spend the money, so they put in a fake substitute for the real ingredient, and it turned out to be lethal. Shortages are real. People are dying. And people suffer. If you cannot get the right antibiotics and doctors have to come up with a substitute, you get a secondbest antibiotic. That can cause a whole lot of problems. This is real. We just do not count the number of people who are harmed, because it is so hard to do that, but this is a very serious problem that affects all of us. It is not democrat or republican. It does not discriminate in any way. Host how did we get here . Guest we got here because we have stopped making, in the United States of america, many of the medicines that are vital. Many of your viewers have probably taken an antibiotic lets take penicillin. We used to have penicillin plants all over this country. Rees to have other antibiotic plants all over this country we used to have other antibiotic plants all over this country. Now we have virtually nothing. If we cannot make the medicine and are relying on other countries this is how we lost penicillin. In the early 2000s, china dumped penicillin product on the u. S. And global market. They made it at a really cheap price. What happened was u. S. Producers couldnt compete, so that drove out all of the u. S. Producers and producers around the world. And then they raised the price. If we cannot make something, and if we are dependent on another country that is applying the whole world it is like oil. Can you imagine if lee and the world depended on china for 80 of our oil . What would that look like . That would be a problem. You would have a problem with supply and a problem with quality. That is how we got into this situation. And that chemotherapy drug you know why that was in shortage and had to be rationed . The food and Drug Administration went into the plant and found very serious problems. There were medicines that did not have will potency. They do not have the real active ingredient, which is devastating if you are a cancer patient. Some of those medicines have particles and other things in them that should not have had them, so they had to ban all those products coming from that plant. But because the fda was so concerned about a shortage, he later said he will allow some of it in. This is the situation we are here in 21st century american medicine. It is really concerning. Host you brought up the fda. I wanted to read this quote from your book. Its no in china rx, ones job in the federal government to know who controls our drug supply. Are you literally saying that there is no one responsible for the drug supply of the United States of america . Guest if there is someone who was responsible, we would not have shortages. What the fda does, and they do a good job of this they track what medicines are in shortage. They have a website you can go on and see what audits are in shortage right now. Reported, and doctors and pharmacists have to scramble and ration, and people can be adversely affected. That is our system now. We do not have anyone in charge of assuring that we have a full supply of medicine whenever we need it, every person, every day , in this country. That is what needs to change. And it really is a manufacturing issue. If we cannot make things anymore, if our plans have shut down, i went on and looked, before the show come out all the drugs on shortage on the e. A. List, and itfda turns out there are u. S. And western manufacturers stopping production of generic drugs. It says that discontinuing production. Why is that . Because they cannot compete with a lower cost of china, which is ramping up its production of generic drugs. Ourt now, about 9 of generic drugs are coming from china. That happened in just 10 years. Where are we going to be . And they are ramping up quickly. So where are we going to be 10 years, 15 years from now . There will be 25 , eventually up to 80 of suppliers of our generic drugs. Think of what could happen with that. Host since you brought up generic drugs, you are just talking about drugs used in surgeries. We are talking about every day, overthecounter drugs and prescription drugs, given to americans by their doctors. So we are not just talking about drugs used for surgery, we are talking maintenance drugs as well. Guest that is right. Lets take Blood Pressure medicine. I am sure a lot of your viewers will get calls about Blood Pressure medicine recalled. There was a hearing in summer at the u. S. China Economic Security review commission, and one of the commissioners, who is retired military, as a commissioner, he took a few minutes during the hearing to talk about his experience with his Blood Pressure medicine. He said i have three recalled Blood Pressure medicines. The ingredient came from china. And it had rocket fuel in it. And if i am getting medicines like this, then active duty military must be getting it. So millions of americans were affected by this. That is not something you get in a hospital. Supply the hospitals may Blood Pressure medicine, but you go to the drugstore and pick up the Blood Pressure medicine, they will say we do not have that one, you will have to call your doctor and get a new prescription. This has created havoc for doctors. They do not know what to prescribe with so many shortages, prices have gone up. It is a really difficult situation for so many americans. Host we will open up regional lines. That means if you are in the eastern or central time zone, we want to hear from you at 202 7488000. If you are in the mountain and pacific time zones, your line is 202 7488001. And we will open up a special line this morning we want to hear from medical professionals. Are you seeing this shortage in your hospital, in your pharmacy, in your Doctors Office . We want to hear from you. This is something you are seeing . Medical professionals, call in at 202 7488002. And remember, you can always text us at 202 7488003. We are always reading on social media, on twitter, cspanwj, and on facebook, facebook. Com cspan. Lets take our first caller, hanover,m pennsylvania. Good morning. Caller how are you doing . The greed that is involved with all of these Companies Moving out. You cannot get anything but generics now. I am diabetic, taking all kinds of stuff all my life. Youlet me tell you this are right. You do not know exactly where this comes from or that comes from, yet they have an idea. The administration. I will not mention names we get stuff from canada, we get stuff from here that is no good. What is the difference . It is all about the greed. That is why i am on generics. I cannot afford to get lipitor. It is all about the greed. Thank you, for you looking into it. It disturbed me, what you are saying. I understand you 100 . God bless you all. Guest thank you for the call. The caller mentioned about you do not know where it is coming from. There was, about 10 years ago, a bill introduced to have country of origin legislation that would require manufacturers as where a product comes from, where medicine comes from, and that was killed immediately. Nurses,umers, doctors, pharmacists, we should know where our medicines are being made. We have to do that quickly. China is ramping up production, taking a whole lot of our generic market as western generic any factories are collapsing. We have to do that quickly, or we will be in a situation where china is the predominant producer of our generic drugs. Host does our dependence on china on these medicines, is already causing some of the shortages . Guest absolutely. If we cannot make antibiotics anymore, if we stop making ingredients for chemotherapy, if we are dependent on a single country once again, if we had all of the worlds oil, all the country in the world had to go to china to get there oil supply or wheat or corn we do not do that. But that is where our medicine supply has migrated. China controls about 80 of the ingredients to make generic medicine. Think about that. They make the raw materials, the chemicals, and then they turn that into what makes medicine medicine. It has been a very deliberate strategy, i really smart strategy, crafted over many years. Shortage problem is we need to bring some of this manufacturing back home, so we are not dependent on a single country and have to stand in line. Orthere is a Global Pandemic a Natural Disaster in china, we will be lining up to get medicines, and china any country would keep those medicines to themselves. They will not send them patients and hospitals here. It is a serious problem. Host is it that the United States cannot make these medicines or that we will not . Shut down a lot of manufacturing plants. With that goes the talent and skill and knowledge to know how to make them. The next 10ment, in years, where we need to capture that talent to make sure we do not lose it. Here is some good news about what is happening to address shortages. There is a consortium of about 1000 hospitals, mayo clinic and others, that have been really concerned about these shortages. So they have set up a new organization, and they are doing something really smart, like anybody would do in any other market. They are looking for new suppliers and trustworthy countries and giving them longterm contracts, paying a fair price, not a race to the bottom price. And, within one year of start up, they were able to supply their member hospitals with a really important antibiotic. One of these last resort on the life or death reticence. And the finished drug is made in a plant in ohio, and the active ingredient is coming from europe. There are are 13 other drugs in line, and more to come next year, so shortages are solvable. We do not have shortages of anything in this country why is it we have shortages of medicine . It is remarkable. But we are seeing hospitals turn it around. We just have to grow this exponentially. We have to do it quickly to have some of that manufacturing back here in the u. S. Host how is this not a National Security issue . I assume our military needs all of these medicines that the civilian population does. I assume they are getting the same medicines everyone else gets. How is this not a National Security issue . Or is it . Guest it is a huge National Security issue. Think of what you could do with medicines in a geopolitical context. If you control the supply of penicillin, if you are the dominant use of antibiotics, you can withhold those. You can contaminate them. You can make them look like medicine and have nothing in them. If you want to destabilize a country and demoralize a population really quickly, all you have to do is withhold medicine. Like at least someone at the fda agrees with you. Janet wilcox as head of the fda center for drug evaluation and research. Heres what she said lack of reliable supply of critical medicines creates a significant risk to National Security, not just for our military but for all of our citizens. That is just what you were just talking about, right . That is right. You do not have to hack the electric grid or fire a missile to take a country down. And our military think of the young men and women in the South China Sea on the aircraft carriers. They are looking out on an adversary and they are dependent on that adversary for basic medicines, the ingredients to make them. It is remarkable. But i am delighted, on a positive note, with china rx and the hearings on capitol hill, that word has gotten out, and people are now seeing this as a tremendous National Security risk that we have to tend to quickly. Host back to our phone lines, lets talk jim, who comes from cheyenne, wyoming. Caller earlier, it was stated no one in the government is responsible for our drug supply. I am wondering who is responsible here. Is there anybody in the house or senate really making a concerted effort to correct this . Or does china have such a powerful lobby that it is somehow depressing any political activity to correct the issue . Thank you. Guest the first thing that is taking place is that there is National Security reviews going on in the federal government to understand where we are vulnerable. At aent hearing recent hearing in a subcommittee, this topic came up. On fda provided answers where we were vulnerable. That is the first recommendation in china rx we have to know where we are vulnerable. Ive been surprised, briefings ive done in many different sectors, that people are not aware of it. But that is changing. Then we need a plan to escalate this, and how do we use our procurement dollars, our taxpayer money, to support manufacturing to come back to the United States for various medicines . Our military, the department of the v. A. , taxpayers are spending millions of dollars a year, and some of that is going to china we need to bring that money back home so we can support our workers and communities here and have the security of medicine supply when we need it, every person, every time. Robert,ts talk to calling from california. You are a medical professional. Tell us what you are seeing. Issue goingad this on for years now where we have essential medications, something had to give to people having seizures and other conditions, and it just disappears off the market we have our pharmacies scrambling to find places for it. I am not big into regulation, but capitalism is failing, and you have Companies Stop making andntial medications opioids flood the market somebody needs to step in and find out what these Drug Companies priorities are. Guest the caller is right. There is a drug to treat tuberculosis that has been in short supply, and it has been in short supply many times this is the situation we are in. Foreed incentives manufacturers to come back home. You know what the root cause is . Manufacturers are going out of business because we are viewing generic drugs as cheap commodities, like buying cheap tshirts. If you and i go to the Shopping Mall next weekend and look for the cheapest possible tshirt, we will find an save . 10 on it. On adibly, this is, largescale, how our drugs are being purchased a are looking for cheap. Peoplewant to find keep, will find a. Businesses are going out of business because they want a quality product. That is what we have shortages. Because there are so few producers left. We need to bring that manufacturing back home, support those companies that want to do it right, pay them a fair price, and shortages will disappear. Host i want to read a bit from an editorial you wrote earlier this year about this over the past 30 years, a lot of drug and you factoring has been offshore. 90 ofnerics comprising the medicines americans consume, there is not a growing reliance on china for essential drugs. The u. S. No longer makes penicillin, for example, with the last u. S. Penicillin plant closing in 2004. Now, the u. S. Has virtually no capacity to make generic antibiotics used treat ear infections, strep throat, pneumonia, urinary tract infections, sexually chessmen it diseases, lyme disease, and other illnesses. And when the u. S. Government needed to buy 20 million doses of the antibiotic doxycycline after the 2001 anthrax attacks, it turned to a european supply that sourced ingredients from china. This seems to be a huge problem. Guest it is anna normas problem. Problem. Is an enormous we need to fix it quickly. It is remarkable how our dependency is accelerating. China has a plan, and industrial policy. It has an industrial policy. They said their aim is to become the pharmacy to the world. They are on track to do exactly that. A plan and we need to do it quickly. Has the tradeect battles between the United States and china during this administration have on the drug supply . Has it had any . Has china threatened the drug supply because of these trade battles . Or has this been a completely separate issue that has nothing to do with their trade talks between the administration and china . Guest for the most part,