Joseph R. Anticaglia MD
Medical Advisory Board
What happens if the drug you depend on for dialysis, epilepsy, hypertension or type1 diabetes suddenly becomes unavailable? What happens if the drug you thought was safe turns out to kill you?
Randy, a 62 y/o insurance salesman has been treated most of his life for diabetes and hypertension. Several years ago his kidneys stopped working requiring hemodialysis three times a week. The anticoagulant heparin is a life saver, because it prevents blood from clotting during dialysis. The year was 2008 and in Randy’s case, heparin instead of saving his life became the cause of his death.
Dialysis had become a routine part of his life but it dramatically pivoted into a life and death crisis. During one dialysis session, he was injected with contaminated heparin. Thirty minutes after that injection, he complained of tingling sensations, feeling nauseated and shortness of breath accompanied by a drop in his blood pressure. The combination of symptoms caused his death.
Evelyn celebrated 10 years as a cardiac care nurse in 1995 with friends and hospital associates. The next day she was driving home as usual after completing her 3 pm to 11 pm shift from the local hospital. It was a slippery January night. She lost control of the car, struck a tree and suffered severe head trauma.
The EMS was quickly on the scene. Evelyn was unconscious with irregular breathing, pupils not responding to light and no response to painful stimuli. The EMS team supported her breathing, administered intravenous fluids while taking her to the emergency room of the hospital she just had left.
Evelyn underwent multiple diagnostic tests and received lifesaving medications which included intravenous antibiotics and I.V. steroid medications. After ten days she regained consciousness thanks to her doctors and in no small part to the availability of the vital ingredients in the medications she received.
The safety, efficacy and availability of medications are crucial considerations for all Americans.
Safety
Most Americans don’t know where drugs come from. We nonchalantly take for granted that the medication we take are safe and effective be it insulin, birth control pills, antidepressants or medications for HIV Aids. We assume the Food and Drug Administration does its job to protect Americans against unsafe drugs. Why should we be concerned?
At one time, as in Evelyn’s case, the U.S, pharmaceutical companies made the critical ingredients needed to manufacture pills and intravenous medications. These American companies met high standards of safety and quality assurance to protect American consumers.
Over the last two decades, however, there has been a dramatic shift toward China and India to supply the U.S. companies with medications and vital chemical ingredients to fight infections and other conditions. The vitamin C pill or antibiotic tablet you took was most likely was made in China. Are they of high quality and safe?
In 2009 it was revealed that a Chinese company deliberately adulterated heparin to save money. Randy was one of 250 fatalities in the U.S. due to a shipment of contaminated Heparin for economic gain.
Availability
Aspirins, steroids, blood pressure and Parkinson medications plus others are made in China and sold in the United States. If China decided to stop the supply chain of pharmaceutical ingredients and medications to the outside world, doctors in the United States would be put in a position of treating patients much as they did in the 1900s.
Rosemary Gibson, co-author with Jonathan Prasad Singh, titled China Rx, said on C-Span in May of 2018: ”If China closed the door on exports, within months pharmacy shelves in the United States would be empty and hospital would cease to function.”
Security
Daniel Slane a panel member with Gibson on the May, 2018 C-Span program noted: “China uses trade as a weapon. In 2016, Japan seized a Chinese fishing vessel; thereafter, China stopped supplying a Toyota plant in China with a rare mineral. The Toyota plant in China closed down.”
Imagine the powerful weaponry China would wield if it fulfilled its stated goal to become the “Pharmacy to the World?” This is not some ‘pie in the sky’ pipe dream. It potentially could affect the health of patients, the practice of medicine, the workings of hospital and our national security.
Slane points an accusatory finger at the American leadership for allowing this drug debacle to compromise the welfare of Americans. He said: “I’ve seen the enemy and it is us.” Well, what can be done about it?
Rosemary Gibson offers the following recommendations:
- “We need to view medicine as a strategic asset the same as we view oil and food.
- We need to maintain our manufacturing capability here at home
- We need to control the supply chain of medication.
- We need to set up a tracking system so we know where medications are coming from and a forecasting system to anticipate future medicinal needs.”
The takeaway — The U.S. military, American children, families and the elderly should never be at the mercy of a foreign country for their medications.
References
David Blossom et al; Outbreak of Adverse Reactions Associated with Contaminated Heparin; N Eng J Med, Dec 18, 2008
Rosemary Gibson, Jonathan Prasad Singh: China Rx—Risks of American Dependence on China for Medicine
C-Span May 7 2018; Rosemary Gibson and Daniel Slane talk about the risks of relying on China to supply the U.S. with medications
Consumer healthcare product association, CHPA; FAQ about manufacturing quality
This article is intended solely as a learning experience. Please consult your physician for diagnostic and treatment options.