The US could make billions more doses of medication each year

In the early days of the pandemic, there were shortages of seemingly everything from toilet paper to glass jars (obviously for your sourdough starter kits). One of the more serious shortages we’re still seeing nearly three years later is pharmaceuticals.

A big reason for this is that the US relies on other countries—mainly India and China—to manufacture the main ingredients for drugs, called active pharmaceutical ingredients, or APIs. A 2019 FDA study found that 72% of the facilities that supply the US with APIs are overseas because it’s simply cheaper to make them there.

India relies on China for manufacturing materials, and when the pandemic started, the country experienced supply chain delays. In response, the Indian government restricted exports of APIs to prevent shortages in its country, leading to shortages in the US.

Having enough manufacturing capacity to make drugs domestically and avoid relying on other countries would go a long way to prevent drug shortages, which cost hospitals an estimated $360 million every year.

And yet, nearly 30% of American manufacturing sites are operating at—or below—50% capacity, according to a study from Washington University in St. Louis. Of the remaining sites, about 35% are operating between 50%–80% capacity and about 30% are operating over 80% capacity. Slightly more than 5% are operating near full capacity, the study found.

Lynne Byers, global managing director of pharmaceuticals and dietary supplements consulting at NSF, a global public health and safety organization formerly known as the National Sanitation Foundation, said the sites writ large aren’t operating at 100% because they just don’t have the demand.

But if all of the sites got their capacities up to 100%, nearly 30 billion more doses of medicines could be made in the US without having to build new manufacturing plants, according to the Washington University study. The researchers estimated that all US sites could reach full capacity within three years.