Comment: Our medication supply doesn’t need an act from 1933

Buy American Act could complicate prescription drug supply lines and increase costs for patients.

By Jeff Peterson / For The Herald

For the patients I treat as a rheumatologist, most of whom are seniors or immune-compromised, the spread of COVID-19 adds an extra layer of challenge to an already difficult day-to-day experience.

The questions that many Americans are now asking themselves about whether to engage in public spaces or what to do if an unexpected illness imposes economic insecurity, are questions that autoimmune disease patients face continuously; with or without the coronavirus.

For these vulnerable patient populations, access to medicine is a prerequisite for participating in activities that most people take for granted. Americans who are anxiously awaiting a coronavirus vaccine or therapy now share an existential urgency with immune-compromised patients in communities across our state and the rest of the country. Unfortunately, access to life-saving medications could be circumscribed if restrictive executive action currently under consideration by the Trump Administration is enacted in the days ahead.

Administration officials have been debating internally about implementing provisions of the Buy American Act, or BAA of 1933, a Depression Era, protectionist policy that would leverage government procurement requirements to force the repatriation of U.S. medical supply chains from overseas. While the impetus for this action is rooted in protecting American national security interests, the inevitable disruptions to essential medical supplies and therapeutics far outweighs the potential benefits.

The logistical components that must come together to ensure medicine cabinets in America remain well-stocked requires the integration of critical reagents, medical manufacturing capacity, and scientific expertise from all over the world; a global supply chain that is now at-risk for disruption when our country needs it most. With news outlets already beginning to report shortages of urgently needed medicines in different communities across the country, now is the time to do everything we can to protect and support the supply chain that manufactures and delivers prescription medicine.

Invoking the BAA would disrupt the global supply chain for health-related goods in the U.S., which would add cost for consumers, lead to shortages of essential medicines for at-risk patient populations, and may incite retaliatory trade actions that would damage our already fragile economy.

When Hurricane Maria struck Puerto Rico, where many therapeutic manufacturers produce medicines for the U.S. domestic market, companies were able to work quickly with the FDA to establish safe, effective alternatives to ensure Americans wouldn’t experience any shortages of medication. If the Buy American Act were implemented, this sort of flexibility would disappear overnight – and we might not be able to pivot to alternate routes of production when disaster strikes.

Implementing the BAA would require many manufacturers to race to retool complex supply chains back to U.S. shores, a move that would cost billions of dollars and several years to complete under the best of circumstances. Currently, with many American businesses running idle or with decreased capacity, this step just isn’t feasible and whole production lines for medical goods could grind to a halt while industry adjusts.

Further, increasing the cost of doing business just means that U.S. consumers would see higher prices at the pharmacy counter. This is unacceptable at a time when many families are struggling to cope with COVID-related income loss

While the BAA was well intentioned in 1933, and may help us ask some of the right questions about vulnerabilities in our medical supply chain today, the reality of how the interconnected, contemporary global economy operates is much different than how it operated in the early 20th century. The domestic need for durable medical goods, medicines and essential supplies is only becoming more urgent as our country combats the coronavirus. Administration officials should resist the temptation to try and address shortcomings in the response to the current crisis by precipitating others.

Dr. Jeff Peterson is the president of the Washington Rheumatology Alliance, a physician-run advocacy group that promotes communication between rheumatologists, the patients they serve, and elected officials.

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