Lessard handles drug purchasing for Rochester Regional Health’s Unity Hospital in Greece, where drug shortages – many caused by manufacturing and supply problems – have become routine.
“It really is the new normal,” Lessard said. “You have to find something to help these patients. You can’t put this on the back burner. It’s got to be the first thing that you’re working on, all the time.”
Now, trade disputes threaten to further interrupt the supply, which is already stretched thin. It’s not just Unity where drugs are in short supply. Jen Shaw faces the same problem at the University of Rochester Medical Center’s Strong Memorial Hospital. She’s the drug shortage specialist there.
“Every day we get a list from our wholesaler, and it tells us what didn’t come in that day. I’ll look, and I’ll start seeing, well, what can we do? How can we work with this?” Shaw said.
Shaw’s position didn’t exist until just a few years ago, when a surge in drug shortages threatened the hospital’s supply of important medications, said Curt Haas, the pharmacy director at URMC.
Now, he said, the job description is common. “Most hospitals our size have someone like Jen.”
Drug shortages ebb and flow, but they’ve been a fact of life for pharmacy workers across the country for more than a decade, according to local pharmacists and federal documents.
The Food and Drug Administration maintains a list of compounds that are in shortage. It’s down in length from close to 250 a few years ago, but there were still more than 100 on the list on Friday. Now, pharmacy leaders and industry experts say, the list threatens to grow again.
More than 80 percent of the active ingredients in prescription drugs sold in America are manufactured abroad, according to industry estimates. The majority of those are made in China.
And with the Trump administration demonstrating a willingness to enact trade barriers to achieve domestic and foreign policy goals, the risk of losing access to those ingredients has grown, said David Gaugh, senior vice president for sciences and regulatory affairs at the Association for Accessible Medicines.
“We monitor that very closely,” Gaugh said.
Gaugh’s organization, which advocates for greater availability of generic drugs in the United States, did not have a person working specifically on trade issues until February, he said.
“That’ll probably tell you something,” he said.
When the office of the US Trade Representative came out last summer with a list of products that would be exempt from the first round of tariffs on Chinese imports, “pharmaceuticals were not on there,” said Jonathan Kimball, the person hired to address trade issues at the Association for Accessible Medicines.
“After engagement from us and other stakeholders,” pharmaceuticals were added to the exemptions list, Kimball said.
But it’s still a concern. Every round of trade discussions, he said, there’s a risk that pharmaceutical products will not be on the exemptions list.
The largest fear, though, is not that the US federal government will levy new tariffs against pharmaceuticals. Gaugh said that would be antithetical to the Trump administration’s stated interest in lowering prescription drug costs.
The greater peril is that China would retaliate against tariffs on other goods by blocking pharmaceuticals from being exported to the United States.
“It is a bigger concern now,” said Haas. “Would they shut it off? Make it restrictive, subject it to tariffs? I don’t know."
If China were to cut off pharmaceutical exports to the United States, Haas said, “It would be catastrophic.”
Brett Dahlberg is health-care reporter for WXXI News.