Let’s say you are a heart attack survivor like me, who must now take a fistful of cardiac drugs every day. And let’s say one of them is Crestor, a drug manufactured by the U.K – Sweden based pharmaceutical company, AstraZeneca. But today you learn that AstraZeneca plans to move all drug production of its “active pharmaceutical ingredients” from the U.K. to China.
Next, you find out that the world’s biggest drug company, Pfizer – manufacturer of both Norvasc (your calcium channel blocker drug) and Accuretic (your ACE inhibitor) – is doing the same thing.
Pfizer plans to close its Connecticut plant and expand operations in Wuhan, China, where hundreds of new jobs will be added. Pfizer is also expanding in Shanghai.
The list gets longer. The drugmaker Novartis (creator of many ‘over the counter’ drugs like Maalox, ExLax, Buckley’s, Bufferin, as well as generic prescription drugs like amoxicillin and fentanyl) has just announced a $1 billion investment that will create China’s largest pharmaceutical plant. Eli Lilly (makers of many diabetes drugs, plus Cymbalta, Prozac, Cialis) has just axed 5,500 North American jobs, and is adding 2,000 jobs at its China plants. Contract drug sales rep firms are ramping up in China to serve these companies.
Outsourcing to China is part of a disturbing Big Pharma trend. Drug companies with massive Western operations are shutting them down and moving them to China to reduce costs. The question you should be asking now is: “How will our government regulators monitor drug safety if all the factories are in China?”
China has a reputation for adulterated drugs and low quality products, some of which have proven to be lethal. The country has in recent years exported poisonous toothpaste, lead-painted toys, toxic pet food, tainted fish, deadly baby formula and contaminated medicine – like the blood thinner heparin.
Heparin is a perfect example of why patients and their doctors should be extremely alarmed at this ‘made in China’ drug trend designed to decrease costs for Big Pharma. Heparin is made from the mucous membranes of the intestines of slaughtered pigs that, in China, are often cooked in unregulated family workshops.
Contaminated heparin produced in China has led to severe illness in hundreds of patients, and the deaths of up to 81 in North America alone. The contaminant was identified as oversulfated chondroitin sulfate, a cheaper substance. Last year, the American Food & Drug Agency identified 12 Chinese companies that supplied contaminated heparin to 11 countries — Australia, Canada, China, Denmark, France, Germany, Italy, Japan, the Netherlands, New Zealand and the United States.
Apparently, the agency did not know the original source of all the contamination, or the points in the supply chain at which it was added.
As industry journal BNET noted online last year, the FDA had only 12 inspectors in China, who were able to visit just 80 of 714 drug establishments in China over the previous two years.
Interestingly, this mass migration of pharmaceutical jobs and plants to China coincides with a Chinese government-sponsored campaign of 30-second TV ads now being broadcast throughout North America and Asia, commissioned to combat the damage done by lead-contaminated toys, melamine-laced pet foods, spontaneously-combusting DVD players, and countless other recalls big and small of Chinese-made products – on top of the frightening tainted drug scandals.
Professor Jing Bing of the Cheung Kong Graduate School of Business explained in a Globe and Mail interview last week:
“This advertising campaign makes foreign consumers less resistant to Chinese-made products.”
However, these TV ads (ironically, their launch was actually delayed by the melamine-contaminated baby formula poisonings last summer) do not address the fundamental shortcomings in the safety of Chinese-made goods.
The Ethical Nag 
I fail to see how it could get worse than it already is. A woman taking cholesterol lowering drugs no matter where they were manufactured is a victim of unethical marketing. There is no evidence for women with or without cardiovascular disease for statins.
Apart from my practice of refusing to buy anything from China if I can avoid it, I think this idea of where a drug like a statin is manufactured is a red herring: it’s dangerous. Period.
Evidence for caution: Women and statin use
in Documents
http://www.whp-apsf.ca/en/index.html
Business Week: Do cholesterol drugs do any good?
http://www.businessweek.com/magazine/content/08_04/b4068052092994.htm
“unethical marketing”
I *do* apologize. Usually, I avoid the oxymoron.
1.* Vytorin payments to KOLs and CME payments (Letter to Senator Kohl, Pages from 2009-08-12 (3))
*Document Date*: 20080912
*Author*: Davies, P
*Corporate Author*: Merck; Schering-Plough; Covington & Burling
*Page Count*: 116
*Search Terms in Context*: Vytorin Documents Payments to KOLs and CME payments pgNbr=1 Covington & Burling llp 1201 PENNSYLVANIA AVENUE NW BEIJING PATRICK S. DAVIES WASHINGTON, DC 30004,2401 BRUSSELS TEL 202.662.6274 TEL 202.662.6000 LONDON FAX 202.778.5274 FAX 202.662.6291 NEW YORK PDAVIES g COV.COM http://WWW.COV.COM SAN FRANCISCO WASHINGTON September 12, 2008 CONFIDENTIAL TREATMENT REQUESTED DELIVERED BY HAND The Honorable Charles E. Grassley United States Senate 219 Dirksen Senate Office Building Washington, DC 20510-620
*Bookmark*: http://dida.library.ucsf.edu/tid/zxb37b10
I resent yet another slap in the face of Chinese manufacturing. North Americans are happy to buy our products in their big box stores at attractive prices without worrying about quality at all until these sensational media scandals.
I appreciate your perspective S.W. – but going to a big box store for an answering machine made in China is hardly the same as buying pharmaceutical ingredients made in China that can KILL US.
We can’t have it both ways; if we want to shop at Costco and Walmart to save money – and isn’t that the ONLY reason people patronize big box stores? – we’d better get used to MORE of our products, yes including important medication ingredients, to be manufactured in China. We vote with our wallets.
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Absolutely frightening. This is far more sinister than just a way for corporate pharma to save money by off-shore sourcing. It’s a slippery slope to abdicating regulation and oversight on the production of life-saving (or life-threatening!) medications to a foreign country that has proven its inability or unwillingness to do this properly.
Thx for bringing this to our attention. Why aren’t we hearing more of this in the mainstream media? What is our government (in my case, the U.S.) doing to address this crisis BEFORE we have another melamine catastrophe?
Love your website – regards, Mark
I used to be a happy guy and then I discovered The Ethical Nag. Everytime I read one of your posts now, I get upset about what the world is coming to! Maybe I should stop reading. But it’s addictive! What else are you planning that’s going to ruin my day next? 🙂
It’s a mistake to lump everything made in China together as one big shoddy mess. Reminds me of the early days of the Japanese automotive industry when we considered anything MADE IN JAPAN meant cheap, inferior quality. Nobody wanted a Japanese car! But now, the 2010 Best Resale List of vehicles from the Kelley Blue Book includes the Toyota Tacoma truck, Honda CRV, Honda Odyssey minivan, Toyota Matrix wagon, Toyota Camry hybrid, etc. —- all hold their value on resale better than most American-made vehicles. I predict we’ll get over this aversion to Chinese manufacturing too just as we did with MADE IN JAPAN items.
“Drug companies with massive Western operations are shutting them down and moving them to China to reduce costs.”
Is this the cost of corporate progress? We lose jobs and our economy suffers because more and more big companies are moving offshore to outsource production to cheap labor under who knows what kind of working conditions? You wrote elsewhere a while back about the world’s chocolate production succeeding on the backs of child slaves in the Ivory Coast – just so we can buy cheap chocolate.
I just book marked your blog on Digg and StumbleUpon.I enjoy reading your essays.
No I don’t want my medicine ingredients made in China but what can we do? Big Pharma makes these money-saving decisions because they can. Who’s going to tell them NO you can’t shut down plants here or fire employees because you need to make your shareholders happy and the only way you can do that is to cut your costs by importing ingredients or moving operations to China?
“…The country has in recent years exported poisonous toothpaste, lead-painted toys, toxic pet food, tainted fish, deadly baby formula and contaminated medicine like the blood thinner heparin….”
And to this shameful list we’re going to now add our widely prescribed medications. Just great. The standards in China, let’s face it folks, are appallingly lax. Are you going to trust your health to these standards?
I’ve spent many years working/living in China and I can assure you that quality control/hygiene/patient safety standards are far different from what you or I would expect in the medicines we put into our bodies.
In answer to your title question: NO I do NOT want to take medications made in China!
There is no way on earth that a small number of North American inspectors (or industry’s local trustees over there inspecting on our behalf) can oversee or regulate what goes on. Their bad rep speaks for itself. This isn’t the same as sending jobs overseas to call centers in India – these plants with their substandard business practices are killing people in this country. It’s an outrage. Why aren’t all MDs hopping mad about this development?
In answer to your title: “NO” I do not want to take medications made in China. But until I read this, I’d never been asked that question. Thanks for this eye-opener, Carolyn.
Shocking. Horrifying. Yet utterly predictable in a strange fashion. Where will this all end?
I know why I had bad reactions from Crestor and aspirin which included bruising, constipation, and other symptoms I don’t care to mention. Once the Doctor took me off these medications, symptoms disappeared and I was able to function optimally.
Calling it “money saving” makes one think Big Pharma is trying to stay in business. They are profit increasing. Nothing to do with saving money, the CEOs want the bucks in their pockets. THis is a nightmare.