“According to a 2022 report from the National Academies of Sciences, Engineering, and Medicine, “on average, the number of ongoing drug shortages has been increasing and are lasting longer.” The root cause of that problem, per a report from the Food and Drug Administration, is the economics of the pharmaceutical market itself.
The reasons for shortages are generally consistent no matter the drug: either a shortage of raw materials or a problem at the plant where the drug is manufactured. Shortages for medicines that a patient can pick up at the pharmacy often draw the most headlines, but most of the medications that end up in short supply are generic, injectable drugs that are used in hospitals: usually, these drugs have only one or two suppliers. So if there is a problem at the factory of one company, there is not an easy way to scale up production to make up for a shortfall. And they are usually cheap, which means the companies that manufacture them do not have a strong economic incentive to produce any excess supply.”
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““It makes a lot of sense when you think about it from their perspective. But when you think about it from the hospital perspective, it’s very frustrating.”
Some of these shortages have led directly to patient deaths. An Associated Press report in 2011 linked at least 15 deaths over the prior 15 months to drug shortages. A more recent study, following the year-long shortage of a drug used to treat septic shock, found higher mortality rates for patients who relied on a substitute. Even short of death, drug shortages can meaningfully change the care patients get — if, for example, a pregnant person undergoes a cesarean delivery, with its higher risk of complications and longer recovery time, because the drug that could have induced labor earlier is out of stock.
Experts do have ideas about how to make the pharmaceutical supply chain more resilient. But they require action by the federal government. Until that happens, there is little reason to think the pace and duration of America’s drug shortages will slow down.”
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“These companies rely on razor-thin margins and massive scale to make their business work. They have a “just in time” production schedule, which means almost as soon as the product rolls out of the factory, it is delivered to health care providers. There aren’t warehouses with emergency stockpiles, because it wouldn’t really make financial sense for manufacturers to produce and store the excess supply.”
“The goal is to send National Advanced Surface-to-Air Missile Systems to Ukraine in the next three to six months, CEO Greg Hayes said in an interview. The U.S. would then backfill those systems with new NASAMS in the Middle East over the next 24 months.
“There are NASAMS deployed across the Middle East, and some of our NATO allies and we [the U.S.] are actually working with a couple of Middle Eastern countries that currently employ NASAMS and trying to direct those back up to Ukraine,” Hayes said.
He noted that shifting systems from the Middle East is faster than building them in the U.S. “Just because it takes 24 months to build, it doesn’t mean it’s going to take 24 months to get in [the] country,” he said.”
It takes two years to build NASAMS because of the lead time required to buy electronic components and rocket motors, Hayes said.”
“a senior administration official said the easing of sanctions was not driven by the oil market pressures and was instead a response the Venezuelan regime’s decision this week to participate in the negotiations with opposition groups. Those talks, which were originally launched in Mexico City in September 2021, are expected to focus on humanitarian programs and setting future elections.”
“Much of the European ire is directed at an IRA requirement that electric vehicles must have their final assembly in North America to qualify for a $7,500 tax credit. That has eliminated many European models that previously qualified, and even more could be excluded when additional domestic content provisions take effect, beginning in January.
The Treasury Department is currently developing guidance for how it will implement that tax provision, and Biden referred specifically to language that provides better treatment for countries that have a free trade agreement with the United States as one area where the law could be implemented in a flexible manner.
“That was added by a member of the United States Congress who acknowledges that he just meant allies. He didn’t mean literally free trade agreement. So there’s a lot we can work out,” Biden said.
That would solve some of the EU’s problems, since it doesn’t have a free trade pact with the United States. However, there is still the bigger problem that many of the cars that European companies sell in the United States are assembled in Europe, disqualifying them for credit because of the North American assembly requirement.
Biden did not say how that could be addressed, but U.S. lawmakers in recent days have said the administration is considering giving automakers more time to comply with the IRA provisions. That’s an issue that the France and other EU member states will continue to discuss with the United States through a recently established bilateral task force.”