Via the New York Times, this interesting article:
...India’s advantage is not just expertise. Peter DeYoung, the American-born chief executive of Piramal Global Pharma in Mumbai, runs more than a dozen factories, including in Europe and the United States. In America, he said, labor is the highest cost “by a wide margin,” followed by energy and materials. In India, it’s the reverse: Materials are the greatest cost and workers the least.
Mennisha Paka, 23, supervises a line at the F.T.O. U-3 factory for Dr. Reddy’s Laboratories, packaging generic metoprolol, a beta blocker prescribed to heart patients. She earns $3,840 a year and uses part of her salary to pursue a bachelor’s degree in pharmaceutical chemistry. One of her subordinates, Susmita, who goes by one name, earns about $2,000 a year.
I recommend reading the whole thing if you would like to understand what Indian generics manufacturers see as their advantage. I think it is particularly interesting that they view the relative lack of API manufacturing in India (compared to China) as their vulnerability, and that Indian construction is faster than the United States (not a particular surprise.)
I have consistently imagined that 500-600% tariffs are needed in order to level the playing field, and those are economically not viable (especially now!) It's taken probably over a century for pharmaceutical and chemical manufacturing to leave the United States, and it will not return overnight.
I used to support generic medicines until I read the book Bottle of Lies: The Inside Story of the Generic Drug Boom. I regret doing that as it is now scary to think about the potential risks of using the generic over brand name products.
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