Latest news with #UniversityofUtahHealth
Yahoo
27-05-2025
- Entertainment
- Yahoo
Freak Accident Burned 50% of High School Senior's Body. It Didn't Stop Him from Starring in 'Footloose' (Exclusive)
Rising Virginia high school senior James Culatta was on a summer hike when the ground gave way beneath him and he fell into a near-boiling hot spring He was horribly injured and spent months in the hospital but eventually recovered enough to star in his school's spring musical "I felt so grateful for these people that believed in my kid," his mom saysLast June, James Culatta was hiking with his family in Orem, Utah, during a college visit when he stepped on a rock and the ground opened up beneath him — sending him tumbling into a underground hot spring of scalding water and mud. 'I was terrified,' the 18-year-old from Herndon, Va., says now. 'I had never experienced that much pain in my life. I didn't know you could feel that much pain.' The spring that James fell into was more than 200 degrees, close to the boiling point. He tried to swim out but the ground was too unstable. Eventually, though horribly injured — the skin had melted off of both of his hands and he had suffered burns on about half his body — he pulled himself to safety. 'There was blood everywhere,' he says. James drank two gallons of water while he waited for a LifeFlight helicopter to take him to the University of Utah Health's Burn Center in Salt Lake City. What had started out as a summer trip for a family reunion, with a detour to see a prospective college, was suddenly something much more dire. 'We thought there was a good chance he was never going to walk again,' says James' dad, Richard Culatta, 46. The recovery, James says, was 'more painful' than his accident. Doctors had to remove the burned skin from the bottom half of his body, then they had to strip the skin that had not been burned — from his belly button to his neck — and stretch it to make grafts for to help replace what had been lost. (He looked, his dad says, like a mummy in a museum.) '[It] was so stressful and so painful, and I really couldn't have done it without my family. They've helped me so much,' says James, the second oldest of four children. 'They were by my side the whole time.' The teen spent two months in the hospital in Salt Lake. He was still an inpatient when his school, Herndon High, announced they were staging a musical production of Footloose for the spring. The news caught his family's attention. James says he's always felt a connection to the original movie, and he loves singing and dancing. He was in his school's production of Fiddler on the Roof last year. 'We looked at each other and said, 'Oh my gosh,' wouldn't that be amazing [for him to be in it],' recalls James' mom, Shaundra Culatta, a 42-year-old professional violinist. 'But,' she says, 'it felt so far out of reach. He couldn't even stand at that point — it felt like an impossible goal.' And then, with time, it wasn't so impossible after all. Earlier this month, after six months of grueling rehab and seven surgeries, he starred as Ren McCormick, the character Kevin Bacon originated in the 1984 movie. 'To see him dancing up on stage is just amazing,' says Richard, who runs the nonprofit Innovative Learning. 'I was like, 'Are you able to do this?' You should see his knees. If I showed you a picture of what his knees look like, they look like they've been through a garbage disposal. It's just totally shredded,' Richard says of James. 'He's like, "No, we made it work.' ' Never miss a story — sign up for to stay up-to-date on the best of what PEOPLE has to offer, from celebrity news to compelling human interest stories. The teen had to miss the first semester of his senior year because he was in the hospital and, when he returned home, he needed four hours of physical therapy at a MedStar in Washington, D.C., with a commute that took about 90 minutes each way. The possibility of Footloose hung out in the future. Friends encouraged him to audition for Ren and while he says he 'never really thought I would actually get the role … I'm so glad that I did, because I made so many friends and I strengthened relationships.' 'It gives me hope going forward,' he says. His parents say they are very grateful that the director took a risk in casting James — at the time he auditioned, he was walking 'like a penguin,' Richard says. 'His overall health was in the balance from the very beginning, he was still sick all the time,' Shaundra says. 'I felt so grateful for these people that believed in my kid.' The choreography and costuming were adjusted for James. For example, in a gym class scene, he wore long pants (with medical-grade compression garments underneath) when the rest of the actors rocked shorts. Nonetheless, he danced, shuffled and slid on his knees as the part required. 'It was an incredible miracle,' Shaunda says. 'It's just such a testament of the power of family and community and prayer and faith. It was truly horrific what he went through. But it is kind of this wonderful comeback story because this musical is all about dancing." James has a 'really, really long road' ahead, according to his mom. He has several more surgeries planned to improve his mobility. 'But he's a really, really tough kid." His care team sat with his parents in the second row for his final performance on May 4. 'There were lots of tears,' Richard says. This summer, James plans to return to Utah and be a counselor at a summer camp for kids who are burn survivors, alongside the doctors and medical team he got to know from the University of Utah Health. 'They've become my family,' he says. 'I love them so much.' And in the fall, having now caught up on the schoolwork he missed, he plans to attend Utah Valley University, where he had been planning to visit before his injuries. He's considering becoming a physical therapist and working with other burn victims. 'You can do anything if you believe in yourself,' he says. 'And with the power of friendship and family, anything's really possible.' Read the original article on People
Yahoo
22-05-2025
- Health
- Yahoo
Trump Wants Pharmaceutical Tariffs Soon — Here's Which Drugs Could Disappear From Hospitals First
We use pharmaceutical drugs every day to heal infections, treat cancers and relieve pain. But if President Donald Trump has his way, these largely foreign-made drugs would be targeted with tariffs, potentially causing unexpected shortages and making your doctor's visit look much different in the future, experts say. Erin Fox, a drug shortages expert at University of Utah Health, said a major tariff could cause companies to discontinue production of low-cost, low-margin drugs like the ingredients in epidurals, as one example. She said patients could end up receiving alternative medicines because the hospital has a shortage of certain pharmaceutical drugs. 'Maybe everybody doesn't get an epidural,' she said. 'We may be going back in time there.'So far, pharmaceutical drugs have been one of the few exceptions from Trump's ongoing trade war against the world. They were left out of Trump's 'Liberation Day' announcement in April to impose exorbitant levies on imports from foreign nations. But this reprieve may not be for much taking office again, Trump has repeatedly said that he believes using tariffs on pharmaceuticals can pressure drugmakers to move their manufacturing back to the U.S. 'We're going to be announcing very shortly a major tariff on pharmaceuticals,' Trump said in April at the National Republican Congressional Committee dinner, and earlier this year, he said he would impose a tariff of at least 25% on April, the Department of Commerce also announced an investigation into the national security implications of pharmaceutical imports, which could set the stage for justifying tariffs on pharmaceutical drugs as a solution. 'The reason why it's particularly relevant is that the [Trump] administration has used it to also do steel tariffs,' said Marta E. Wosińska, a senior fellow on health policy at the Brookings Institution. It is not yet clear when that national security investigation will end, and if and how tariffs on pharmaceuticals will be implemented. But U.S. pharmacists are already stockpiling the most common drugs for that possibility. Because the supply chain for medications is not transparent, Fox said, it's not exactly clear which drugs would be impacted by tariffs the most. But if an extreme pharmaceutical tariff does happen, here's which types of drugs could be most at risk of disappearing for people in need. Most over-the-counter pain medication you get in the U.S. comes from China. You wouldn't notice drug disappearances right away because of stockpiles. If tariffs went into effect on June 1, Fox said you could realistically notice some shortages by Halloween and Christmas. 'The first thing that would happen is you would just have way fewer choices,' Fox said. Right now, if you go to a drugstore, you can buy ibuprofen in multiple forms, as a liquid or as a tablet from different store brands. 'I think it's very realistic that that would shrink,' she said. Most prescriptions in the U.S. are for generic drugs, and many active pharmaceutical ingredients (APIs) in those drugs are sourced from injectable drugs that hospitals use every day, like lidocaine and morphine, are basic drugs that are cheap to produce, and they would be vulnerable to getting discontinued under a major tariff because companies would pivot to making more profitable drugs, Fox said. 'What my fear is and what I anticipate is that we will see ... six to eight months out, we're going to see companies start to discontinue these very basic but very essential drugs, because they just can't absorb those added costs,' Fox drugs have low profit margins and 'unless they can increase the price, the drug is going to be completely unprofitable, and they'll want to get out of the U.S. market,' Wosińska said. There are 'zero requirements' from the government to force any company to make any drug, no matter how life-saving it is, Fox said. 'Cancer drugs, I would say, are the ones that I worry about the most' of getting impacted by major pharmaceutical tariffs, Wosińska said, noting that they could lead to hospital shortages. 'You get admitted to a hospital, go for your cancer treatment, and the doctor tells you, 'Sorry, we don't have that,'' Wosińska said as one scenario. These drugs already face supply issues. In 2023, there were shortages of Cisplatin, a critical chemotherapy drug, driven by manufacturing quality problems in an Indian facility. The facility had 50% of the market share for the drug, highlighting how one problem in the supply chain can cause ripple effects. That 2023 supply disruption was due to quality issues. But if Trump enacted widespread pharmaceutical tariffs, this kind of shortage would be due to money. Most cancer drugs have to be administered by a physician, and many are covered under the U.S. government's '340B' safety-net program, which allows qualified hospitals and other health care providers to buy certain outpatient medications at steeply discounted prices from manufacturers. This program is meant to increase access to outpatient medications. But it could also make cancer drugs unprofitable for manufacturers to continue making under 20-25% tariffs. 'Manufacturers in this scenario, if they sell to a '340B' hospital, would have to eat 90% of the tariff,' Wosińska said. 'If their margins are really low, they're just going to say, 'We're out of here,'' she continued. 'Cancer drugs in particular have really high exposure to '340B' ― it could be more than half their market.' The higher the tariffs are, the more likely this kind of market exit will happen, she said. Not in the near future, Fox said, noting it takes at least three years to build a medication factory in the U.S. because they involve complicated Food and Drug Administration regulations and inspections. There have been tariff success stories, though. Hospital-administered drugs usually come in a vial that you need a syringe to use, and most of those syringes are made in China. Wosińska cited how tariffs on Chinese syringes pushed U.S. facilities to reopen during COVID and have ensured we have a domestic supply of a critical product. But that worked because factories already had the capacity to produce that way that tariffs aren't all bad: Wosińska said a China-only tariff could be helpful at incentivizing other nations like India to stop relying on Chinese active pharmaceutical ingredients. That would, in turn, helps the U.S. since it buys a lot of products from India. But a widespread tariff that includes India would exacerbate the risk of generic drug shortages and incentivize India to purchase from cheaper Chinese sources, Wosińska has argued. For now, Trump continues to defend his tariff trade policy as a 'legendary' achievement. If he ends up setting a 25% tariff on all foreign-made pharmaceuticals, it will certainly be memorable. But losing access to preferred or necessary medical treatments because of drug shortages is not a future we would want to remember. 'We don't want to see products discontinued that we need, and it could be a reality,' Fox said. 'This winter, when you have a cold, that medicine that you're looking for, it may not be on the shelf.' Trump Announces His Next Tariff Target We Could Soon Be Seeing Empty Shelves Everywhere. Here's Which Items Might Disappear First. Worried About A 'Trumpcession'? Here's What Finance Experts Say You Should Do Now.
Boston Globe
07-05-2025
- Health
- Boston Globe
Genetics of Korea's extreme divers could unlock chronic disease treatments
Now, an international team of researchers has found evidence of natural selection at work: a genetic variation found in Jeju Islanders that helps to keep their blood pressure from rising as much when diving, according to a paper published in the journal Cell Reports. In theory, understanding the genetic adaptation could lead to the development of medications that help people at risk for stroke or blood pressure problems. Advertisement 'When you're diving, your blood vessels are responding in complicated ways to try to keep your vital organs safe as your oxygen is running low,' explained Melissa Ilardo, assistant professor of biomedical informatics at the University of Utah Health, who led the study. 'It becomes a trade-off between short term and long term benefits - what keeps you safe while you're diving might lead to complications further down the line. Evolution seems to have found a way to balance this out - a genetic variant that may protect divers while they're holding their breath and beyond.' Advertisement In their study, researchers discovered two kinds of adaptation at work. The first, developed over centuries, affects part of the genetic blueprint of all Jeju Islanders whether or not they dive, providing a protective blood pressure response to immersion in water. The variant is also thought to protect pregnant women who dive from developing preeclampsia, a complication of pregnancy that can be serious, even fatal. The other adaptation, present only in the Haenyeo, is gained from training and causes the heart rate to slow when the women dive. 'When you're diving, every heartbeat is bringing more oxygen to your cells which is normally a good thing,' Ilardo said, 'but when you don't have oxygen coming in, you want to slow that down.' Although it has not been established definitively, the history of diving and the genetic adaptation might be the reason Jeju Islanders have one of the lowest age-standardized stroke death rates in South Korea: a little over 24 deaths per 100,000 people; the rate in the United States is about 37 deaths per 100,000 people. The Haenyeo are not the only diving population scientists have studied. Ilardo and others have examined the male and female Bajau divers of Indonesia who have evolved larger spleens, which may help them hold their breath longer underwater. Other scientists have investigated Tibetans, who have evolved with the ability to live at higher altitudes where there is less oxygen. Insights gained from examining small populations with unique characteristics have helped researchers develop treatments for various medical conditions. The class of medications called PCSK9 inhibitors, used to lower LDL (bad) cholesterol, were discovered when research teams studied a French family with the genetic condition familial hypercholesterolemia, which affects about one in 300 people worldwide. Advertisement Ilardo said it is not clear why the Jeju Island divers are all women, 'but at some point, we think, it switched from men and women diving, which we see in many places in the world, to all women.' In the course of her work on the Haenyeo, Ilardo made three trips to Jeju Island and collaborated with another scientist, Joo-Young Lee, from Seoul National University, who has spent years with the divers and earned their trust. 'I mean it's mind-blowing, especially given the average of age of the divers,' Ilardo said. 'I watched an 87-year-old woman jump off a boat that hadn't stopped moving.' Although generations of Haenyeo dove into the icy waters wearing only cotton bodysuits, around the 1980s, they began wearing wetsuits. The scientists compared three groups of about 30 women each: Haenyeo; non-Haenyeo Jeju Islanders; and non-Haenyeo women from the South Korean mainland. The authors acknowledged the study was limited by its relatively small sample size. Researchers measured physiological characteristics, such as blood pressure and heart rate, then sequenced the DNA of participants to look for genetic differences. In a simulated dive, ordinary Jeju Islanders' heartbeats slowed by about 20 beats per minute, researchers found, about the same amount as women on the South Korean mainland. In the same circumstances, the Haenyeo, who have been diving their whole lives, slow their heartbeats by up to twice that number. In simulated dives, participants held their breath and submerged their faces in a basin of cold water, which triggers the same response in the body as diving. The simulation allowed the researchers to carry out the study without having untrained, and possibly non-swimming, older women try to dive in the open ocean. Advertisement The genetic variant shared by Jeju Islanders, not just the Haenyeo, triggers the protective blood pressure response to immersion in water, but it's not entirely clear how it works. The variant appears to influence a receptor that plays a role in blood vessel inflammation. Ilardo and her colleagues validated their findings by searching the large-scale All of Us database, run by the National Institutes of Health, for people with the same genetic variant. They found that among people of European ancestry, the same variant was linked to the protective blood pressure response seen in the Jeju Islanders, though the effect was not as strong. The scientists think that natural selection for this genetic variation started about 1,200 years ago. The process, they say, may have unfolded like this: Two pregnant Jeju Island women were diving many years ago. One of them carried the protective genetic variant while the other did not. Over the course of her pregnancy, the woman without the protective variant developed preeclampsia because of her daily diving; the condition led to the deaths of mother and child. The woman with the protective variant survived and so did her children. Even the loss of a few children per generation adds up over time. Gradually, more and more Jeju Island children are born with the variant. Tatum Simonson, associate professor of medicine at UC San Diego Health, called the study, which she was not involved in, 'a good first step towards understanding how genetic adaptation, but also importantly, how training can have an effect on blood pressure in these sort of extreme conditions.' Advertisement Simonson cautioned that working with blood pressure measurements can be challenging. Human blood pressure is a snapshot in time that reflects what is going on in a person's life at that moment. It will be different if a person is anxious, excited, angry, or depressed. To their credit, she said, the scientists collected multiple blood pressure readings at different points. Ilardo collaborated on the research with a team of physiologists led by Nikolai Nordsborg at the University of Copenhagen.
Yahoo
09-04-2025
- Business
- Yahoo
Trump drug tariffs would drive up prices, worsen shortages before any boost to US manufacturing, experts warn
'Major' tariffs on pharmaceutical imports are coming soon, President Donald Trump says, pledging that they'd help bring drug manufacturing back to the US while lamenting that other countries pay much lower prices for the same medicines. Instead, patient advocates and drug supply chain experts warn, tariffs are likely to drive the price of medicines higher and exacerbate already dangerous drug shortages. Whether they influence manufacturers to make more drugs in the US is a source of debate, and any increase in production is at least several years away. 'We're going to be announcing very shortly a major tariff on pharmaceuticals,' Trump said Tuesday at the National Republican Congressional Committee dinner, although he didn't specify the size of the tariff or when it would be implemented. Medicines had been exempted from the president's 'Liberation Day' tariff announcement April 2, causing the industry to breathe a brief sigh of relief. The president had also exempted the industry from the tariffs he imposed in his first term. In his tariffs speech last week, Trump said it was a 'tremendous problem' that 'the United States can no longer produce enough antibiotics to treat our sick.' That problem may get worse if tariffs come into play, experts warned while agreeing that it's a problem that needs fixing. The impacts of tariffs could be largest for generic drugs, which make up about 90% of the medicines prescribed in the US and many of which rely on ingredients made in China and India. Generic drugs, whether they're antibiotics, diabetes drugs or statins to lower cholesterol, sell for 'pennies per dose,' said Tom Kraus, vice president of government relations for the American Society of Health-System Pharmacists. Increasing the cost of ingredients that go into them 'can make it so that it's no longer profitable to sell that drug in the United States.' Already, shortages of antibiotics are a major problem in the US. Antimicrobials are among the most common drugs to be in short supply, with 40 active shortages in the US as of the end of 2024, according to data from the American Society of Health-System Pharmacists. Antibiotics currently in shortage include amoxicillin, commonly used for strep throat and ear infections, and Bicillin, crucial for treating syphilis infections. Other especially precarious medicines include sterile injectable drugs used in hospitals. Those can be products as simple as IV saline bags or injectable dextrose, used in emergency settings, as well as cancer chemotherapy drugs. They're required to be manufactured under pristine conditions and have been in shortage for years because of low prices and market disruptions. 'Added costs to already low-margin products may be a tipping point for companies to discontinue production,' said Erin Fox, a drug shortages expert at University of Utah Health. 'I'm worried we'll see discontinuation and a less resilient supply chain if companies quit making essential products.' An estimated 40% of generic drugs have only one or two suppliers making their ingredients, said Rena Conti, an associate professor at the Boston University Questrom School of Business. 'That's a pretty fragile supply,' Conti said. 'If one of those manufacturers exits, well, then we're a little bit in a pickle' – causing challenges for pharmacies and hospitals in stocking the drugs in the coming months. Consumers, meanwhile, could have trouble finding the medications they need when they go to the drugstore. And when one manufacturer is the sole supplier of a medicine, prices often rise. That can sometimes be astronomical, even for generic medicines – such as when Martin Shkreli, known as the Pharma Bro, raised the price of a medicine used by people with HIV from $13.50 to $750 overnight. Public and political pressure has made moves like that less common, but they still occur. But for many generic medicines, especially sterile injectables, it may be difficult for manufacturers to pass along price increases, said Dr. Marta Wosińska, a senior fellow at the Brookings Center on Health Policy. 'One reason is immediate – group purchasing organization (GPO) contracts,' Wosińska wrote in an article analyzing the potential effects of tariffs. 'All hospitals use GPOs to contract for sterile injectable generics used in inpatient settings, with those contracts locking in prices but not quantity.' Those contracts generally last one to three years, she noted, 'and may limit price increases.' Moreover, 'there are laws that make increasing prices faster than inflation a problem for a drug company,' said David Maris, a managing partner at Phalanx Investment Partners who spent years as a financial analyst following the drug industry. 'So I am not sure how they would even be able to pass along the increase.' For branded medicines – those that still have patent protection and don't face cheaper generic copycat competition – it could be a different story, Maris said. There, it would be tariffs from Europe that could hit hardest, with a huge amount of drug manufacturing in countries including Ireland, which has a favorable tax environment. Ingredients for a branded drug may make up only 10% of the total cost to produce a product, Maris estimated, 'so if that 10% rises by 35%, the overall impact on production costs is relatively small.' Unlike with generic medicines, makers of branded drugs have more cushion to absorb price increases, Maris pointed out. But he doesn't think they will. 'These costs will be passed on, leading to higher drug prices,' he said. 'For consumers with insurance, that likely means higher premiums and potentially higher out-of-pocket copays.' Already, the US pays the highest prices for drugs in the world, an imbalance Trump has targeted in the past and one of the few issues that puts him in agreement with lawmakers like Sen. Bernie Sanders. 'Tariffs will exacerbate that problem,' said Merith Basey, executive director of the advocacy group Patients for Affordable Drugs. 'Prescription drugs aren't luxury goods; they're essential to people's health and survival.' Political and public scrutiny could stop drugmakers from raising prices precipitously, with one Wall Street analyst even begging the industry in a research note to avoid passing tariffs along in the form of higher drug prices for that reason. Umer Raffat, an analyst with financial firm Evercore ISI, wrote in a March 28 note to clients that he'd heard from multiple CEOs that 'they may have to pass on some of the impact as a price increase.' 'There is already a price discrepancy on many drugs between US vs Europe,' Raffat wrote. 'Raising prices in US will add more fire to this burning issue,' potentially backfiring 'in a big way' by accelerating conversations in Washington about bringing back a plan from Trump's first administration to tie US prices to those paid in other similar countries, known as the 'most favored nation' policy. And even as drug shortages may worsen and prices increase in the nearer term, experts are skeptical that tariffs would achieve their main stated goal of bringing drug manufacturing back to the US. 'Global supply chains are complex, with pharma among the most,' Evan Seigerman, a pharmaceuticals analyst with financial firm BMO Capital Markets, wrote in a research note. 'It's not as simple as moving where someone screws in little screws to make an iPhone.' Seigerman predicted that most large pharmaceutical companies 'are likely to look at imposed tariffs with the intention of 'running out the clock,' waiting until the end of Trump's presidency to consider more permanent manufacturing decisions.' Still, some major US pharmaceutical companies have made large investments in domestic manufacturing recently. Eli Lilly said in February that it would invest an additional $27 billion to build four manufacturing plants in the US, with the potential for tariffs in mind. The company said it anticipates that the plants could start making medicines within five years. 'We're trying to do this quickly, because I think there will be constraints in everything from supply chain of building materials to energy,' Lilly's CEO, David Ricks, told CNN at the time. Ricks also said the plan to build so many new domestic plants relies on renewal of certain favorable tax provisions for the industry. Still, the process of building new plants or establishing new manufacturing sites can take years. And while multiple experts told CNN they agree it's crucial to reduce the nation's reliance on other countries for critical medicines, they questioned whether tariffs are the way to accomplish that. 'We think that's a critical thing for us to explore with the administration over the next several years,' said John Murphy, CEO of the Association for Accessible Medicines, which represents generic drug manufacturers. 'That's a long-term proposal, right? We can't build that infrastructure overnight, but we can lose access to a number of drugs overnight, if we're not careful.'
CNN
09-04-2025
- Business
- CNN
Trump drug tariffs would drive up prices, worsen shortages before any boost to US manufacturing, experts warn
'Major' tariffs on pharmaceutical imports are coming soon, President Donald Trump says, pledging that they'd help bring drug manufacturing back to the US while lamenting that other countries pay much lower prices for the same medicines. Instead, patient advocates and drug supply chain experts warn, tariffs are likely to drive the price of medicines higher and exacerbate already dangerous drug shortages. Whether they influence manufacturers to make more drugs in the US is a source of debate, and any increase in production is at least several years away. 'We're going to be announcing very shortly a major tariff on pharmaceuticals,' Trump said Tuesday at the National Republican Congressional Committee dinner, although he didn't specify the size of the tariff or when it would be implemented. Medicines had been exempted from the president's 'Liberation Day' tariff announcement April 2, causing the industry to breathe a brief sigh of relief. The president had also exempted the industry from the tariffs he imposed in his first term. In his tariffs speech last week, Trump said it was a 'tremendous problem' that 'the United States can no longer produce enough antibiotics to treat our sick.' That problem may get worse if tariffs come into play, experts warned while agreeing that it's a problem that needs fixing. The impacts of tariffs could be largest for generic drugs, which make up about 90% of the medicines prescribed in the US and many of which rely on ingredients made in China and India. Generic drugs, whether they're antibiotics, diabetes drugs or statins to lower cholesterol, sell for 'pennies per dose,' said Tom Kraus, vice president of government relations for the American Society of Health-System Pharmacists. Increasing the cost of ingredients that go into them 'can make it so that it's no longer profitable to sell that drug in the United States.' Already, shortages of antibiotics are a major problem in the US. Antimicrobials are among the most common drugs to be in short supply, with 40 active shortages in the US as of the end of 2024, according to data from the American Society of Health-System Pharmacists. Antibiotics currently in shortage include amoxicillin, commonly used for strep throat and ear infections, and Bicillin, crucial for treating syphilis infections. Other especially precarious medicines include sterile injectable drugs used in hospitals. Those can be products as simple as IV saline bags or injectable dextrose, used in emergency settings, as well as cancer chemotherapy drugs. They're required to be manufactured under pristine conditions and have been in shortage for years because of low prices and market disruptions. 'Added costs to already low-margin products may be a tipping point for companies to discontinue production,' said Erin Fox, a drug shortages expert at University of Utah Health. 'I'm worried we'll see discontinuation and a less resilient supply chain if companies quit making essential products.' An estimated 40% of generic drugs have only one or two suppliers making their ingredients, said Rena Conti, an associate professor at the Boston University Questrom School of Business. 'That's a pretty fragile supply,' Conti said. 'If one of those manufacturers exits, well, then we're a little bit in a pickle' – causing challenges for pharmacies and hospitals in stocking the drugs in the coming months. Consumers, meanwhile, could have trouble finding the medications they need when they go to the drugstore. And when one manufacturer is the sole supplier of a medicine, prices often rise. That can sometimes be astronomical, even for generic medicines – such as when Martin Shkreli, known as the Pharma Bro, raised the price of a medicine used by people with HIV from $13.50 to $750 overnight. Public and political pressure has made moves like that less common, but they still occur. But for many generic medicines, especially sterile injectables, it may be difficult for manufacturers to pass along price increases, said Dr. Marta Wosińska, a senior fellow at the Brookings Center on Health Policy. 'One reason is immediate – group purchasing organization (GPO) contracts,' Wosińska wrote in an article analyzing the potential effects of tariffs. 'All hospitals use GPOs to contract for sterile injectable generics used in inpatient settings, with those contracts locking in prices but not quantity.' Those contracts generally last one to three years, she noted, 'and may limit price increases.' Moreover, 'there are laws that make increasing prices faster than inflation a problem for a drug company,' said David Maris, a managing partner at Phalanx Investment Partners who spent years as a financial analyst following the drug industry. 'So I am not sure how they would even be able to pass along the increase.' For branded medicines – those that still have patent protection and don't face cheaper generic copycat competition – it could be a different story, Maris said. There, it would be tariffs from Europe that could hit hardest, with a huge amount of drug manufacturing in countries including Ireland, which has a favorable tax environment. Ingredients for a branded drug may make up only 10% of the total cost to produce a product, Maris estimated, 'so if that 10% rises by 35%, the overall impact on production costs is relatively small.' Unlike with generic medicines, makers of branded drugs have more cushion to absorb price increases, Maris pointed out. But he doesn't think they will. 'These costs will be passed on, leading to higher drug prices,' he said. 'For consumers with insurance, that likely means higher premiums and potentially higher out-of-pocket copays.' Already, the US pays the highest prices for drugs in the world, an imbalance Trump has targeted in the past and one of the few issues that puts him in agreement with lawmakers like Sen. Bernie Sanders. 'Tariffs will exacerbate that problem,' said Merith Basey, executive director of the advocacy group Patients for Affordable Drugs. 'Prescription drugs aren't luxury goods; they're essential to people's health and survival.' Political and public scrutiny could stop drugmakers from raising prices precipitously, with one Wall Street analyst even begging the industry in a research note to avoid passing tariffs along in the form of higher drug prices for that reason. Umer Raffat, an analyst with financial firm Evercore ISI, wrote in a March 28 note to clients that he'd heard from multiple CEOs that 'they may have to pass on some of the impact as a price increase.' 'There is already a price discrepancy on many drugs between US vs Europe,' Raffat wrote. 'Raising prices in US will add more fire to this burning issue,' potentially backfiring 'in a big way' by accelerating conversations in Washington about bringing back a plan from Trump's first administration to tie US prices to those paid in other similar countries, known as the 'most favored nation' policy. And even as drug shortages may worsen and prices increase in the nearer term, experts are skeptical that tariffs would achieve their main stated goal of bringing drug manufacturing back to the US. 'Global supply chains are complex, with pharma among the most,' Evan Seigerman, a pharmaceuticals analyst with financial firm BMO Capital Markets, wrote in a research note. 'It's not as simple as moving where someone screws in little screws to make an iPhone.' Seigerman predicted that most large pharmaceutical companies 'are likely to look at imposed tariffs with the intention of 'running out the clock,' waiting until the end of Trump's presidency to consider more permanent manufacturing decisions.' Still, some major US pharmaceutical companies have made large investments in domestic manufacturing recently. Eli Lilly said in February that it would invest an additional $27 billion to build four manufacturing plants in the US, with the potential for tariffs in mind. The company said it anticipates that the plants could start making medicines within five years. 'We're trying to do this quickly, because I think there will be constraints in everything from supply chain of building materials to energy,' Lilly's CEO, David Ricks, told CNN at the time. Ricks also said the plan to build so many new domestic plants relies on renewal of certain favorable tax provisions for the industry. Still, the process of building new plants or establishing new manufacturing sites can take years. And while multiple experts told CNN they agree it's crucial to reduce the nation's reliance on other countries for critical medicines, they questioned whether tariffs are the way to accomplish that. 'We think that's a critical thing for us to explore with the administration over the next several years,' said John Murphy, CEO of the Association for Accessible Medicines, which represents generic drug manufacturers. 'That's a long-term proposal, right? We can't build that infrastructure overnight, but we can lose access to a number of drugs overnight, if we're not careful.'
