An "America first" pharma supply chain sounds good. But it won’t work.

As Thomas Cosgrove, a former senior FDA official who spent a decade enforcing quality regulations in overseas facilities that serve U.S. markets, told STAT, “What would it take the supply chain to come all the way back to the U.S.? It’s simple: It will take decades and billions.”

We don’t have decades.

Keep in mind that drug prices in America have trended steadily upward even as drug makers cut their costs dramatically by moving ingredient manufacturing offshore. We can guess which direction prices would go with even incremental shifts back to domestic production.

There is no doubt the current economic and political uncertainties wrought by Covid-19 will change the pharmaceutical landscape in some way. However, if this pandemic has taught us anything, it’s that affordability is just as important as availability.