Are Hydroxyurea ingredients coming from China?

Excellent letter, @janemc! Hope everyone takes note!

Thanks. I wrote to my representatives in Congress and like you emphasized the Sickle Cell aspect. Because it is a disease that is, I think, known and certainly more known than PV, as an example.
I like the specifics in your letter so I will be following up using your draft.

I'll confess: Until I did some research, I had no idea generic drugs represent 90% of every prescription filled in the U.S., nor that only 10% of them are made in this country.

It is extremely unlikely American companies will ever manufacture these low-profit drugs. So tariffs on them will come straight out of our pockets, first in higher prices, next in higher health care premiums.

The highest cost will be the toll on our health.

Warmest thanks to everyone who contacts her or his representatives about this! It will only take a few moments of your time.

Let's all thank nohrt4me for being the leader on this!

Sounds like, in Canada, brand-name HU is available. Lucky you! To me, that suggests your supply is much more reliable than it is here in the U.S.

Sorry, the following gets wonky. But might help folks understand how the US drug supply works and why it's complicated:

Bloomberg reports that a reduction in tariffs on Chinese goods may be in the offing, but it's still unclear how this will play out or what the tariff rate will eventually be.
https://www.bloomberg.com/news/articles/2025-04-23/trump-says-he-ll-be-very-nice-to-china-in-trade-talks
There was a realization during COVID that the US drug supply was vulnerable to supply chain disruptions and foreign relations. Some economists then urged the "repatriation" of the generic drug industry. The biggest obstacle, as janemc has pointed out, is that US pharmaceutical companies make their biggest profits on newer drugs. Companies hold exclusive patents on new drugs for 20 years, and justify high prices to recoup research, development, and promotional costs.

Cranking out old drugs like HU with formulas that are no longer patented requires a different business model and relies on high volume sales. The generic drug business has been a boon to Indian and Chinese companies that spent lots of money and effort complying with US regs to ensure safe, consistent product before being allowed to sell here.

Repatriating generic drugs will be difficult as long as American drug companies don't want that part of the industry and foreign companies are eager for the business.

My senator (Mark Warner) tells me that bipartisan proposals on tariffs have been made in both the Senate and the House.

Please, urge your representatives to vote for the Trade Review Act of 2025. That's Senate Bill 1272, and House Resolution 2665. These would restore to Congress its constitutional power to set tariffs.

Passage of these bills won't immediately halt the threat to generic medications, but it would be an important step forward.

President Trump has signed a new EO that attempts to bring US drug prices in line with those that other countries pay for the same drugs. The methods proposed for reducing drug prices, however, may not be allowed under current rules and regs. HHS and the FTC will be involved in trying to determine whether and how this could work. Drug companies oppose the order saying it will impede research and development of new drugs.
https://www.reuters.com/business/healthcare-pharmaceuticals/trump-says-he-will-cut-drug-prices-by-59-2025-05-12/
Meantime, tariffs against Chinese goods have dropped to 30 percent, from 145 percent, for the next 90 days. Hoping this is good news and keeps open supplies of meds like generic hydroxyurea that originates in China.

I just read an article somewhere, The Atlantic? The author was writing about the capsule he takes daily for his cancer. He determined the cost to produce was 25 cents. The cost to consumers, $1000! He likened it to the price, daily, of a new iPhone.
There’s more wrong here than tariffs and the blame is enough to spread around. I did write to my reps and, of course, Im glad there’s been a reversal of some tariffs but this goes so much deeper.

Some countries negotiate with drug manufacturers as whole on drug prices. In the US, individual insurance companies negotiate for prices with manufacturers. Obviously, an entire country has more negotiating clout than an insurance company.

President Trump may want to go in the direction of national negotiation with drug makers.

The Inflation Reduction Act under President Biden allowed Medicare to negotiate for certain high-priced drugs. President Trump might also want to go in that direction, giving Medicare and Medicaid negotiating power for some drugs. But that could lead to higher prices for those with private insurance.

Nothing is really clear at this point because the EO is really more of a goal statement than a plan.