Tariffic. This week Eli Lilly announced they were investing at least $27 billion in US manufacturing, which is pretty cool. Was it to buy favor with the new Administration? It certainly does not hurt.

I get the allure of manufacturing in the United States. If a country wanted to hurt us, they could stop sending us drugs or components of drugs. India sends the U.S. 47% of all our generic drugs and most of the active pharmaceutical ingredients (API) for those drugs come from China.

Part of the goal of tariffs is to push some of that back to the United States, but supply chain logistics dictate that, even if you think you want to have more manufacturing here, what you want produced here is limited. The process of making small molecule drugs is not pleasant. APIs can be released into the environment during production and can pollute the environment. It is a dirty business.

Manufacturing in the U.S. absolutely can have its upsides in terms of protecting the supply chain and working through shortages, but it is expensive. And there are other reasons to want to avoid tariffs on pharmaceuticals like exacerbating quality concerns, shortages, costs.

I think I might have just landed on a future post. Or a book. Covering this in two hundred words feels completely inadequate.

At a Cost. Kaiser Family Foundation released an analysis on Medicaid that found that a per capita spending cap in Medicaid could save up to a trillion dollars over 10 years but 15 million people could lose their Medicaid coverage. If you are not a Medicaid expert but need to pretend to be one, go to their site.

No bueno. News broke this week that the Food and Drug Administration canceled the annual March meeting of the committee that determine what flu strains will be covered by next year’s vaccine. I mean it could be just a delay but …

Nerdy by nature. If you’ve been on regulations.gov, this primer on the regulatory process is for you. If you have no idea what regulations.gov is, just move on ahead.