Millions in the U.S. take this drug. Tariffs might complicate their care. [View all]

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https://www.washingtonpost.com/health/2025/04/11/tariffs-pharmaceuticals-china-heparin/

Millions in the U.S. take this drug. Tariffs might complicate their care.
Heparin is cheap and essential to millions of hospitalized people. Tariffs could disrupt the supply chain that gets ingredients from China to their beds.
By Sabrina Malhi

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The U.S. domestic supply chain is not equipped to meet national heparin demand. Building a self-sufficient supply would require substantial investment in processing infrastructure, a reliable source of animal tissue and regulatory support. Unless that capacity expands, the United States will remain reliant on international suppliers to meet the bulk of its needs.

The American Society of Hematology estimates 12 million hospitalized patients use heparin each year. On average, a heparin injection costs 70 cents for a one-milliliter vial, said David Stimler, a pharmacy purchasing administrator at Johns Hopkins Medicine.

The drug is derived from the mucosal lining of pig intestines. China dominates the global market because of its large pig population and processing infrastructure. While countries such as India and Spain also produce the necessary raw materials, trade experts say China’s scale, cost efficiency and streamlined systems make it the preferred source.

“If China retaliates with restrictions on pharmaceutical exports, that would be a serious concern,” said Prashant Yadav, a senior fellow for global health at the Council on Foreign Relations. He said U.S. manufacturers may temporarily avoid shortages if they have built up reserves, but those supplies are limited.

Heparin is used in surgeries, dialysis and maintenance of intravenous lines.

“In the scope of patients in the hospital, a few percent are getting antibiotics, but at least 50 to 70 percent of patients are ordered heparin or other related medications to help prevent blood clots,” said Elliott Haut, an administrator in the department of surgery at Johns Hopkins Medicine.

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