Importation of prescription drugs to help lower prices for Americans will remain a major issue no matter who is president next year. The more we know about where our meds are made (mostly not here) the less successful drug industry lobbying will be against lower-cost, imported medicines.

In some cases, it’s as simple as a drug sold at a U.S. Walgreens is made in a manufacturing facility in one foreign country. For example, type 2 diabetes drug Jardiance (empagliflozin) is made in Italy. Another drug that treats type 2 diabetes, Januvia, is a little more complicated. Its active pharmaceutical ingredient (API) is made in Italy, but that API is formulated into the finished drug in the UK.

Last year, Par Pharmaceutical, a subsidiary of Endo International PLC, began shipping authorized generic versions of Merck’s Proventil (albuterol sulfate), an HFA inhalation aerosol.

In a class of medical products called bronchodilators, Par’s albuterol sulfate provides fast breathing relief for people with asthma and COPD (chronic obstructive pulmonary disease). Where’s it made? Three countries have a hand in making it. More specifically, different aspects of its production occur in three countries. Here’s what the label says:

That’s a mouthful!

As it happens, Par’s generic Proventil is quite affordable in the U.S., at least with a discount coupon. Checking on GoodRx, the generic Proventil price is one inhaler for $16.91, which is comparable to the price at Canadian and other international pharmacies. The lowest listed price on PharmacyChecker is around $45 for three generic inhalers.

In the coming months, followers of this blog will be learning more and more about drug supply chains. In the meantime, let’s continue to come together on the importance of lowering drug prices in America.