On the same day Alibaba’s ‘Singles’ Day’ sales took China by storm, The New York Times ran an article describing an unusual online transaction taking place in rural China – a son with a cancer-stricken mother was purchasing raw materials from e-commerce sites like Alibaba to make a version of AstraZeneca’s Tagrisso, a lung cancer drug .
Cancer drugs manufactured by large pharmaceutical companies such as AstraZeneca go through stringent regulation and a complex global supply chain to eventually reach a local hospital where patients can purchase them. In rural hospitals, these critical drugs are often not in stock. Desperate patients and their families are further pushed into prolonged suffering. Feeling they have nothing to lose, some resort to DIY solutions. Perhaps due to lack of access to drugs, rural cancer patients in China are 30% more likely to die than urban cancer patients after a diagnosis .
As additive manufacturing is applied to drug production at patients’ closest point of sale, we can imagine a world where rural cancer patients purchase out-of-stock drugs within a few hours of visiting a local hospital. What if the hospital had a 3D printer? What if CAD files from AstraZeneca were available?
Additive manufacturing of drugs
Drugs containing API such as acetaminophen and guaifenesin have been successfully 3D printed between 2006 to 2015 . In July 2017, researchers at GlaxoSmithKline and the University of Nottingham demonstrated that a combination of inkjet printing and UV curing can produce oral dosage forms of drugs to treat Parkinson’s .
Patient demand for increased access to life-saving drugs at lower unit costs of production have led biohackers such as Michael Laufer to debut 3D-printable drug makers this summer. Laufer used his 3D-printed ‘Apothecary Microlab’ to synthesize pyrimethamine, a drug better known by its trade name Daraprim. Pharmaceutical company CEO Martin Shkreli had bought the patent for Daraprim and raised the price by 5,500 percent to $750 a pill. Laufer wanted to make the point that with his 3D-printed Microlab, a layperson could essentially make Daraprim for $2 a pill .
Opportunities and Threats for AstraZeneca
For AstraZeneca, additive manufacturing presents an opportunity to improve its supply chain by outsourcing production to the point of sale. In the long term, AstraZeneca would be able to save costs by relying less on supply chain intermediaries in charge of shipping, transport, and quality maintenance. 3D printing at local hospitals would not replace all of its supply chain system but it would be useful for solving out-of-stock problems for rural areas where AstraZeneca faces a last mile problem.
Even more important is preparing for potential disruptions, such as becoming disintermediated by desperate and underserved patients who may take drug manufacturing into their own hands. China already has large online forums dedicated to DIY cancer drugs, such as “Dances with Cancer” and “I Want Miracles” with over 440,000 members . Another downside is losing an edge to competitors such as GlaxoSmithKline that are conducting projects to provide more use cases of 3D drug manufacturing.
Recommendations for AstraZeneca
AstraZeneca is beating competitors in China, and saw a 32% increase in the region for the past quarter . However, winning in a geography and winning in terms of new drug development does not exempt it from taking on projects to disrupt its supply chain and improve access to rural markets. Because so many of China’s cancer patients live in rural areas, it is critical for AZ’s China division to improve access to drugs and 3D printing at local hospitals and pharmacies is one way of addressing this problem.
AstraZeneca should pay close attention to what competitors are doing to simplify their supply chain through inkjet 3D printing. According to GSK Director of Technology Martin Wallace, “Inkjet 3D-printing methods are of particular interest to the pharmaceutical industry because they have many parallels with current manufacturing processes, and may offer a more efficient longer-term printing solution.” 
Uncertainties to resolve
AstraZeneca will have to figure out how to be adequately compensated for the drugs produced in local, rural hospitals. Is there a way to configure the 3D printing machines so that only designated, qualified individuals with purchasing accounts can use it?
It will also need to protect itself from liability issues, because they will be giving more drug quality control to the rural hospitals. How will AstraZeneca protect itself from quality issues?
Later, as 3D printing of drugs in local hospitals becomes more common, AstraZeneca and other drug manufacturers will need to reconcile 3D printer – company drug formula compatibility issues. Will there be a different printer for every brand, or will all companies be allowed to make their drug through one printer?
(Word count: 775)
 Wee, S. (2018). In China, Desperate Patients Smuggle Drugs. Or Make Their Own.. [online] Nytimes.com. Available at: https://www.nytimes.com/2018/11/11/business/china-drugs-smuggled-homemade.html.
 Prasad, L. and Smyth, H. (2015). 3D Printing technologies for drug delivery: a review. Drug Development and Industrial Pharmacy, 42(7), pp.1019-1031.
 3D Printing Industry. (2018). Scientists 3D print Parkinson’s medicine for first time with UV inkjet 3D printing – 3D Printing Industry. [online] Available at: https://3dprintingindustry.com/news/scientists-3d-print-parkinsons-medicine-first-time-uv-inkjet-3d-printing-117695/.
 Rosenblatt, S. (2018). Biohacker’s latest answer to health care hurdles: Homebrew meds – The Parallax. [online] The Parallax. Available at: https://www.the-parallax.com/2018/07/20/biohacking-homebrew-meds-hope/.
 BioPharma Dive. (2018). AstraZeneca at ‘inflection point’ in turnaround, predicts CEO. [online] Available at: https://www.biopharmadive.com/news/astrazeneca-at-inflection-point-in-turnaround-predicts-ceo/541756/.
 Redshift EN. (2018). GlaxoSmithKline and the Future of 3D-Printed Pharmaceuticals. [online] Available at: https://www.autodesk.com/redshift/3d-printed-pharmaceuticals/.