Greenville’s PAI Pharma Makes a Name for Itself With Liquid Medications

What began more than 50 years ago as an over-the-counter medication startup has blossomed into a multi-million-dollar Greenville, South Carolina, business that its owners say produces almost a third of all the liquid prescription medicines sold in the U.S.

“If you have kids or elderly parents who are in a nursing home, there’s a good chance they’ve taken a product from us,” said Brandon Rockwell, president and chief operating officer for PAI Pharma, “because 30 percent of all the oral liquids in U.S. come from us.”

PAI is a generic specialty pharmaceutical company concentrating on oral liquid and injectable medications, he said. It also has offices in Parsippany, New Jersey.

Located at the Donaldson Center, the Greenville campus spans more than 300,000 square feet over three buildings including a manufacturing facility, a research-and-development lab, a quality lab, office space and a warehouse, he said.

The company has some 650 employees – more than 550 of them in Greenville, Rockwell said. 

“We employ a lot of scientists from the Greenville and South Carolina area and a lot of our people have been with the company for 20-plus years and have really grown up and fostered careers in the industry,” he said. “We’re really proud of PAI’s ability to have done that for the Greenville community over time.”

Started in 1968 by two local pharmacists, PAI originally stood for Pharmaceutical Associates Inc., he said. But about five years ago, it rebranded to PAI – which everyone was calling it anyway - because “it rolls off the tongue better,” he said.

While originally run by the pharmacists, it changed hands a few times over the years, Rockwell said, its owners ranging from a local family to an early investor before it was sold to a private equity company, Connecticut-based Olympus Partners, in 2019.

Though it produced liquid over-the-counter medications and nutraceutical products at first, it eventually grew to include more prescription medicines and regulated products, he said.

“Today, the products we make are predominately oral liquid medications,” he said. “People get a pill if they can swallow. If they can’t, they tend to get a liquid. And that’s largely children or geriatric patients.”

Among the products it manufactures are prednisolone, a corticosteroid used to reduce inflammation; lidocaine viscous, an oral solution used to numb the pain of mouth sores related to chemotherapy and to numb the throat before surgery; and the liquid antihistamine cetirizine, he said.  

It’s also one of three companies nationwide that makes methadone and other addiction medications, which are shipped directly to treatment centers across the country, he said.

“When it comes to oral liquids in the U.S., PAI is number one in what we do, producing 30 percent of these products,” he said. “And almost all of it is made here in Greenville, S.C.”

PAI is also a leader in unit-dose cups, which are pre-packaged individually-dosed medications dispensed in hospitals, he said. 

“At Greenville, this year, we will make about 10 million bottles of medication and 100 million cups,” he said. “It’s one of the bigger pharma companies in South Carolina.” 

Recently, Rockwell said, PAI started expanding its product portfolio in partnership with other companies to launch sterile injectable products, like those used to treat prostate cancer and infertility.

As for the future, the company plans to increase its investment in automation over the next few years to improve the efficiency and capacity of its manufacturing process, he said.

And while artificial intelligence is appearing in more and more industries these days, it’s something that PAI is exploring but has limited use in regulated industries like pharmaceuticals, he said.

“It’s more about technical upscaling over time,” he said. “We’re looking to do more domestic expansion of manufacturing.”

PAI doesn’t report its annual revenues, but Rockwell allowed that it is a “multi-million-dollar company.”

The company is a member of SCbio, a leader in South Carolina’s life sciences sector which fosters collaboration and innovation as well as start-ups and established businesses.    

“In terms of SCbio, I love seeing what they do in the state because they’re very active in supporting the life sciences area,” Rockwell said. “And we’ve grown our membership and engagement with them because I’ve seen the passion they have for bringing life sciences to South Carolina.”

SCbio President and CEO James Chappell said the success of PAI Pharma shows that South Carolina has the resources, talent and business climate for a company to not only launch and develop, but to thrive and make an impact on thousands of lives across the nation.

“And for South Carolina, PAI has provided hundreds of jobs, invested millions in expansions, and supported the next generation of our workforce through its opportunities for trade school and university students,” he said. “That is the work of more than an industry leader in South Carolina - that is a legacy maker."

In fact, SCbio reports that Greenville is ranked the 20th Best City in the nation for Life Science Manufacturing Talent, according to CBRE, the world's largest commercial real estate services and investment firm, which reports on real estate markets and trends.  

Meanwhile, the state Department of Commerce has designated life sciences as a key growth business sector with the industry employing nearly 90,000 people and generating an annual economic impact of $25.7 billion in 2022, according to SCbio.  

Rockwell, 43, came to PAI five years ago after serving as head of business development and strategy at Endo Pharmaceuticals in Pennsylvania. 

He also serves on the board of directors for the Association for Accessible Medicines in Washington, D.C., the trade group for manufacturers of generics and biosimilar products.

He lives in Cedar Knolls, New Jersey, with his family. The company’s CEO, Kurt Orlofski, is headquartered in New Jersey as well.

Over his 20 years in the industry, Rockwell said he’s seen lots of changes. 

“In the generic space over the past 10 to 15 years, we’ve seen a lot more manufacturing move outside the U.S., increasing pricing pressure on U.S. manufacturers and accelerating consolidation,” he said. 

“A lot of companies were acquired or moved manufacturing overseas … (seeking) the benefit of low-cost labor,” he added. “PAI stands out as one of the larger remaining fully domestic companies in the U.S. for generic products.”

While generics comprise about 90 percent of prescriptions in the U.S., they only make up about 12 percent of the total spending because of their lower cost, he said. On the other hand, he said, 10 percent of the prescriptions – brand-name drugs – make up over 88 percent of the spending. 

PAI has also benefited from the fact that oral liquids are expensive to ship, so that means lower costs for shipping domestically, he said. 

The company also sources a lot of its materials from the U.S., he said.

“Our bottles, our caps, our labels all come from the U.S., and a lot of our raw materials come from the U.S.,” he said. “And about 30 percent of our active pharmaceutical ingredients are sourced from North America. A third are from Europe and another third from Asia, mostly India.”

Rockwell notes that PAI has not been impacted by the tariffs implemented earlier this year because pharmaceuticals are exempted from most tariffs. 

“We have limited exposure because of the supply chain this company has set up,” he said. “So we’re able to keep prices manageable.”

PAI also maintains a high standard of quality for medications, Rockwell said, noting that inspections by the FDA this year resulted in a clean report.

Chappell said that when investments are made in South Carolina’s life sciences industry, they benefit the residents and the economy. 

“The life sciences industry makes South Carolina competitive,” he said, “it is creating high-wage jobs, developing breakthrough treatments and technologies, and attracting top talent with its acclaimed academic and research institutions.”