Witnesses testify on Capitol Hill in Washington at a Senate Special Committee on Aging hearing, “Bad medicine: closing loopholes that kill American patients,” on Wednesday. Photo by Bridget Erin Craig/UPI
The United States has grown dependent on foreign drug supplies, particularly from China and India, causing a national security and public health threat, lawmakers said Wednesday.
That was the verdict when senators on the Special Committee on Aging held a hearing titled “Bad Medicine: Closing Loopholes that Kill American Patients” to assess challenges and potential solutions to the country importing 83% of the top-100 generic drugs.
“With the vast majority of our generic drugs and their ingredients, Communist China is the world’s largest producer of active prescription drug ingredients, and India relies on Communist China for approximately 80% of the active drug ingredients that are used in drug manufacturing,” said Chairman Rick Scott, R-Fla.
Sen. Kirsten Gillibrand, D-N.Y., concurred.
“Currently, too many active pharmaceutical ingredients and key starting materials are made outside the United States,” Gillibrand said. “Given recent instability in geopolitics and international trade policy, this reliance increases the risk that Americans may not have access to life-saving drugs in a time of crisis, threatening our national security.”
Proposed solutions include leveraging federal purchasing power, investing in domestic manufacturing and implementing country-of-origin labeling. Witnesses from across sectors and backgrounds emphasized the need for robust oversight, modernizing facilities and ensuring quality to protect American health and sovereignty.
One of the steps toward bettering domestic manufacturing, it was noted, is through the Active Pharmaceutical Ingredients Innovation Center at Washington University in St. Louis. The center works to produce more of these ingredients in the United States to help ensure constant, reliable access to various medicines.
Founder and chair of the innovation center, Tony Sardella, testified Wednesday about progress being made.
“We take the investment in the new modern techniques and we contract existing idle FDA facilities to produce these modern methods of production. First, we partner with long-term agreements to be able to ensure predictable demand and supply for the entire network,” Sardella said.
Although he noted progress in recruiting domestic manufacturers, API found that 40 of the top-100 generic drugs had “key starter materials exclusively 100% dependent on China.”
Senators and witnesses emphasized the need to fix the issue from the ground up, alluding that Americans could be prescribed unsafe drugs because of the supply chain.
Andrew Rechenberg, an economist at the nonprofit Coalition for a Prosperous America, noted that U.S. production of generics fell to 37% in 2024 from 84% in 2002. He said state subsidies and poor labor standards in India and China made them less expensive to manufacture overseas.
According to the witnesses, changing supply chains would be a costly solution.
“No one actually wants to bear the full blunt of the cost,” said Marta E. Wosińsk, a Center on Health Policy senior fellow at the Brookings Institution.
“I think part of this committee’s job is to really do all the pieces that you’ve all suggested. Such as adding country of origin labeling, making sure we know the quality up-front. And, having an incentive to do the quality testing,” Wosińsk said.
Lawmakers showed bipartisan support to decrease dependence on foreign prescriptions by finding more reliable supply chains, whether through domestic manufacturers or partnerships with allies.
“Congress has to work with the Trump administration and act now to make sure that Americans have safe and high-quality drugs and secure the prescription drug supply chain,” Scott said.
