Our Pharmaceutical vulnerability

A nation that cannot make its own essential medicines is a nation living on borrowed security

President Trump has recently signed a new proclamation to swiftly accelerate the onshoring of pharmaceutical manufacturing — one of America’s most strategically vulnerable sectors.

America’s vulnerability runs across all three stages of the medicine-making process. That begins with the raw ingredients, known as key starting materials; extends to the active pharmaceutical ingredients in the second stage; and finally it includes finished dosage forms, such as tablets, capsules, and injectables.

Today, more than half of the branded pharmaceuticals distributed in America are manufactured overseas. Upstream dependence is sharper still. Only 11 percent of active pharmaceutical ingredients manufacturers are in the U.S., compared with 22 percent in China and 44 percent in India. And of all patented active pharmaceutical ingredients sold in the U.S., only 15 percent by volume are made here.

America’s vulnerability runs deeper still at the front end of the supply chain, where more than 40 percent of the key starting materials used in U.S.-approved pharmaceuticals are sole-sourced from China and another 16 percent from India.

While America still leads the world in pharmaceutical discovery, it no longer controls enough of the industrial base to turn that discovery into secure supply. We have become a design-and-discovery superpower with a hollowed-out production base.

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