OPINION:
Here’s something to consider: In 2002, the United States manufactured 83% of its consumed pharmaceuticals. By 2024, that number had dropped to just 37%.
Essentially, in the past 20 years, the United States has become incredibly dependent on imports to meet its daily pharmaceutical needs. This heavy reliance on imports is now creating serious drug shortages and has led to a flurry of safety concerns. Still, Congress can take action and use the federal government’s procurement policies to start incentivizing new U.S. drug manufacturing.
Consider the rate at which America has surrendered control of its medicine cabinet. Nearly two-thirds of all U.S. pharmaceutical supplies are now imported.
In 2024 alone, the U.S. pharmaceutical trade deficit hit a record $118.3 billion.
Particularly worrying is that China controls 80% to 90% of the global supply of active pharmaceutical ingredients, the chemical building blocks of modern medicine. Even drugs labeled “Made in USA” often originate in China. India, which produces roughly half of America’s finished generic drugs, relies on China for up to 80% of its pharmaceutical ingredients.
Relying on medicines produced halfway around the world has led to serious supply chain problems. American hospitals report an average of 301 critical drug shortages at any given time, leaving doctors without crucial medicines such as antibiotics, sedatives and cancer drugs.
Imported drugs are also proving unsafe. A 2025 study found that generic medicines produced in India are 54% more likely to cause serious side effects than their U.S.-made counterparts. India’s factory violations have also been tied to at least eight U.S. patient deaths. China’s record is equally disturbing; in 2008, dozens of Americans died after receiving contaminated heparin from Chinese suppliers.
In April, the Trump administration launched a Section 232 investigation into America’s pharmaceutical imports to assess the subsidies and market distortions that have allowed China and India to undercut domestic U.S. drugmakers. That’s a helpful first step, but Congress must also act.
According to the Congressional Budget Office, the federal government is the largest single purchaser of prescription drugs in the United States, thanks to programs such as Medicare, Medicaid and veterans health care. That means Washington possesses real leverage, the vast purchasing power needed to stimulate new, domestic drug production.
Consider, for example, that Americans spent $450 billion on prescription medications in 2023 alone. Roughly one-third of that spending, approximately $150 billion, came straight from Health and Human Services Department programs such as Medicaid and Medicare Parts B and D.
Unfortunately, far too much of this federal money is being spent on imports. That’s why Congress must step in: to ensure that federal drug procurement prioritizes American-made pharmaceuticals. Doing so could allocate tens of billions of dollars annually for domestic U.S. drug producers, helping stimulate investment in new, domestic pharmaceutical infrastructure.
A 2020 Coalition for a Prosperous America study found that reshoring domestic pharmaceutical production lost to imports since 2010 could create 804,000 U.S. jobs. That means the benefits of new, domestic drug manufacturing would extend to patient safety and economic growth.
In many ways, this should be a no-brainer. Americans want their medicines to be safe and their tax dollars spent on reliable, quality medications.
Washington is in the midst of a bipartisan reckoning on the need to rebuild U.S. industry. President Trump’s tariffs and the Biden administration’s Inflation Reduction Act focused on reshoring critical U.S. industries. Now, it’s time to use federal procurement in the same manner to stimulate new U.S. pharmaceutical production.
Redirecting federal prescription drug spending to American-made pharmaceuticals isn’t just feasible. It’s also the most direct means to ensure dependable medicines and patient safety. It can also deliver meaningful economic benefits for American workers.
It’s past time to spend taxpayers’ dollars on the safest and most reliable medicines. Using the full weight of federal procurement to incentivize new domestic U.S. drug production is urgently needed to rectify the nation’s serious health and safety challenges.
• Jon Toomey is president of the Coalition for a Prosperous America.
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