China's Growing Control Over US Pharmaceutical Supply Chain

• •China supplies 39.9% of U.S. imports of active pharmaceutical ingredients as of 2024.
• •The U.S. regulatory framework is enabling increased Chinese control over the pharmaceutical supply chain.
• •China's dominance poses a national security risk, potentially turning access to medicines into a geopolitical bargaining chip.

The U.S. is increasingly dependent on China for critical pharmaceuticals, with China supplying 39.9% of U.S. imports of active pharmaceutical ingredients (APIs) in 2024. This dependency poses a national security risk, as China's influence could turn life-saving medications into bargaining chips. The Trump administration's recent one-year truce with China may delay efforts to reduce this reliance. China dominates the supply of essential drug ingredients, controlling 99% of certain critical inputs, including prednisone and antibiotics. The U.S. regulatory framework inadvertently supports this trend, allowing companies to conduct clinical trials in China, which accelerates the development of Chinese pharmaceutical companies. If left unchecked, this could lead to a scenario where American lives are at the mercy of Chinese production and distribution capabilities.