Raw materials from overseas fuel the production of medicines used in the US

When the COVID-19 pandemic disrupted the global supply chain, the impact hit home in the US. Drug shortages resulting from halted shipments revealed the vulnerabilities of the US pharmaceutical industry, which for years had outsourced much of its production of active drug ingredients to China and India. According to a new study by the nonprofit US Pharmacopeia (USP), US dependence on those countries goes even deeper. The report reveals a heavy reliance on China, and to a lesser degree on India, for key starting materials needed to make the active pharmaceutical ingredients (APIs) in some of the most common medicines sold in the US. The USP started the study in 2019 to trace the supply chains of important medicines used in the US. They found that although most APIs used in drugs sold in the US are made in India, the raw materials needed for many of them come from China.China was the sole supplier of at least one key starting material for about 700, or 37%, of all APIs included in the analysis. Meanwhile, India was identified as the sole supplier of at least one key starting material that went into 22% of all APIs. Many of these APIs are used in cardiovascular medicines, antibiotics, and oncology-related drugs. “What’s interesting is that it’s just two countries which are responsible for the majority of the key starting materials, not just for the US market but for the global market,” says Vimala Raghavendran, a study coauthor and USP’s vice president for informatics product development. “The