Cheap drugs, high risks: America’s risky beta bets on China

In the wide mechanism that maintains the health of the United States, one of the most orthodox systems is the pharmaceutical supply chain. From daily pain relievers such as ibuprofen and asymaminophen to critical antibiotics and chemotherapy, medications that Americans depend on increasingly sources abroad – especially from China.

Although globalized production competencies have led to low costs, they have also introduced serious risks: dependency, diminishing supervision and the quality of the questionable product.

A lot of general anxiety focused on final drugs or active pharmaceutical components. But the deeper weakness lies on the source. Many chemical construction blocks that make modern medicine possible – reagents, solvents and major starting materials – are now produced by an overwhelming majority in China. These raw materials are necessary to collect active pharmaceutical components, and in many cases, they have no applicable alternative to China.

China’s dominance is clear in difficult numbers. According to American trade data, 95 percent of American ibuprofen imports, 91 percent of hydrocortisone, and 70 percent of acetaminophen and up to 45 percent of penicillin comes from China. However, the most dangerous dependency may be indirect. India, for example, provides most of the general medicines of the United States. But India itself imports approximately 70 percent of its pharmaceutical components of China. This means that many medications called “India”, in practice, deeply depend on Chinese source supplies.

This complex dependency network was acutely analyzed in the 2025 report by the Brookings Institute. The authors have argued that although the total exposure to the size of the American drug of Chinese pharmaceutical components is less than 25 percent, such averages block sharp weaknesses in some drugs-especially antibiotics and chemotherapy factors. The results of their findings also revealed a disturbing misconception: The idea that just converting the production of active pharmaceutical components into the United States will cancel the risks. In fact, unless chemical production is also transferred or diversified, the primary weakness remains.

In fact, Brookings highlighted that more than half of the inputs of solvents and detector in India – used to make medicines that are later exported to the United States – come from China. Moreover, India lacks the local infrastructure of some highly dangerous operations such as fermentation (necessary for many antibiotics) and fluorine (used in the synthesis of cardiovascular drugs). Over time, the external sources of these dangerous or almost technician dangerous processes were used almost to China – not only for economic reasons, but due to the complexities of organizational and safety.

Meanwhile, the quality monitoring problems associated with the Chinese Chinese, Chinese, continue to raise the alarm. Reports have documented cases of ineffective anesthesia, blood pressure medications that fail to reduce pressure and non -functional laxatives. These are not rare extremist values. Instead, it reflects the structural deficiencies: insufficient regulatory control within China and a priority purchase system.

China’s central drug purchases program gives contracts to the lowest bid. While this has led to low prices, it also presses manufacturers to reduce corners. It raises concern, there are documented cases of fake biological equivalence data – aimed at proving that the general drug works in the form of trademarks.

One of the last scandal included approximately 2000 wings, its clinical data was “similar to the last decimal place”, a statistical possibility that has caused general criticism from Chinese doctors and health experts.

Even inside China, these issues have sparked criticism from medical professionals. But their warnings often meet censorship instead of repair. For American patients, this represents a serious dilemma. While the US Food and Drug Administration oversees the safety of drugs, the presence of inspection in China is the minimum. Several production sites are rarely examined, if any. Pharmaceutical companies are not currently required to publicly reveal where their components come from – leaving patients, doctors, and even organizers in the dark.

Looking at the scale and complexity of the threat, this exposure requires a comprehensive strategy:

• Motivating local manufacturing: The United States must invest in restoring domestic production not only of the final drugs and active pharmaceutical components, but for basic chemicals and raw materials that feed the entire process. Without this, the “prominent” becomes a shallow solution.
• Promotion of transparency: Companies must be required to detect the origin of active pharmaceutical components and major inputs. This would allow government agencies and health systems to determine the selection and planning points around them.
• Increasing the supervision of the FDA abroad: The number of food and drug administration inspectors stationed in foreign countries – especially in China – should be widely expanded. Organizational control cannot be optional.
• Development of strategic stocks: The federal government must build and maintain basic drug reserves and their components, such as the strategic national stock, to the temporary store against geopolitical shocks.
• Partner with the Allies: Instead of trying to build a completely satisfied pharmaceutical system, the United States must cooperate with reliable partners such as Japan, South Korea and Germany to create a varied and flexible international supply chain.
• Advanced manufacturing support: You must receive technologies such as continuous manufacturing, which allows the production of the most efficient and high -quality drugs, support for federal research and development and organizational rapid tracking.

Brookings is really noticed that not all weaknesses are created on an equal footing. Some drug categories – such as controlled substances – are not exposed to or not. Others, such as antibiotics and statins, are almost completely dependent. The policy approach will fail in everything. Instead, the United States needs targeted reviews that give priority to basic drugs and specific failures, especially those that are not easily available alternatives.

Yes, these procedures will come at a cost. However, it would lead to a sudden disruption in Chinese pharmaceutical exports – whether due to a geopolitical crisis, a pandemic or commercial war. The difference is that the cost of work can be predicted and strategic, while the cost of failure from work is chaotic and perhaps fatal.

Cheap medicine should not come at the expense of safety or sovereignty. America must face the uncomfortable truth: its people’s health is unstable to supply the unforgettable chains. This equation will require leadership, investment and preparation to determine the priorities of flexibility on short -term savings. The clock beats, and the following drug shortage may not wait until the policy is attached.

Gianlly Yang is a research fellow at Kennedy College of Government at Harvard University. He is the founder and head of the Citizen Force Initiatives for China and author of “For us, The Living: A Relay to The Light on Truth” and “It is time for values ​​-based economist.