Trump administration urged to take on China’s ‘Pharma Death Grip’

The push comes as policymakers recognize the United States relies heavily on China for key pharmaceutical materials, particularly the raw components of many antibiotics, while producing a small share domestically, China specialist Gordon Chang said.

“Healthcare, as evident in country after country, is best left to the market, but as China weaponizes trade—and continually threatens war—it’s clear that Washington has to temporarily implement non-market solutions to ensure that Americans have access to the medicines they need,” he wrote in a paper published on Conservative Political Action Conference’s website titled “China’s ‘Pharma Death Grip’ on America.”

“In short, America has to quickly onshore production.”

Chang, who is testifying on Wednesday afternoon before the Senate Special Committee on Aging, said tariffs, as Scott suggests, should be part of the mix, but that the challenge for the Trump administration will be to find the right combination of coercive state action, public subsidies, and free-market incentives.

Generics, which make up roughly 91% of prescriptions filled in the U.S., are particularly exposed.

“More than 40% of generic drugs prescribed in America have just one manufacturer,” Chang added. “Some 83% of the top 100 generic drugs consumed by Americans have no U.S.-manufactured [active pharmaceutical ingredients].”

On antibiotics, Chang said the U.S. was particularly vulnerable.

“Amoxicillin, one of the most widely used of them in America, is made from four separate [key starting materials] that are produced almost entirely in China,” he said. “America gets about 45% of its imported penicillin from Chinese factories. Around 90% of the APIs for antibiotics used worldwide come from that country.”

At the moment, China has the most monopolies or near monopolies on many pharmaceuticals.

There are, for instance, about 100 drugs that require ingredients only made in one Chinese factory.

India, he said, is “the other heavyweight generic drug producer” and gets about 80% of its APIs — the building blocks of pharmaceuticals — from Chinese factories. Approximately 45% of KSMs, the building blocks for APIs, are produced only in China.

Chang believes several policy tools could help rebuild domestic capacity and is expected to testify on the options. One would be for the federal government to use its enormous purchasing power to prioritize American-made drugs. Agencies such as the Department of War, the Department of Veterans Affairs, and Medicare could be directed to favor domestically produced medicines whenever possible, and to source from trusted allied nations when the U.S. supply is unavailable.

Lawmakers could also require clearer labeling of drug origins and ingredients, and close loopholes that allow foreign products to be marketed as “Made in America.” At the same time, regulators could streamline parts of the Food and Drug Administration’s approval process that critics say add unnecessary delays and costs for manufacturers.

Chang also argued that Congress could tighten import standards. Drugs produced at facilities that have not been properly inspected, or that fail to meet safety requirements, could be barred from entering the U.S. Another step would be to enforce Section 307 of the Tariff Act of 1930 more aggressively, which bans goods made with forced labor. Taken together, these measures could help neutralize some of the cost advantages Chinese producers enjoy.

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For now, the stakes are immediate and high, Chang said, adding that the U.S. should not be in a position where it cannot guarantee a reliable supply of basic medicines for its own citizens.

Neither Scott nor the Department of Commerce responded to a request for comment.