10/10/2025 | Press release | Distributed by Public on 10/10/2025 11:21
U.S. drug imports have increased 7x since the year 2000.
Overreliance on foreign pharmaceuticals leaves the U.S. susceptible to drug shortages and safety risks.
Video of Exchange (YouTube)
Washington, D.C. - At a hearing of the Senate Special Committee on Aging, U.S. Senator Elizabeth Warren (D-Mass.) raised concerns about the vulnerabilities of the U.S. drug supply chain, highlighting the risks of foreign-made pharmaceuticals and advocating for greater investments in U.S. manufacturing.
In the hearing, Senator Warren highlighted the United States' dependence on foreign countries for drug manufacturing, which leaves the U.S. susceptible to drug shortages and safety risks. Low production costs abroad have also driven drug manufacturers-including around 77 percent of active pharmaceutical ingredient (API) manufacturers-out of the U.S., enabling the country's dependence on foreign-made drugs.
Andrew Rechenberg, an economist at the Coalition for a Prosperous America, highlighted that other countries heavily subsidize the manufacturing of prescription drugs, allowing them to severely underprice U.S. producers and drive them out of the market. Rechenberg suggested production incentives to support U.S. producers, like federal procurements, can be a "huge part" of incentivizing and prioritizing American-made medicine.
Tony Sardella, Founder and Chair of the API Innovation Center, agreed with Senator Warren that it would "absolutely" help national security to use federal contracts at the Department of Defense (DOD) and other agencies to prioritize domestic-made pharmaceuticals. "It would be a significant lever to bring back a strong U.S. industrial base for manufacturing," he said.
When asked whether shifting to more domestic-made pharmaceuticals would cost more money or save more money, Mr. Rechenberg confirmed it would save "far more" money. "Over the long run, you save much more money than you would otherwise, because you stop these shortages, and you guarantee safer, more effective medicine," he replied.
Senator Warren concluded the hearing by calling for bipartisan support for herPharmaceutical Supply Chain Defense and Enhancement Act, which would enhance domestic production of pharmaceuticals, preventing shortages and ensuring safer, more effective medicines.
"Americans shouldn't have to worry about the quality of their prescriptions, whether they're safe to be able to take, or whether they're effective, [or] what will happen if the supply chain breaks," said Senator Warren. "And for me, that's reason enough to manufacture right here in the United States and us[e] federal contracts to lower those production costs."
Senator Warren has worked to end the United States' overreliance on foreign countries for critical drugs and boost the nation's domestic manufacturing capacity. In 2024, she reintroduced the Pharmaceutical Supply Chain Defense and Enhancement Act and, in 2025, secured provisions in the Fiscal Year 2026 National Defense Authorization Act(NDAA) to require DoD to report on pharmaceutical supply chain challenges and their impact on military readiness.
Transcript: Bad Medicine: Closing Loopholes that Kill American Patients.
U.S. Senate Committee on Aging
October 8, 2025
Senator Elizabeth Warren: Thank you, Mr. Chairman, and thank you, Ranking Member, for holding this hearing today.
So, we're talking about a broken supply chain. And I was looking at the numbers on this. So, the U.S. imports seven times the amount of drugs that we were importing in the year 2000. That's how much this has gone up. And you all are discussing how our reliance on foreign-made pharmaceuticals exposes Americans to drug shortages, to safety risks, and exposes seniors more than anyone.
So, for years, I've been working with my colleagues to try to advance reforms, establishing stronger transparency rules, closing loopholes in "Buy American" requirements. And I just want to say we've got a lot of pushback from people who make a lot of money by keeping all of this opaque and maximizing their profits and minimizing safety for the American people. So, today I want to hit on something that you all have mentioned, and that is how we get more drugs manufactured domestically. How we move our supply chain here to the United States.
So, Mr. Rechenberg, you're an expert on drug supply chains. You know that other countries are subsidizing the manufacture of prescription drugs. How does that affect our ability to make these drugs here in the United States?
Mr. Andrew Rechenberg: Yes, and this is one of the main problems, that these foreign companies are being subsidized by their own governments, and so they're able to severely underprice U.S. producers and drive them out of the market. And so, we really need a comprehensive approach here, starting with something like a tariff rate quota system, to create a space in the market for U.S. producers, and we need to supplement that with direct production incentives for companies, whether through an act, like the Pills Act, or through federal procurement. Federal procurement can be a huge part of this and incentivizing and prioritizing American-made medicine.
Senator Warren: So, let's talk a little bit about buying here in the United States. The Federal Government could make it easier and less risky for manufacturers to make their products in the U.S. if we would just leverage the power of our federal contracts. That means the government makes a deal with the manufacturer and says, "We guarantee we will buy a certain volume of drugs over the next several years," and that makes it better for you to make the investments, you get out there, and you produce the drugs. Now the DoD actually has contracts for essential medicines because, for obvious reasons, it is important to make sure that our service members have the drugs they need as a national security issue. And I have been pushing DOD to make those contracts domestic production advances.
So, Mr. Sardella, you lead the API Innovation Center, and you've actually looked into how many critical drugs rely on ingredients manufactured exclusively in China. I think you were talking about this earlier.
Would it help national security to expand federal contracting programs at DOD and other agencies and focus them on domestic drug manufacturing?
Mr. Tony Sardella: Absolutely, it would be a significant lever to bring back a strong U.S. industrial base for manufacturing. I commend all the incredible work you've done in this area. And then secondly, one of the elements that would be also very effective is shifting the contracting vehicle from what is an IDIQ, indefinite demand-indefinite quantity, in business. And indefinite demand and indefinite quantity does not reduce the risk. There's no certainty. You could lose a contract or volume. Turning that into a certainty of demand and volume and even cost or price so that a manufacturer can make an investment. We have a small business in Missouri where we've placed two medicines for manufacturing for a healthcare system. We've provided them our technology that we developed. They are now making investments to expand their facility because they have certainty that the healthcare system is giving them a long-term agreement. If the U.S. government did the same, we expect the same.
Senator Warren: So, you and I are in the same place on this: that more robust federal contracting can create the kind of sustained demand that manufacturers need so that we can eliminate these supply chain vulnerabilities and protect our national security and for me, that is reason enough to implement them. But some critics have warned that "Oh, if you shift to American-made drugs, it will be too expensive." On the other hand, we're paying a price: A, for vulnerability, and B, if our seniors end up taking drugs that are ineffective and so they are sicker. They stay sick, lower-quality drugs, or if our hospitals are getting price gouged during shortages.
So, Mr. Rechenberg, do you think that shifting to more domestic manufacturing of pharmaceuticals would, over the long run, cost more money or save more money?
Mr. Rechenberg: It would save far more money. We've seen, as I mentioned in my opening statement, 300 to 500% price hikes during a shortage. So that's one way we would save money. But also, we're paying a lot more every time the medicine is not there, and the people have to be in the hospital longer, or you have to have a substandard medicine, or the hospitals have to pay extra staff to take care of people. And so over the long run, you save much more money than you would otherwise, because you stop these shortages, and you guarantee safer, more effective medicine.
Senator Warren: Thank you. You know, Americans shouldn't have to worry about the quality of their prescriptions, whether they're safe to be able to take, or whether they're effective, [or] what will happen if the supply chain breaks. And for me, that's reason enough to manufacture right here in the United States and using federal contracts to lower those production costs. But I think there are a lot more benefits for doing this. That is why I have a bill-the Pharmaceutical Supply Chain, Defense, and Enhancement Act- that would do just that. And I hope we can get some bipartisan support and get that moving. So, thank you very much. And again, thank you, Mr. Chairman, for holding this hearing today.
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