Proprietary data and AI analysis examines how America's pharmaceutical supply chains carry hidden risks to consumers
WASHINGTON, April 15, 2025 -- Exiger, the market-leading supply chain AI company, published the findings of its proprietary investigation into U.S. healthcare supply chains in its new report, A Bitter Pill: America's Dangerous Dependence on China-Made Pharmaceuticals. Exiger risk-assessed 2,309 companies, including drug manufacturers, packagers, labelers and suppliers, and 1,376 active pharmaceutical ingredients using its award-winning, AI-powered supply chain platform, 1Exiger. Exiger's analytics reveal patterns of severe quality control issues, including contamination and falsified testing data, deep dependencies on foreign drug manufacturers and unethical international sourcing practices, including forced labor.
China supplies 90% of U.S. antibiotic APIs—an acute dependency that could be exploited in a geopolitical crisis
"Exiger's AI reveals America's imbalanced dependencies on India and China for production of critical antibiotic, heart and diabetes drugs, and ties to Uyghur forced labor, compliance issues and quality failures," said Exiger CEO Brandon Daniels. "Particularly in the midst of retaliatory tariffs and escalating geopolitical tensions, these findings have serious implications for safe and affordable healthcare in the U.S., especially Medicaid, and underscore the need for urgent protective measures like investments in supply chain transparency and diversification, strategic stockpiling and increased domestic production."
Key Findings:
- The U.S. imports 75% of its essential medicines, exposing American patients and healthcare systems to disruptions from international conflicts, trade restrictions, pandemics, and natural disasters.
- China and India dominate the global market, producing 60% of APIs.
- India supplies about half of U.S. generic drugs yet depends on China for 80% of APIs.
- China supplies 90% of the antibiotic APIs used in the U.S., creating an acute dependency that could be exploited in a geopolitical crisis.
- U.S. imports of Chinese drug ingredients surged by ~24% from 2020 to 2023.
- Over 504 generic drugs, including 10 essential medicines, have only a single identified API manufacturing country, heightening risks of supply shocks.
- Systemic quality control failures have already impacted U.S. consumers. Incidents involving substandard and contaminated drugs highlight real health threats posed.
- More than 30% of all new import alerts were for sites in China, and 16% were for sites in India, highlighting recurring manufacturing issues.
- Pharmaceutical ingredients linked to forced labor pose ethical and legal issues, potentially compromising the integrity and reputation of the entire supply chain.
- Food and Drug Administration import alerts have surged due to severe violations, disproportionately involving Chinese (33%) and Indian (16%) manufacturers
- The top Medicaid prescription provider with 11 million prescriptions in 2024, and almost a third of the antibiotics market share, procures pharmaceutical ingredients from at least six China-based companies with allegations of forced labor and links to China's military.
- The third-largest Medicaid prescription provider, procures pharmaceutical products from companies tied to forced labor and Chinese-state ownership.
Exiger is the largest provider of supply chain risk technology to the U.S. Federal Government and a Preferred Cybersecurity & Risk Provider of the American Hospital Association, which represents nearly 5,000 hospitals, healthcare systems, networks and providers across the country. Exiger has briefed its customers, including 150+ Fortune 500 companies and 65+ organizations across the Defense Industrial Base and government agencies, on the report's findings and immediate steps that can be taken to rapidly mitigate the risks identified and secure pharmaceutical supply chains to safeguard American health and national security.
About Exiger
Exiger is revolutionizing the way corporations, government agencies and banks navigate risk and compliance in their third-parties, supply chains and customers through its software and tech-enabled solutions. Exiger's mission is to make the world a safer and more transparent place to succeed. Empowering its 550 customers across the globe, including 150 in the Fortune 500 and over 65+ organizations across the Defense Industrial Base and government agencies, with award-winning AI technology, Exiger leads the way in ESG, cyber, financial crime, third-party and supply chain management and recently achieved FedRAMP® Moderate Authorization. Named one of Fast Company's 2023 and 2024 'Brands That Matter' and recipient of the Third Party Risk Association's 2024 Innovator Award, Exiger's work has been recognized by 50+ AI, RegTech and Supply Chain partner awards. Exiger partners with healthcare organizations – from medical product manufacturers to hospital systems to government policy-makers – consolidating third-party risk and due diligence into one tool that spans supplier, supply chain and software risk. Learn more at www.exiger.com/industries/healthcare and follow Exiger on LinkedIn.
Press contacts:
Kody Gurfein
kgurfein@exiger.com
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