Americans Rely on China For 90% of Prescription Drugs Despite Lax Safety, Ethical Standards

The Congressional Select Committee on China held a hearing where they discussed the United States’ reliance on foreign countries for the vast majority of drugs, including the fact that roughly 90% of all prescription drugs used in the US run through Chinese-controlled inputs. The experts in the hearing also explained to the committee that China and India have deregulated standards, lax inspection protocols, and higher rates of serious adverse side effects compared to domestically produced drugs.

Chairman John Moolenaar explained how China gained control of the generic drug market through subsidies and lax environmental standards, pricing out Western competition. “China enters a market with subsidized capacity, prices out competitors, and waits. The difference here is that the product is medicine. If China restricted API exports tomorrow in the same way it has restricted rare-earth exports, American hospitals and pharmacies would begin running short of essential medicines. Our military, our veterans, and our most vulnerable patients would be the first to feel it. China is also now leveraging its dominance of the low-tech base of the pharmaceutical industry to seize control of its high-tech, profitable future.”

Patrick Cashman, president of USAntibiotics, told the panel that leverage over America and control of the global drug market is the purpose rather than profit.

“The Chinese government doesn’t look at this as a profitable enterprise. I believe they view it as a strategic asset they can leverage against us, so the cost of production is irrelevant to them. They’re going to work to drive anybody out of business if they have to, and that’s what they’ve done in the past. We’ve seen that in many, many different models across many industries.”

Chairman Moolenaar said China operates the cheapest and fastest early-stage human clinical drug trials, but operates with lax ethical standards that would never be acceptable by US standards. He said more than 60% of patients in Chinese clinical trials were given treatment before they were informed of their diagnosis, and the CCP coerces Uyghur Muslims and other minorities into clinical studies. The FDA still allows data from these studies to be used for US drug applications.

Cashman referenced a 2025 study by Indiana University and Ohio State University that found generic drugs from India were 54% more likely to cause serious adverse effects compared to domestically produced generic drugs. Cashman explained that the FDA conducts unannounced visits to domestic manufacturers, but foreign manufacturers receive up to 12 weeks’ notice before inspections. This allows producers time to conceal issues before inspectors arrive on site.

“Yeah, I think of it a lot like uh the course of water. If you let water go, it’s going to naturally find the easiest path through to its objective,” Representative Nathanial Moran said during the hearing. “Mr. Becraft mentioned this earlier about the blockades we put up. It just incentivizes companies to go somewhere else or to do something different. They’re going to shift and take the easier path through research and development to reach the end goal they need. So, we need to take away those unnecessary blockades. We need to keep safety in place. No question. But we have gone way overboard in doing that.” 

Dr. Jacob Becroft, CEO of Strand Therapeutics, explained earlier in the hearing that regulatory burdens in the US push companies to conduct clinical trials in other countries like China and India.

“It takes longer, and it’s much more expensive to run a first-in-human trial here in the United States, partially because of the hurdles it takes to run these INDs (Investigational New Drugs) and the expense and time at which it takes them to run here in the United States. If we make that an easier hurdle, if we make it a faster and cheaper amount, you not only open up the capital pools to power that, but you open up the types and places where we will run clinical trials.”

Dr. Becroft suggested the FDA could decentralize the process while working with institutional review boards and maintain rigorous safety oversight. Doing so would increase the speed of the process, reduce the manufacturer’s costs, and incentivize companies to conduct more clinical trials domestically.

Approximately 66%, or two-thirds, of American adults currently take prescription drugs, and 90% of those drugs run through Chinese-controlled inputs. The experts and representatives discussed how relying on the Chinese Communist Party poses a national security risk.

Recently, President Trump signed an executive order calling for domestic production of glyphosate because 99% of the chemical that is used in the US comes from China. Other national security concerns related to China have included domestic residential biolabs with dangerous biological agents operated by Chinese nationals. These labs have also been located near military installations.