America’s Other Health Care Crisis: Generic Medicine Supply Chains



For the last two years, our nation has been engulfed by a health care crisis, as Covid-19 and its variants halted global supply chains, shuttered small and large businesses, and upended the everyday lives of countless Americans. Yet as the national and local media, elected offi­cials at every level, and health care experts focused on addressing this challenge, a separate health care and national security crisis continued to affect nearly every American.


Today, the United States is dangerously dependent on foreign manufacturers—particularly in China and India—for essential, lifesaving generic medicines. (Of all prescriptions dispensed in the United States, roughly 90 percent are generics.) As detailed in a recent report by our organization, the Coalition for a Prosperous America, a loophole in the 1984 Hatch-Waxman Act has led to the offshoring of America’s domestic production of generic pharmaceuticals to China and India, price gouging in the U.S. market by foreign companies, and generic drug shortages in the United States.


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This dangerous reliance on overseas supply chains has contributed to widespread drug shortages and price gouging, driving up costs and preventing Americans from receiving the world-class health care that they deserve. The only way to resolve these public health challenges is to bring generic drug manufacturing back to the United States. Doing so begins with leveraging the federal government’s buying power, paired with supportive trade policies and financial incentives to give domestic manufacturers the certainty they need to rebuild America’s pharmaceutical industrial base. Together, these policies would represent the most significant change in the American generic manufacturing industry since the 1980s, and would finally accomplish the original goals of the Hatch-Waxman Act by creating more competition for generic pharmaceuticals. Accomplishing this would leave the United States far more prepared for a future pandemic, and ensure that essential medicines are safe, affordable, and readily accessible for all Americans.


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This article originally appears in American Affairs Volume VI, Number 1 (Spring 2022): 33–48. To read the full article, click here.