Domestic manufacturing is the answer to America’s essential medicine shortage 

Our health care system is facing a silent crisis — generic medication shortages. The severity of this crisis transcends partisan politics and demands immediate, unified action to increase generic drug production right here in America.

Countless patients across the country are unable to receive life-saving treatments for severe diseases, including cancer, in a timely manner. The American Cancer Society warns that patients could experience worse health outcomes if these shortages continue. That should strike urgency in all of us. Furthermore, our hospitals face challenges in procuring essential medications, ranging from poison antidotes to vital fluids for surgeries. Even basic medicines like antibiotics and children’s fever medication are in short supply. This escalating crisis is impacting everyone, from a child with a cough to adults battling chronic illness, and it’s only getting worse. 

Generic drugs make up nearly 91 percent of all prescriptions filled but account for just 18.2 percent of the retail drug spend. This is a significant achievement that directly benefits millions of Americans, and access to these products must be maintained. The U.S. generic drug market, despite being cost-effective and equivalent to their brand-name counterparts, however, is currently unsustainable. Misaligned incentives are driving pharmaceutical manufacturing away from the United States to foreign, often adversarial, countries.  

Drug shortages arise from a mix of international supply chain disruptions, financial strains, and manufacturing shutdowns. Here in America, many manufacturers have shifted production overseas to save money on labor costs. Furthermore, the consolidation of drug product purchasing groups in the U.S. has stifled competitive opportunities. Just three companies control nearly 90 percent of all generic medicine purchasing for U.S. hospitals and clinics, and three purchasing consortiums collectively control 90 percent of the retail prescription market. Further exacerbating this situation, by one count, for every $100 spent on a generic prescription drug, $44 go to a middleman.  Under these conditions, it is common for one or two overseas manufacturers to corner the market on an essential medicine or its active pharmaceutical ingredient. When production slows or stops, other manufacturers cannot fill the gap quickly enough, and patients suffer. These many challenging dynamics require that we in Congress address the root causes of drug shortages with a multifaceted approach so that patients can access the drugs they desperately need.    

Revitalizing domestic manufacturing of essential medicines is a crucial part of the solution, and we commend the Energy and Commerce Committee’s recent work to bolster our pharmaceutical supply chain. Moreover, recognizing our heavy dependence on foreign competitors like China, we must work towards fortifying our domestic production capacity. 

We need policies that support domestic manufacturing of these drugs, including regulatory changes that incentivize domestic generic drug production. Additionally, a review of pricing and reimbursement policies for essential generic medicines would ensure that manufacturers have the financial incentive to produce these necessary drugs domestically. Reshoring, or bringing the drug supply chain back home, will increase the reliability of our drug supply chain, stimulate our economy, reduce foreign supply chain dependence, and increase our national resilience in the face of global crises. 

Lastly, it’s important that our pursuit of a fair and competitive market does not compromise the quality and affordability of medications. Enhancing supply chain transparency and fostering communication and collaboration amongst all stakeholders — patients, manufacturers, distributors, pharmacies, hospitals, and regulatory agencies — can help identify roadblocks to patient access.  

The path to a reliable pharmaceutical supply chain is right here in America. As representatives of the people, we must champion policies that enhance our domestic capabilities and local economies. Reshoring not only demonstrates our commitment to American workers but also prioritizes the health of every American. We must transcend our political differences and act urgently to resolve this public health crisis. It’s not just about securing our supply chain – it’s about securing our nation’s health and future. Together, we can bring relief to patients and safeguard the health and well-being of our fellow Americans.

U.S. Rep. Earl L. “Buddy” Carter represents Georgia’s First Congressional District. A pharmacist by trade, he sits on the House Energy and Commerce and Budget Committees.