Core Insights - The urgency of addressing pharmaceutical supply chains is highlighted, particularly the reliance of the US on China for essential drug ingredients [1][12] - The US-China Economic and Security Review Commission has proposed legislative changes to enhance FDA authority over pharmaceutical supply chain transparency [1][12] Industry Dependence - The US heavily depends on China for foundational ingredients in medicines, with China producing a significant share of key starting materials (KSM) and active pharmaceutical ingredients (API) [1][6] - In 1980, China was not a significant player in drug master files submitted to the FDA, but by last year, it accounted for 45% of total filings, surpassing India [6][16] - Approximately half of the active ingredients used in the US originate from China, which is the sole supplier of at least one chemical in nearly 700 essential medicines [9][16] Supply Chain Risks - The COVID-19 pandemic underscored the risks of over-reliance on a single source for medical supplies, particularly from a geopolitical rival [11][16] - The potential for future global health crises poses additional threats to the stability of the pharmaceutical supply chain [11][16] Strategic Initiatives - There is a push to develop a supply chain involving India and other allies to reduce dependence on China, although this presents challenges due to low profit margins in the production of starting compounds [12][13] - The US may need to implement measures similar to the Pentagon's agreement with MP Materials Corp. to stabilize the supply chain for critical medicines [14][16]