The trade war that Donald Trump started with China and his threats to impose duties on the imports of medicinal products, testifies to America’s dependence on another important sector, the pharmaceutical.

OR amoxicillin, A relative of penicillin in chronic lack is the most commonly prescribed antibiotic in the United States, which is used by tens of millions of people each year to treat bacterial infections, such as pneumonia, stomach ulcers and streptococcal pharyngitis. However, it only has one manufacturer in the US andChina controls 80% of raw materials required to produce it.

“The growing commercial hostilities or the most prolonged conflicts could destroy our access to amoxicillin or the ingredients used to make it, if Beijing uses its weapon its dominance in the supply chain,” Unique amoxicillin manufacturer in America.

Last year, 96% of hydrocortisone imports in the US (the active ingredient of itching cream), 90% of ibuprofen imports (found in common analgesics available without a medical prescription) and 73% of acetaminophen imports (in other species) based on commercial data from the inventory service.

As the US is already facing shortcomings on many basic drugs, experts warn that Beijing could potentially to exploit this dependency as a pressure lever in a escalating trade war.

Lille Miller, commissioner of the US-China Economic and Security Committee, said China’s “obstacles” to the supply of medicinal products from the US are “harmful to American security”.

“Just having this influence … Whether they ever get the trigger or not, it forces us to change our political positions to many things, and that’s not good,” he said.

So far, China has not formulated any formal public threat for the exploitation of its dominant position in the field of pharmaceutical industry. However, if Trump imposes duties in this area, they could aggravate existing drug shortages and raise prices for Americans, undermining his promise to reduce the cost of health care.

General drugs account for 90% of all prescription drugs in the US. India produces many of these generic drugs, often from ingredients imported from China.

Although people in the industry and experts widely recognize America’s great dependence on Chinese medicinal products, there is little comprehensive data on the full extent of this dependency throughout the field, as large pharmaceutical companies have little incentives to disclose such information.

This is partly the reason why last month, the Trump government began an investigation into imports of medicinal products in the context of imposing duties in the field for national security reasons.

A ‘devastating’ interruption

Since China produces 80% of raw materials for amoxicillin worldwide, according to Rick Jackson, this is a clear example of how vulnerable the world could be in “Chinese political or economic whims”.

In 2021, Jackson bought a bankrupt production unit in Bristol, Tennessee and renamed it to usantibiotics. The facility, built in the 1970s, produced a lot of amoxicillin for the whole country.

After the end of the patent of amoxicillin in 2002, the installation in Tennessee began to produce generic medicines. At that point, he began to face lower cost competition than overseas and eventually went bankrupt.

But concerns about America’s dependence on Chinese medicinal products are not new. As early as 2019, the US-China Economics and Security Committee recommended in Congress to evaluate the vulnerabilities of America’s medicinal products. Two years later, when Jackson bought the amoxicillin plant, he mentioned national safety and the need to ensure a steady supply of antibiotics as an important reason for the market.

However, progress in the development of the supply of medicinal products in America is slow. At the end of April, Trump said the pharmaceutical companies would have to produce drugs in the US or face a “tariff wall”.

A key goal behind Trump’s threats to pharmaceutical duties is the “domestic” production of medicines. An American study of 2021 found that the US imports 72% of their basic drugs.

However, experts have said that duties are unlikely to achieve this target for generic medicines, which have become goods, with the price being the main difference of differentiation. On the contrary, so -called branded drugs are protected by patents and therefore require higher prices and higher profit margins.

On the contrary, duties will not only increase medical costs for patients, but could also aggravate continuing drug deficiencies by pushing generic drug manufacturers outside the US market. Even if they are willing to build drug production facilities in the US, the process could take years.

Dependence on China

China’s sovereignty in the global drug supply chain is an integral part of it. For decades, the pursuit of lower production costs has prompted pharmaceutical companies to transport production from western countries to places such as China and India. Thus, China now plays a huge role in the supply chain for the significant production of critical chemicals, called basic initials or KSM materials, which are essential for the production of active ingredientscalled active medicinal ingredients or API.

China and India dominate global capacity for active substances (API). Together, they represent 82%.

Chinese manufacturers have also benefited from the political motives and subsidies of Beijing for the pharmaceutical sector since the early 2000s, which led to the emergence of industrial clusters in the country, said Qingpeng Zhang, Associate Professor at LKS Medical School.

“These industrial groups, which help reduce the overall cost while maintaining quality … finally made China Ideal location for generic production Medicines and Active Substances (API) in an environment of free trade, “he said.

In addition to the lowest costs, the environmental impact of drug production have also contributed to China’s rise in this sector, as the US and the European Union often have more stricter environmental regulations, according to Ronald Piervincenzi, USP chief executive. Even India, the world’s leading supplier of generic drugs, is based on China for active substances (APIs) and other essential ingredients. In fact, 70% of India’s active substances (APIs) come from China, according to a 2023 report assigned by the Indian government.

Increases in prices

While Trump is not the first US president to push for relocation of drug production, he is the first to attempt it through the threat of sweeping duties. Some companies have followed the policy.

However, experts warn that duties on medicinal products will eventually burden patients, expanding them inequalities In the field of health in an already pressured healthcare system. Because generics are up to 85% cheaper than branded drugs, low -income patients and those who do not have health insurance are disproportionate to them.

A April study commissioned by the main American pharmaceutical lobby group, the Pharmaceutical Research and Manufacturers of America, revealed that a 25% duty would increase the cost of imported pharmaceuticals by $ 50.8 billion per year, raising prices by 12.9%.

ING also found that a 25% duty on a common generic cancer drug could increase its price up to $ 10,000 for a 24 -week prescription.

Instead of achieving the aim of relocating production, experts said the duties could push generic drug manufacturers to completely abandon the US market.