10 September 2019 - If you take a pill every day to treat high blood pressure or high cholesterol, you probably don’t spend much time thinking about where those drugs come from or what you would do if your pharmacy suddenly couldn’t fill your prescription. But when it comes to the sources of their prescription drugs, what Americans don’t know can hurt them.

Most of the drugs Americans take — as much as 90% — are generics. But before such drugs arrive at pharmacies in pill form, they start as active pharmaceutical ingredients. China now dominates that market globally. And though India is a large manufacturer of the finished product along with China, Indian companies get 80% of their ingredients from China.

There is no single accounting of the percentage of active ingredients in U.S. drugs that are manufactured in China, but it’s significant and growing. The FDA has said approximately 80% of active-ingredient manufacturers are located outside the United States, and for some key drugs, China is the only supplier.

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