Hooked On India

U.S. generic drugmakers depend on more than 100 factories in India for crucial ingredients

- Anna Edney

Amid the first Covid-19 lockdowns in 2020 and worries that critical drugs could run low, a 200-year-old nonprofit, little known outside the drug industry, took it upon itself to meticulously map the supply chain of medications Americans take. It was an ambitious undertaking that not even the Food and Drug Administration had tried before.

U.S. Pharmacopeia has long played a critical role in the drug industry, which relies on its chemical samples to help ensure quality. The results of its huge data-mining probe were startling: Indian factories, the data showed, provide a vast amount of ingredients that go into the generic drugs Americans take.

USP Chief Executive Officer Ron Piervincenzi says that before his organization sought to map the supply chain during the lockdowns, he was surprised by the paucity of data. “We were just frustrated—not just frustrated, truly annoyed,” he says.

Active ingredient production, USP found, is far more concentrated in India than was previously understood given the FDA’s limited data, which had made China look like a more dominant player in the pharmaceutical supply chain than it really is. Active ingredients are what make a drug effective against a particular disease or condition.