Source: United States House of Representatives – Congresswoman Doris Matsui (D-CA)
WASHINGTON, D.C. – Today, Congresswoman Doris Matsui (D-CA-07) and Congressman Brad Schneider (D-IL-10) led a group of 26 lawmakers in sending a letter toUnited States Trade Representative Ambassador Jamieson Greer and U.S. Department of Commerce (DOC) Secretary Howard Lutnick. The letter raises serious concerns that the Trump Administration’s tariffs may jeopardize the fragile supply chains of generic drugs and medical devices, risking dangerous shortages of these essential medical supplies.
“We write with deep concern over your Administration’s tariff actions affecting medical supply chains,” wrote the lawmakers. “Reckless tariffs, retaliatory measures, and an escalating trade war threaten the supply of essential medicines and medical goods, risking severe shortages that could harm U.S. patients.”
The vast majority of active pharmaceutical ingredients used for generic drugs come from overseas. The same is true of crucial medical devices. Imposing tariffs on these products will lead to shortages given the low tolerability of manufacturers to take on additional economic risk. These same factors could force manufacturers overseas where critical inputs are less expensive.
“The supply disruptions of critical medical products will unavoidably hurt U.S. patients, force providers to make impossible rationing decisions, and potentially even result in death as treatments are delayed and more effective medicines and products are swapped for less effective alternatives,” the lawmakers continued.
Congresswoman Matsui has been a leader in Congress to secure medical supply chains. Last Congress, she authored the Mapping America’s Pharmaceutical Supply (MAPS) Act, a bill to help the federal government prepare for and mitigate future drug shortages by identifying pharmaceutical supply chain vulnerabilities.
Full text of the letter can be found below or HERE.
Dear Ambassador Greer and Secretary Lutnick,
We write with deep concern over your Administration’s tariff actions affecting medical supply chains. Reckless tariffs, retaliatory measures, and an escalating trade war threaten the supply of essential medicines and medical goods, risking severe shortages that could harm U.S. patients.
Critical drug supply chains are already fragile, with 271 drugs currently in shortage, down from a record 323 in early 2024 but still alarmingly high. Many of these are low-margin generic sterile injectable drugs (GSI) crucial in hospital settings, including IV saline, chemotherapy, antibiotics, and anesthetics. Often priced at $2 or less per unit, these drugs are highly vulnerable to economic disruptions.
These economic conditions discourage manufacturers from investing in reliable supply chains, leaving these drugs heavily reliant on foreign active pharmaceutical ingredients (API), particularly from China and India, which together account for 80% of registered API manufacturing sites. The Administration for Strategic Preparedness and Response estimates that 90-95% of GSI for acute critical care depend on API from these countries. This reliance threatens military readiness as well as general public health; in 2019, a Defense Health Agency official warned that disruption of Chinese supply could cause “severe shortages.”
Similarly, nearly 70% of U.S.-marketed medical devices are produced solely overseas. The Organisation for Economic Co-operation and Development (OECD) highlights the complexity of global medical device supply chains, where disruptions lead to prolonged shortages. These supply chains are characterized by varying access to inputs across the globe, specialized regional economies and production capabilities, and an incoherent international regulatory landscape. If tariffs are implemented on medical products, it would be extremely difficult to coordinate a response such that the number and duration of shortages in the U.S. does not increase.
The supply disruptions of critical medical products will unavoidably hurt U.S. patients, force providers to make impossible rationing decisions, and potentially even result in death as treatments are delayed and more effective medicines and products are swapped for less effective alternatives. We have already seen these harmful effects during chemotherapy drug shortages in the U.S. in 2023. If tariffs are implemented, clinicians would be forced to make similar decisions on a much larger scale, having devastating impacts on patient care and resource allocation across the healthcare system.
Tariffs may also backfire by driving manufacturers to cheaper foreign markets, undermining efforts to strengthen domestic and allied-country production. With generic drugmakers already operating on thin margins, cost spikes could force them to cut product lines, exacerbating shortages. For example, we aware of one large generics manufacturer that has identified 60 products that would immediately be at risk of being discontinued if the administration moved forward with tariffs as proposed. Onshoring production requires deliberate policy incentives, not blunt economic penalties.
The shared goal of bringing more of our critical medical supply chains to the U.S. and allied countries requires the deliberate attention of the Executive Branch and Congress to incentivize manufacturing. Unfortunately, without additional policy changes, the blunt instrument of tariffs will likely result in more shortages of essential medicines and medical goods, threatening public health and inadvertently increasing reliance on foreign countries for our supply of critical medical products.
To avoid devastating consequences to patients and our public health infrastructure, we urge you to consider the following in tariff decisions:
- Assess the impact of tariffs on essential medicines and medical goods and seek input from manufacturers and experts.
- Exempt or provide waivers for API, generic drugs, essential medicines, and critical medical supplies.
- If tariffs are implemented, coordinate with the FDA to expedite approval of alternative sources.
- Issue timely and clear guidance to manufacturers on tariffs, exemptions, and exclusions.
- Collaborate with Congress and international allies to build resilient medical supply chains.
Congress stands ready to work toward securing our medical product supply chains. We implore you to carefully weigh tariff decisions with respect to essential medicines and medical goods.
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