U.S. Biotech Future Is Now Made in China

Mike Kuiken

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This past year, oncologists across the United States faced an agonizing choice: Which cancer patients would receive their full, life-saving chemotherapy regimen and which would face delays or substandard alternatives? Widespread shortages of essential drugs like cisplatin and carboplatin—workhorse medicines that form the backbone of countless cancer treatments—left doctors scrambling and put hundreds of thousands of American patients’ lives at risk.

This crisis was not a natural disaster; it was a self-inflicted wound, the predictable outcome of a decades-long strategic failure. While Washington focuses on areas like semiconductors and AI, we have quietly ceded control over the very foundation of modern medicine to our primary geopolitical rival: China. The American biotech ecosystem, long considered the world's engine of innovation, is now dangerously dependent on China at every level of the supply chain.

When Americans pop an ibuprofen for a headache or take their daily blood pressure medication, they're unwittingly participating in one of the most dangerous dependencies in modern geopolitics. The active pharmaceutical ingredients—the actual medicine that treats your condition—increasingly come solely from China. Beijing didn't stumble into controlling 40 percent of the world's Active Pharmaceutical Ingredients (APIs) by accident. Through systematic state subsidies and predatory pricing, Chinese manufacturers have methodically destroyed Western competitors, then jacked up prices once the competition was eliminated. The result? When COVID hit and China briefly restricted pharmaceutical exports, American patients faced immediate shortages of a wide variety of drugs, from antibiotics to heart medications. We've essentially handed Beijing a kill switch for American healthcare.

Equally troubling is the dependency on Key Starting Materials and chemical precursors. These foundational chemicals are needed to manufacture both active ingredients and the supposedly "inactive" components that make pills work. Through systematic investment, China has come to dominate the global bulk chemical industry used in the pharmaceutical industry, meaning that even when we think we're buying "American-made" drugs, we are often just assembling components sourced from Chinese precursors.