Chairman Moolenaar’s Opening Statement: China Is Cornering the Market on Our Medicines

Today, Select Committee on China Chairman John Moolenaar delivered this opening statement at the Select Committee’s hearing on the generic drug supply chain – roughly 90% of drugs Americans take every day run through Chinese-controlled inputs – and the drug development pipeline, where China is close to outpacing the U.S. in clinical trials.

As prepared for delivery.

"China is cornering the market on our medicines — from the supply of generic drugs that Americans depend on every day, to the cutting-edge biotech pipeline that will determine who leads medicine in the years and decades ahead.

"For most of American history, when a doctor prescribed a medication, it was made in our country, or somewhere we trusted. That is no longer true — and it’s a problem many Americans are unaware of.

"About 90 percent of the prescriptions filled in this country are generic medicines — off-patent drugs for blood pressure, diabetes, infections, blood clots, and other conditions. The ingredients that go into these medicines are called active pharmaceutical ingredients, and they are largely produced overseas. The upstream chemical building blocks that feed those ingredients — key starting materials — are dominated by one country: China.

"This did not happen by market forces. It happened by China’s design. Decades of Chinese state subsidies, low environmental standards, and other factors drove Western competitors out of the market entirely. Today, USAntibiotics in Tennessee is the only remaining American manufacturer of amoxicillin, which is one of the most commonly prescribed antibiotics in the country. For heparin, the blood thinner used in surgeries, virtually all global processing occurs in China. According to Washington University in St. Louis, 83 of the top 100 generic drugs used by Americans have no domestic source of key ingredients.

"We have seen this playbook before — in steel, in solar, and in rare earths. China enters a market with subsidized capacity, prices out competitors, and waits. The difference here is that the product is medicine. If China restricted API exports tomorrow in the same way it has restricted rare earth exports, then American hospitals and pharmacies would begin running short on essential medicines. Our military, our veterans, and our most vulnerable patients would be the first to feel it.

"China is also now leveraging its dominance of the low-tech base of the pharmaceutical industry to seize control of its high-tech, profitable future.

"China is moving aggressively up the biopharmaceutical value chain — into the development of innovative new drugs.

"In 2020, essentially zero percent of the world’s large pharmaceutical licensing deals involved Chinese-origin molecules. In 2025, that figure was 48 percent. Chinese biotech firms are now developing novel cancer treatments, diabetes drugs, and biologics — and U.S. pharmaceutical companies, facing a wave of patent expirations on their most profitable drugs, are increasingly buying what China is selling.

"Part of what is driving this is China's clinical trial system. China has transformed itself into the cheapest and fastest place in the world to run early-stage human drug trials. However, its combination of deregulation, state subsidies, and lax ethical standards would not be acceptable in the United States.

"Studies show that more than 60 percent of patients in Chinese clinical trials were started on treatment before being informed of their diagnosis. China runs trials at PLA military hospitals and in Xinjiang, where there has been a documented history of people being coerced into medical studies amid the Chinese Communist Party’s genocide targeting Uyghur Muslims and other minorities. In spite of this forced testing, the Food and Drug Administration currently allows companies to use data from uninspected Chinese trial sites to advance drug applications in the United States.

"The result is a feedback loop that hollows out American biotech capacity while building China's. As early-stage trials migrate to China, the infrastructure, expertise, and investment follow. The United States is left with fewer trial sites, fewer trained researchers, and a drug pipeline that is increasingly made in China.

"The witnesses before us today have direct experience with these two threats to our nation’s medicines. We are going to hear about what the supply chain looks like from the inside, what China's ascent means for the future of American medicine, and what Congress can do about it.

"We have allowed this vulnerability to develop quietly over decades, while we focused only on cost and blinded ourselves to consequences for national security, the economy, and the health of the American people.

"I look forward to hearing from our witnesses."