Chairman Rick Scott and Ranking Member Kirsten Gillibrand of the U.S. Senate Special Committee on Aging have sent a letter to pharmaceutical distributor executives seeking information about weaknesses in the U.S. pharmaceutical supply chain. The committee is investigating how dependence on foreign manufacturing of generic drugs and gaps in regulatory oversight may threaten public health and national security.
The letter, addressed to McKesson, Cardinal Health, and Cencora, asks for details about the companies’ awareness of quality issues related to certain drugs exempted from import bans, their ability to detect shortages, and estimates on how long U.S. drug inventories would last if exports from China were halted.
The inquiry follows previous actions by the committee, including a recent letter to group purchasing organization executives and an investigative report that examined the risks associated with reliance on foreign-manufactured generic drugs. On September 17, the committee held a hearing focused on threats to drug safety and availability stemming from this overreliance. A second hearing on October 8 explored possible solutions for strengthening domestic supply chains.
Recent reports indicate that the Food and Drug Administration (FDA) has granted exemptions allowing some drugs or ingredients from factories under import bans—primarily in China and India—to enter the U.S. market despite substandard manufacturing conditions. Since 2013, more than 150 drugs and ingredients have received such exemptions. While many facilities later resolve compliance issues, these temporary allowances can introduce potentially unsafe products into the supply chain.
Geopolitical events also pose risks to pharmaceutical supplies. For example, after a trade dispute between the United States and China was settled with an agreement on rare earth elements in April 2025, China imposed new export restrictions in October 2025. This action raised concerns that similar restrictions could be applied to pharmaceutical products or key starting materials (KSMs) and active pharmaceutical ingredients (APIs), which are essential components for many medications used in the U.S.
The senators wrote: "Ultimately, the interaction between regulatory oversight and geopolitical dynamics presents significant challenges to the safety and reliability of our pharmaceutical supply chain. It necessitates ongoing vigilance and proactive measures to ensure that patients receive high-quality, safe medications."
They continued: "As chairman and ranking member of the U.S. Senate Special Committee on Aging, the health and safety of Americans, especially our seniors, is our top priority. Thank you for the work that McKesson, Cardinal Health, and Cencora do every day to secure supply chains for generic medications and help patients access the treatment they need. Thank you for your attention to this matter. We look forward to your response."
