US Antibiotic Importation and Supply Chain Vulnerabilities

Where do antibiotics for the US market come from?This cross-sectional study analyzed 1992 to 2024 antibiotic importation records and found 50 originating countries of finished dosage forms and 52 countries for active pharmaceutical ingredients as well as a significant increase in annual antibiotic imports and a decrease in importation prices. In the past 5 years, India was the leading originating country for finished dosage forms, with China as the leading originating country for antibiotic active pharmaceutical ingredients.US relies on diversified global sources for antibiotic drugs but primarily on China for antibiotic active ingredients; policies to strengthen domestic production and diversify sourcing are critical to mitigate supply chain vulnerabilities.

Corresponding Author: Mariana P. Socal, MD, PhD, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Ste W7503D, Baltimore, MD 21205 (msocal1@jhu.edu).

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