
FDA has regulations in place to protect the integrity of the
U.S. pharmaceutical supply chain and ensure that safe,
eective, and high-quality drugs reach U.S. consumers.
FDA’s regulatory authority under the Federal Food, Drug, and
Cosmetic Act, as amended by the Drug Supply Chain Security
Act, creates a “closed” drug distribution system, designed to
protect the security and safety of the U.S. drug supply.
Ensuring the integrity of the U.S. pharmaceutical supply
chain requires vigilant attention to issues that may impact
drug availability, safety, ecacy, and quality. These factors
include manufacturing challenges, dynamically changing
demand, and reliance on limited or foreign suppliers for raw
materials, active pharmaceutical ingredients (APIs), and
packaging components. Other concerns for the industry
are disruptions arising from evolving geopolitical dynamics,
natural disasters, and public health crises, as well as
constant uctuations in economic and market factors,
including taris and trade wars.
In recent decades, pharmaceutical manufacturing has
gradually shifted away from domestic production in the U.S.
to foreign-based facilities. This move adds more layers
of challenges and risks. Currently a large portion of the
supply of APIs and raw materials predominantly come from
manufacturing activities in only a handful of countries, such as
China and India, due to lower labor costs, economies of scale,
and other competitive advantages found in those locations.
The pharmaceutical manufacturing industry is at a critical stage in 2025. Drug
supply chain issues, rapid technological advancements, rising regulatory and
compliance complexities, shifting market demands, and geopolitical risks are
converging at lightning speed. Despite their industry-wide prevalence, this
article explores the issues that particularly impact manufacturers of traditional,
small molecule drugs that have historically accounted for the majority of all new
drugs approved by the U.S. Food and Drug Administration (FDA) to date.
Challenges for the
U.S. pharmaceutical
manufacturing industry
JESSICA TIERNEY, PARTNER, JONES DAY
Given that the quality of pharmaceutical drugs heavily
depends on the purity and consistency of the APIs and
other raw materials, maintaining uniform and consistent
quality is a critical issue because even small variations
can potentially compromise the nal nished product’s
safety and ecacy. For U.S.-based companies, maintaining
practical and eective oversight of their foreign-based
suppliers that may be thousands of miles away can be
particularly challenging.
Further, reliance on a limited number of key suppliers—
whether foreign or domestic—can be risky. A single
disruption, such as production delays, quality issues,
nancial instability, or regulatory non-compliance, can cause
serious ripple eects throughout the entire supply chain.
There have also been recent upticks in counterfeiting,
diversion, theft, and imports of falsied, unapproved, or
otherwise ineective or unsafe drugs in the U.S. This
marked increase in the last few years is the result of
many of the same issues and risks previously mentioned.
However, there are some additional factors contributing to
the increase such as high out-of-pocket costs coupled with
higher overall prescription medication used by the U.S.
population, unresolved drug shortages, and the notable
shift of consumers purchasing medications online.
Shifts in the sourcing and availability of pharmaceuticals
allow for greater access to products. However, they also
present a number of challenges. While the vast majority of
online pharmacies operate lawfully within the United States,
there are some bad actors. For example, FDA has warned
consumers and healthcare professionals that some online
websites may use fake “storefronts” to imitate licensed
pharmacies. These sites sell unapproved, counterfeit,
or unsafe drugs in violation of the state and federal laws
that are intended to ensure minimum standards of safety,
ecacy, and quality.
The Centers for Disease Control and Prevention (CDC)
recently warned about potential risks from these illegal
sellers. In addition, the Department of Justice criminally
charged eighteen defendants for running illegal online
pharmacies that shipped millions of unregulated counterfeit
pills containing fentanyl to thousands of U.S. consumers,
allegedly causing numerous injuries and deaths.
Currently, the most frequent cause of FDA pharmaceutical
recalls are impurities and contaminants, sterility concerns,
quality control, and labeling/packaging issues. While recalls
are the most eective way to protect the public from a
defective or potentially harmful drug product, they can have
a big nancial impact on companies because of required
compensation paid to third parties, direct sale losses,
and indirect losses from reputational damage and public
perception. Therefore, to mitigate risk before a voluntary
or mandatory recall is necessary, companies should
prioritize proactive prevention strategies by, for example,
implementing a robust quality management system and
maintaining sucient oversight of suppliers, contract
manufacturers, and other parties involved in the supply
chain to ensure product quality in compliance with FDA
requirements, including the current good manufacturing
practice requirements, and audit these systems on a
regular basis.
Due to FDA’s actions over the years to advance supply
chain resilience and prevent unsafe drugs from reaching
and harming consumers, pharmaceutical recalls have
generally been trending downward. But recent mass layos
at FDA, CDC, and other U.S. health and safety agencies
call into question the government’s ability to continue to
take helpful steps to address potentially adulterated and
misbranded products in the U.S. market.
Furthermore, rumored restructuring within FDA to bring
about a more “centric” regulatory scheme focused not on
product-specic oces but instead on function could shift
the current direction and policies of the agency. Under such
an approach, FDA would potentially reorganize to create
ve new oces. These organizations would focus on 1)
reviews of all products across industries, 2) compliance
and enforcement, 3) administrative services, 4) strategic
planning and innovation, and 5) digital health.
RECALL INDEX 2024 EDITION 1 | Product Recall Data, Trends and Predictions for US Industries 67