The Coalition for a Prosperous America (CPA) today released a new report, “The Hollowing Out of America’s Medicine Cabinet: Two Case Studies in Lost Generic Manufacturing – and a Plan to Rebuild Domestic Capacity,” documenting the collapse of U.S. generic pharmaceutical manufacturing and laying out a policy roadmap to rebuild it. The report finds that U.S. production now supplies just 27% of domestic pharmaceutical demand, down from 72% in 2002 – the lowest share on record.

The report argues that rebuilding domestic generic drug manufacturing will require a coordinated strategy that combines tariffs with investment incentives, stronger FDA oversight, and procurement reform.

Pharmaceutical imports reached a record $292 billion in 2025, pushing the U.S. pharmaceutical trade deficit to roughly $165 billion. Since 2002, U.S. pharmaceutical consumption has grown by about $253 billion – but 99% of that growth has been met by foreign, not domestic, production. U.S. output did double over the same period, but nearly all of that increase went to exports rather than American pharmacies and hospitals.

Read the article.