Chairman Rick Scott and Ranking Member Kirsten Gillibrand of the U.S. Senate Special Committee on Aging have reached out to major U.S. pharmacy chains, including CVS, Walgreens, and Walmart, to seek information about their approaches to managing vulnerabilities in the pharmaceutical supply chain. In a letter sent to the chief executive officers of these companies, the senators referenced recent reports that the Food and Drug Administration (FDA) has allowed import exemptions for drugs produced in foreign factories—mainly in China and India—that previously did not meet safety standards.
The senators expressed concern that such exemptions, combined with current geopolitical instability, could affect both drug quality and availability for American patients, particularly seniors. They are seeking details from the pharmacies about their sourcing of active pharmaceutical ingredients (APIs), quality assurance practices, and whether they plan to introduce country-of-origin labeling for medications.
“This letter builds on the chairman and ranking member’s previous efforts to strengthen America’s drug supply chain, including prior letters to the FDA Commissioner Martin Makary on rare diseases and standards of safety, the Department of Health and Human Services Secretary Robert F. Kennedy, Jr., pharmaceutical distributor executives, and group purchasing organizations, as well as the release of their investigative report exposing the nation’s overreliance on foreign-manufactured generic drugs. The committee has also convened two recent hearings, on September 17, examining how dependence on foreign generics threatens drug safety and availability, and on October 8, exploring solutions to bolster domestic manufacturing and ensure Americans’ access to safe, high-quality medicines.”
In their communication with CVS, Walgreens, and Walmart leaders, Scott and Gillibrand stated: “The U.S. Senate Special Committee on Aging is examining how vulnerable pharmaceutical supply chains present a risk to supply chain security. As America’s largest pharmacies, CVS, Walgreens, and Walmart play a critical role in ensuring that millions of Americans, including many seniors, have access to safe and affordable generic drugs. Given this essential responsibility, we write to request information regarding CVS’s, Walgreens’, and Walmart’s efforts to address existing supply chain vulnerabilities and ensure your customers understand the source and quality of the medications you dispense.”
They noted reports indicating that “the Food and Drug Administration (FDA) has granted exemptions for certain drugs or ingredients subject to import bans that were imposed on foreign factories found to operate under substandard manufacturing conditions.” These import bans were due to failures in meeting FDA standards; exempting these drugs allows potentially unsafe products into the U.S. market. The senators highlighted that since 2013 more than 150 drugs or ingredients from factories—many located in China or India—have received such exemptions.
Scott and Gillibrand further addressed how international events can impact drug supplies: “A recent trade dispute with China exemplifies this dynamic. Despite reaching a bilateral trade agreement on rare earth elements in April 2025, China imposed a new set of export restrictions on October 9… This raises the unsettling possibility that China could similarly restrict exports of pharmaceutical products in future diplomatic or trade conflicts.” They pointed out that disruptions from major suppliers like China could significantly affect medication availability in the United States.
“Ultimately,” they wrote,”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 and safe medications.”
The senators advocated for increased transparency through country-of-origin labeling: “Given these concerns regarding substandard and potentially unsafe foreign generic drugs entering the U.S. market, country of origin labeling would serve as an important transparency measure for both consumers and pharmacists.” They referenced a National Academies report recommending location disclosure requirements but noted this information remains unavailable.
Research cited by Scott and Gillibrand shows both pharmacists’ and consumers’ preference for domestically manufactured drugs over those from China or India; however,”inaccessible and opaque information remains a barrier” for informed choices.
The letter concludes with a series of questions aimed at clarifying how much pharmacies rely on APIs from India or China; whether they purchase any exempted drugs; what quality assurance processes are used; how decisions about sourcing are made; if there are plans for country-of-origin labeling; monitoring practices related to FDA actions against manufacturers; awareness about FDA exemption practices; among other topics.
“The health and safety of American citizens especially our seniors… must be protected from threats posed by U.S. overreliance on foreign-made generic drugs,” wrote Scott and Gillibrand.”Thank you for your continued work… We look forward to a continued dialogue on securing the pharmaceutical supply chain for Americans.”
