Vivek Ramaswamy offers dubious figure for China’s role in supplying pharmaceutical ingredients

NASHUA, N.H. — Republican presidential candidate Vivek Ramaswamy, who as a venture capitalist has had business ties to China in the past, has made policy concerns about China a focus of his campaign.

In an Oct. 13 address to the First in the Nation Summit in Nashua, New Hampshire,  Ramaswamy warned the U.S. against relying on China for key resources. He said the U.S. needed to build up its "semiconductor independence" because chips are vital for a whole host of consumer products. He also cited a need to reduce dependence on pharmaceutical ingredients from China.

He urged the U.S. to declare "pharmaceutical independence," saying that "95% of over-the-counter pharmaceuticals are coming from our enemy in China."

However, the 95% figure is greatly exaggerated. Available data puts the share at no bigger than 20%, and possibly even lower.

Yanzhong Huang, a senior fellow for global health in Washington, D.C., at the New York.-based Council on Foreign Relations, told PolitiFact that the 95% figure "is clearly an overestimate or misquote."

Republican presidential candidate Vivek Ramaswamy addresses the First in the Nation Leadership Summit on Oct. 13, 2023, in Nashua, N.H. (Louis Jacobson/PolitiFact)

Ramaswamy’s campaign did not respond to an inquiry for this article.

His figure for Chinese pharmaceuticals matches one that appeared in a 2019 Politico article about China "weaponizing" drug exports that was produced in partnership with the South China Morning Post, a Hong Kong-based, English-language newspaper.

In 2018, according to the article, "China accounted for 95% of U.S. imports of ibuprofen, 91% of U.S. imports of hydrocortisone, 70% of U.S. imports of acetaminophen, 40% to 45% of U.S. imports of penicillin and 40% of U.S. imports of heparin, according to Commerce Department data."

The 95% figure applied to ibuprofen, not all drugs. Beyond that, the 95% figure for ibuprofen has come under scrutiny since the article appeared. Drug dependence on China became a talking point in the early months of the coronavirus pandemic, when some in the U.S. worried whether Americans would suffer shortages of medicines sourced from overseas producers.

Early in the pandemic, the Pacific Research Institute, a free-market think tank, cited U.S. Census Bureau data showing that China accounted for 18% of U.S. imports of active pharmaceutical ingredients in 2019, and just 1% of U.S. imports of finished pharmaceutical products the same year.

Meanwhile, the health care consulting firm Avalere found a more modest role for China in a 2020 report. 

According to Avalere, 54% of active pharmaceutical ingredients in the U.S. in 2019 were produced in the U.S. Another 19% came from Ireland, and just 6% came from China, with smaller shares for Singapore, the United Kingdom, Switzerland and several other countries.

"No single foreign country dominates the overall supply of (active pharmaceutical ingredients) for the U.S. market," the study concluded. (Avalere disclosed that Pharmaceutical Research and Manufacturers of America, the drugmakers’ trade group, helped fund the study.)

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A third study involved calculations by Niels Graham, a trade policy specialist with the Atlantic Council, a Washington-based think tank. He found that although China does account for 75% of the U.S. supply of vitamins B6, B12, B1 and C and nearly 70% of its vitamin E supply, Chinese producers account for a much smaller share of other key ingredients.

These include 11.7% of U.S. imports of pain relievers, fever reducers, anti-inflammatory medicines, or combinations of those categories; 10.5% of cold and cough medicines; and 12.5% of laxatives. The shares were even smaller for a variety of prescription drugs, such as immunosuppressives, cardiovascular medicines, and certain types of antibiotics.

"Over the past decade, the U.S. has gotten, on average, around 17% of its (active pharmaceutical ingredient) imports from China," Graham wrote. "While still considerable, this number is far short of the often cited but erroneous statistic."

These low shares calculate imports from China as a percentage of all U.S. imports, without taking into account what the U.S. produces. By Graham’s calculations, the U.S. is not only producing significant amounts of pharmaceutical ingredients for itself but is exporting a growing amount to China. 

U.S. pharmaceutical exports to China increased by nearly 400% from 2016 to 2022, he found. That’s a slower rate than the roughly 600% growth in China’s pharmaceutical exports to the U.S., but still a substantial increase.

Ramaswamy said "95% of over-the-counter pharmaceuticals" in the U.S. come from China.

This aligns with a percentage for ibuprofen imports from China that was cited in a 2019 news story. However, the percentages for other medicines listed in the article all have smaller percentages sourced from China.

Regardless, these percentages sharply conflict with at least three other analyses that show China’s share of U.S. pharmaceutical ingredient imports ranging from about 20% down to the low single digits.

We rate the statement False.