Supply chain
How medicine moves from ingredient plant to pharmacy. 18 articles: 3 data story, 15 explainers.
Distribution
Counterfeit drugs and the US supply chain
Fake medicines are rare in US pharmacies but not absent. What FDA's recent counterfeit cases show, how the DSCSA is meant to catch them, and the agency's warnings about online sellers.
Group purchasing organizations and hospitals
How hospital purchasing groups negotiate generic drug prices, the 1987 anti-kickback exception that lets vendors pay them, and what federal reports link to injectable shortages.
How a pill gets from the factory to the pharmacy
The physical and financial chain behind a generic prescription, from ingredient plant to pharmacy counter, and how few companies sit in the middle of it, according to federal reports.
How cold-chain medicines are kept in range, and what happens when they are not
The temperature bands, the federal rules for warehouses and distributors, what an excursion triggers, and 14 years of FDA recall records on temperature problems.
How hospitals buy drugs
Wholesalers, group purchasing contracts and the 340B program, how Medicare pays hospitals for outpatient drugs, and how hospital pharmacies cope with shortages, from federal sources.
Independent and chain pharmacies, by the numbers
About 19,000 independent pharmacies operate alongside chain stores. What the counts show, what a Health Affairs study found about closures from 2010 to 2021, and the Part D rules on distance to a pharmacy.
Pharmacy deserts, and what the closure data show
US community pharmacies posted a net loss of 3,062 stores from 2022 to 2024. How researchers define a pharmacy desert, who lives in one, and what peer-reviewed studies found when pharmacies close.
Repackagers and relabelers, the firms that put generics in new bottles
How federal rules define repackagers and relabelers, why their NDCs and expiration dates differ from the original, and what FDA's NDC and recall data show about them.
The Drug Supply Chain Security Act and drug serialization
The 2013 DSCSA set a 10-year path to electronic, package-level drug tracing. What a product identifier holds, who has to comply, and why small pharmacies now have until November 2027.
What drug wholesalers do
Three wholesalers move more than 90 percent of US drug distribution. For generics they also hold inventory, process hospital chargebacks and keep the package-level tracing records federal law requires.
Sourcing & manufacturing
China's role in drug ingredients and the chemicals behind them
What FDA testimony, FDA site data and USP supply mapping show about China's share of US drug ingredients, from finished pills down to key starting materials.
Contract manufacturing in generic drugs, and who actually makes the pill
A third of the finished-dose plants FDA bills under the generic drug fee program make product only for other companies' approvals. The rules, the counts and what the label leaves out.
FDA drug establishment registration and listing, explained
Every plant that makes, repacks or relabels drugs for the US must register with FDA each year and list its products. What 21 CFR part 207 requires, what FDA's databases show and what registration does not mean.
India's place in the US generic drug supply
What FDA and USP data show about how much US generic medicine comes from India, how FDA inspects Indian plants, and what the figures cannot tell you.
Where generic drug ingredients come from
FDA counts the plants that make active ingredients and finished generics for the US, but not their output. What its testimony and quality reports show, how drug master files work, and what labels leave out.
Why some generics have only one maker
FDA lists 807 off-patent prescription products with no approved generic, and many older generics have one or two suppliers. What the counts show, what ANDA tallies miss, and why makers stay away.
Federal policy
The federal push to make more medicine in the US, and where generics fit
Executive orders since 2020, a new API stockpile, an FDA review pilot and 2026 tariffs on patented drugs, with dates. Generic drugs and their ingredients remain exempt from the tariffs as of late 2026.
The Strategic API Reserve, the federal stockpile of drug ingredients
A 2025 executive order told HHS to fill a near-empty reserve of active pharmaceutical ingredients for about 26 critical drugs. What it holds, what it costs and what is still not public.