Worldwide drug market
The pills in a US pharmacy are the last step of a supply chain that usually starts on the other side of the world. This page shows where they come from — not as a talking point, but computed from the FDA's own filings for the products in our database.
ⓘ How this was built
- FDA DECRS — Drug Establishments Current Registration Site (facility addresses and countries)
- DailyMed SPL drug labels (which facilities make each NDC, by DUNS)
Each drug is linked to the manufacturing facilities its FDA label names; facilities map to countries via DECRS registration. Country shares count distinct drugs, so one label with many package sizes doesn't dominate.
Pipeline and calculations built by Claude (Fable 5) from the public datasets above. Educational only — verify against primary sources before acting.
Where the products in our database are made
For 37,528 of the 136,648 products we track (27%), the manufacturer's own FDA drug listing names the registered facilities that make it. Counting each product once per country where a listed facility performs a manufacturing operation:
Everyday drugs, traced to a plant
Each row is one real product from our database and a manufacturing facility its FDA label declares:
| Drug | Made by | Country |
|---|---|---|
| amoxicillin | Aurobindo Pharma Limited | India |
| atorvastatin calcium | Lepu Pharmaceutical Technology Co., Ltd. | China |
| azithromycin | Sunshine Lake Pharma Co., Ltd. | China |
| gabapentin | ACI HealthCare Limited | Bangladesh |
| lisinopril | Lupin Limited | India |
| metformin hydrochloride | Beximco Pharmaceuticals PLC | Bangladesh |
| omeprazole | Dr. Reddy's Laboratories Limited | India |
| sertraline hydrochloride | Aurobindo Pharma Limited | India |
The bigger picture
About nine in ten US prescriptions are generics, and the generic chain is heavily offshore. India holds roughly 48% of the active API (active pharmaceutical ingredient) master files the FDA relies on and makes about a third of the world's generic API; China dominates the key starting materials one layer upstream — including much of what Indian plants themselves consume. The US Pharmacopeia found 44% of shortage drugs depend on a key material made in a single country.
How the US controls imports — the DSCSA
US drug distribution is a closed system. The Drug Supply Chain Security Act (DSCSA) requires every prescription drug to carry a serial number and an electronic, unit-level trail from manufacturer to wholesaler to pharmacy — track-and-trace built to keep counterfeit and diverted product out. A side effect: buying the same drug from a foreign pharmacy is generally not legal, because that product never entered the sealed US chain.
The one legal crack: the Canada program (Section 804)
Section 804 of the FD&C Act lets a state run an FDA-authorized program importing specific drugs from Canada. Florida became the first — and still only — authorized state in January 2024, extended through May 6, 2026. In practice, almost nothing has moved: each product needs drug-by-drug FDA sign-off, Canada restricts exports, and manufacturers have pushed back hard. Colorado, Maine, New Hampshire, and New Mexico have filed; none are approved.
How this page was built
The per-product manufacturing data above is computed by joining two public government datasets — nothing here is estimated or hand-annotated:
- DailyMed drug-listing labels (NIH) — every FDA drug label is filed as a structured (SPL) XML document whose header names the registered establishments that make the product, by DUNS number, with the operations each performs (manufacture, API manufacture, analysis, packing…). We parse the full human-Rx label release — thousands of labels — and keep those establishment rows per product NDC.
- FDA Drug Establishments Current Registration Site (DECRS) — the FDA's registry of every drug establishment, updated each business day, including the registered address and country. Public labels omit facility addresses, so we sweep this registry and join it to the labels by DUNS number to place each facility in a country.
Current coverage: 37,528 of 136,648 tracked products (27%) matched to at least one establishment; 10,459 of 11,404 facilities placed in a country. Labels last parsed Aug 12, 2026; registry last swept Aug 12, 2026.
Honest limits: this reflects what manufacturers declare in their own FDA listings. It is strongest for finished-dose manufacturing; API origin appears only when the label declares an API facility. OTC-only labels aren't parsed yet. A facility that left the registry keeps its last-known country. None of this is clinical, legal, or purchasing advice.
Context figures (API master-file shares, shortage concentration) are from US Pharmacopeia reporting; the Section 804 status is from FDA announcements.