US medicine imports from India surge; dependence up 70% post pandemic

India's finished pharma trade to the US is on the rise

India’s role as the world’s pharmacy has strengthened since the pandemic, with the US emerging as its most dependent customer. Data reviewed by Moneycontrol show that India’s share in US medicine imports has nearly doubled in six years, led by retail formulations such as tablets, syrups, antibiotics and analgesics.

India’s contribution to US pharma imports rose from 8.9 percent in 2019 to over 15 percent in 2025, driven almost entirely by ready-to-use medicines or finished formulations, whose share climbed from 9.4 percent in 2019 to a record 15.8 percent in 2025.

Tariff uncertainty

The rise comes just as US President Donald Trump imposed a 100 percent duty on branded medicines, unless companies relocate production to American soil. While generics are exempt, ambiguity persists around complex generics, speciality drugs and biologics—segments where Indian contract research and manufacturing firms could face headwinds if tariffs widen.

US as India’s anchor market

For India, the US has become increasingly critical. Washington’s share in India’s total medicine exports has jumped to 45 percent in the first seven months of 2025, up from 38 percent in 2023. In value terms, shipments to the US touched $8.6 billion in 2024 and had already crossed $6.2 billion by July 2025.

Globally, India’s drug exports stood at $20.97 billion in 2024. The US alone absorbed over 40 percent of this trade, underlining the dependence on a single market.

Strategic implications

India’s dominance in low-cost generics positions it as a vital partner for the US healthcare system, which is struggling with affordability. But policymakers and industry alike face the challenge of overdependence on a single market at a time when trade frictions and supply chain security are under renewed scrutiny.