A bipartisan Senate bill reintroduced by three senators would increase transparency around foreign influence in US drug supplies, starting with mapping foreign manufacturing in the pharmaceutical supply chain. The draft legislation, the Pharmaceutical Investment Oversight and Accountability Act, would require government agencies to assess how foreign investment impacts domestic production. Co-sponsor Sen. Rick Scott highlighted concerns about reliance on China and India for critical starting materials and APIs, citing figures for amoxicillin KSM sourcing from China and heparin API sourcing. Proposed annual reporting would involve the FTC and the Department of the Treasury, with inputs flowing to key congressional committees, the health secretary and the FDA commissioner. For the biotech industry, the bill targets structural visibility into “who owns the companies” producing medicines, potentially affecting contracting, investment structures and compliance expectations for supply chain partners.