Security of supply and strategic independence in the pharmaceutical sector are of central importance to the European Union (EU). In recent years, geopolitical tensions, supply chain problems, and the COVID-19 pandemic have exposed the vulnerability of international trade flows. This analysis examines the EU's specific dependence on the USA and Russia in the pharmaceutical sector – focusing on trade volumes, market shares, critical raw materials, and political risks.
1. Overview: The EU as a global pharmaceutical giant
The EU is one of the world's largest producers and exporters of medicines. In 2024, the EU's trade surplus in medical and pharmaceutical products reached a record high of €193.6 billion. Exports rose by 13.5% to €313.4 billion, while imports increased only slightly by 0.5% to €119.7 billion[5][11]. The main export destinations outside the EU were the USA (38.2% of all exports, €119.8 billion), followed by Switzerland (16.4%, €51.3 billion) and Great Britain (5.8%, €18.2 billion)[5][11].
The largest importers in the EU were Germany (€23 billion), Belgium (€21.3 billion), and the Netherlands (€14.7 billion)[11].
2. Dependence on the USA
2.1. Trade volume and market shares
- The USA is by far the most important trading partner for the EU in the pharmaceutical sector – for both exports and imports.
- In 2024, the EU imported pharmaceutical products worth €45.9 billion from the USA, accounting for 38.3% of all pharmaceutical imports into the EU[5][11].
- EU exports to the USA amounted to €119.8 billion (38.2% of all exports outside the EU)[5][11].
Trade direction Value 2024 (€ billion) Share of EU foreign trade (%) Exports to USA 119.8 38.2 Imports from USA 45.9 38.3
The USA is thus the largest single market for EU pharmaceutical exports and, at the same time, the most important supplier for pharmaceutical imports into the EU.
2.2. Structure of trade relations
- The main goods exported by the EU to the USA are medical and pharmaceutical products (22.5% of all exports to the USA)[4].
- The main goods imported from the USA are also pharmaceutical products (13.8% of all imports from the USA)[4][9].
2.3. Mutual dependence and risks
- The USA has a significant trade deficit with the EU in the pharmaceutical sector: in 2024, the US deficit with the EU was $126 billion, with almost two-thirds of US pharmaceutical imports originating from the EU[3].
- Ireland ($66 billion) and Germany ($17 billion) are the main EU suppliers to the USA[3].
- The supply chains are closely intertwined: many medicines sold in the USA are manufactured in the EU (e.g., Novo Nordisk, Merck, AbbVie)[8].
Tariff and geopolitical risks
- Pharmaceutical products have so far mostly been excluded from trade conflicts, but given growing tensions (e.g., US tariffs on Chinese medicines), concerns are increasing that medicines could be affected in future tariff disputes[8].
- The industry warns of negative consequences for supply security if trade barriers arise[8].
2.4. Critical Raw Materials and Precursors
- The real vulnerability lies less with finished medicines and more with precursors (APIs) and critical raw materials, which often come from Asia (especially China and India)[7][8].
- The EU is working on a "Critical Medicines Act" to reduce dependence on imports – especially from Asia – and increase the resilience of supply chains[7].
3. Dependence on Russia
3.1. Trade Volume and Market Share
- Russia's importance as a supplier of pharmaceutical products is extremely low compared to the USA.
- In 2023, the EU imported pharmaceutical products worth US$38 million (approx. €35 million) from Russia[10]. In 2024, the value increased by 18% to €38.8 million[6].
- This ranks Russia only 23rd among EU pharmaceutical suppliers[6].
Year Import Value (Millions €) Rank Among EU Suppliers 2023 35 23 2024 38.8 23
- The most important imported products were medicines and vaccines[6][10].
3.2. Structure of Trade Relations
- In 2024, the EU exported pharmaceutical products worth €2.225 billion to Russia[1].
- While exports of other product groups (machinery, vehicles, steel) to Russia have plummeted sharply since 2022, the volume of medicine exports has remained stable[1].
- Imports of Russian medicines into the EU are marginal and account for only a fraction of the total market[6][10].
3.3. Critical Dependence: Radioactive Medicines (Radiopharmaceuticals)
- A special case is the dependence on Russia for the supply of radioactive isotopes for medical purposes (radiopharmaceuticals).
- The EU relies on High-Assay Low-Enriched Uranium (HALEU), which is needed for the production of medical isotopes. Russia is currently the only commercial supplier capable of delivering HALEU on a large scale[2].
- The USA only began its own HALEU production in 2023 but is not yet a significant supplier[2].
- The European Medicines Agency (EMA) warns of this critical dependence and recommends investment in its own European HALEU capacities[2].
Political Risks
- The supply of radiopharmaceuticals depends not only on production but also on complex transport regulations and the availability of raw materials[2].
- Given the geopolitical tensions with Russia, there is a significant risk of supply disruptions for these specialized medicines.
4. Comparison: Dependence on the USA vs. Russia
Criterion USA Russia Share of EU drug imports 38.3% (2024) <0.05% (2024) Import value (2024) €45.9 billion €38.8 million Main products Pharmaceuticals, vaccines Pharmaceuticals, vaccines, radiopharmaceuticals (HALEU) Political risks Trade conflicts, tariffs, supply chains from Asia Geopolitical tensions, critical dependence on HALEU Importance for security of supply Very high Low (except radiopharmaceuticals)
5. Political and Strategic Implications
- The EU is largely self-sufficient in the pharmaceutical sector, exporting significantly more than it imports – primarily to the USA[5][11].
- The greatest vulnerability is not so much towards the USA or Russia, but towards Asian suppliers of precursor products (APIs)[7][8].
- Dependence on Russia is low in the area of conventional medicines, but critical for specialized products such as radiopharmaceuticals[2].
- The EU is working on initiatives such as the "Critical Medicines Act" and the "European Radioisotope Valley Initiative" (ERVI) to reduce these dependencies and strengthen security of supply[2][7].
6. Conclusion
The analysis shows that the EU's dependence on Russia in the area of conventional medicines is low. Imports of Russian medicines are marginal and have no significant impact on security of supply. However, dependence on Russia for certain specialized medicines, such as radiopharmaceuticals, is critical, as Russia is currently the sole major supplier of HALEU.
Dependence on the USA, on the other hand, is significantly more pronounced: the USA is the most important supplier for pharmaceutical imports into the EU and at the same time the largest sales market for EU pharmaceutical exports. Trade relations are close and reciprocal, but there are risks due to potential trade conflicts and the strong interconnectedness of supply chains.
However, the EU's greatest structural vulnerability lies outside the relationship with the USA and Russia – namely in the dependence on Asian countries for active ingredients and precursor products. The EU is responding with legislative and industrial policy initiatives to strengthen its strategic autonomy.
Security of supply in the pharmaceutical sector thus remains a central component of European health sovereignty and geopolitical resilience.
Quellen:
[1] EU trade with Russia – latest developments – Statistics Explained https://ec.europa.eu/eurostat/statistics-explained/index.php?title=EU_trade_with_Russia_-latest_developments [2] EU agency flags risks to nuclear medicines from dependency on … https://www.euronews.com/health/2025/04/15/eu-agency-flags-risks-to-nuclear-medicines-from-dependency-on-russia-and-us [3] Europas Exportüberschuss und US-Zölle – Vfa.de https://www.vfa.de/de/wirtschaft-standort/macroscope/macroscope-zoelle-usa-europa-konflikte [4] Trade in goods with the United States in 2024 – European Commission https://ec.europa.eu/eurostat/web/products-eurostat-news/w/ddn-20250311-1 [5] Europe’s pharmaceuticals trade surplus hits record high https://www.soci.org/news/2025/4/europes-pharmaceuticals-trade-surplus-hits-record-high [6] EU Increases Russian Pharmaceutical Imports by 18% in 2024 https://easternherald.com/2025/01/18/eu-increases-russian-pharmaceutical-imports/ [7] EU Critical Medicines Act: closer to ending overreliance on Asia https://www.pharmaceutical-technology.com/analyst-comment/eu-critical-medicines-act-overreliance-asian-manufacturers/ [8] Big pharma fears best-selling drugs in crosshairs of US-EU tariff spat https://www.reuters.com/business/healthcare-pharmaceuticals/big-pharma-fears-best-selling-drugs-crosshairs-us-eu-tariff-spat-2025-03-18/ [9] USA-EU – international trade in goods statistics https://ec.europa.eu/eurostat/statistics-explained/index.php?title=USA-EU–international_trade_in_goods_statistics [10] European Union Imports of pharmaceutical products from Russia https://tradingeconomics.com/european-union/imports/russia/pharmaceutical-products [11] EU trade surplus in medicinal and pharmaceutical products hit … https://sofiaglobe.com/2025/04/14/eu-trade-surplus-in-medicinal-and-pharmaceutical-products-hit-record-high-in-2024/ [12] USA-EU – international trade in goods statistics https://ec.europa.eu/eurostat/statistics-explained/index.php/USA-EU–international_trade_in_goods_statistics [13] Mapping the import dependencies in EU and US trade with China https://merics.org/de/studie/growing-asymmetry-mapping-import-dependencies-eu-and-us-trade-china [14] Europe’s Dependence on Russian Natural Gas https://www.marshallcenter.org/en/publications/occasional-papers/europes-dependence-russian-natural-gas-perspectives-and-recommendations-long-term-strategy-0 [15] EU Critical Medicines Act: closer to ending overreliance on Asia https://www.pharmaceutical-technology.com/analyst-comment/eu-critical-medicines-act-overreliance-asian-manufacturers/ [16] [PDF] International EU27 pharmaceutical production, trade, dependencies … https://www.efpia.eu/media/602699/production-import-dependencies-and-export-vulnerabilities-of-pharmaceuticals-for-the-eu27-final.pdf [17] Handelsverflechtungen: Wie US-Zölle deutsche Industrien treffen https://www.vfa.de/de/wirtschaft-politik/macroscope/macroscope-handelsverflechtungen-us-zoelle [18] EU wary of becoming more dependent on US energy imports https://brusselssignal.eu/2025/04/eu-wary-of-becoming-more-dependent-on-us-energy-imports/ [19] USA-EU – international trade in goods statistics https://ec.europa.eu/eurostat/statistics-explained/index.php?title=USA-EU–international_trade_in_goods_statistics [20] EU announces plans to cut reliance on Asia for antibiotics, other … https://www.reuters.com/business/healthcare-pharmaceuticals/eu-announces-plans-cut-reliance-asia-antibiotics-other-critical-drugs-2025-03-11/ [21] European pharma companies issue demands to stay in EU ahead of … https://www.reuters.com/sustainability/boards-policy-regulation/european-pharma-companies-issue-demands-stay-eu-ahead-expected-us-tariffs-2025-04-15/ [22] US-Zölle: Die Auswirkungen auf die Arzneimittelversorgung https://www.pharmazeutische-zeitung.de/us-zoelle-die-auswirkungen-auf-die-arzneimittelversorgung-155089/ [23] Assessing Availability of New Drugs in Europe, Japan, and the U.S. https://www.iqvia.com/insights/the-iqvia-institute/reports-and-publications/reports/assessing-availability-of-new-drugs-in-europe-japan-and-the-us [24] European Union Exports of pharmaceutical products to United States https://tradingeconomics.com/european-union/exports/united-states/pharmaceutical-products [25] European Union Total Imports from USA | 2002 – 2025 – CEIC https://www.ceicdata.com/en/indicator/european-union/total-imports-from-usa [26] Tariff treatment: Six diagnoses for EU pharma sector amid US trade … https://www.euronews.com/health/2025/03/28/tariff-treatment-six-diagnoses-for-eu-pharma-sector-amid-us-trade-war [27] EU exports of medicinal and pharmaceutical products rise by 13.5 … http://cijeurope.com/en/eu-exports-of-medicinal-and-pharmaceutical-products-rise-by-13-5-in-2024/post.html [28] EU imports from Russia dropped 85% between Q1 2022 and Q4 2024 https://sofiaglobe.com/2025/02/24/eu-imports-from-russia-dropped-85-between-q1-2022-and-q4-2024/ [29] Ending European Union imports of Russian uranium – Bruegel https://www.bruegel.org/analysis/ending-european-union-imports-russian-uranium [30] EU’s exports of medicinal, pharma products up by 13.5% in 2024 https://www.wam.ae/en/article/bj6abmk-eus-exports-medicinal-pharma-products-135-2024 [31] Supply bottlenecks can have different causes – Vfa.de https://www.vfa.de/de/englische-inhalte/supply-shortages [32] Exports of medicinal and pharma products up by 13.5% https://ec.europa.eu/eurostat/web/products-eurostat-news/w/ddn-20250414-1 [33] EU trade with Russia – latest developments – Statistics Explained https://ec.europa.eu/eurostat/statistics-explained/index.php?title=EU_trade_with_Russia-_latest_developments
[34] Addressing critical shortages of medicines in the EU https://ec.europa.eu/commission/presscorner/detail/en/IP_23_5190
[35] European Union Imports of pharmaceutical products https://tradingeconomics.com/european-union/imports/pharmaceutical-products
[36] [PDF] EFPIA Key priorities in Russia https://www.efpia.eu/media/26046/russia.pdf
[37] US market is driving world demand of Pharma in first 9 months of 2024 https://www.exportplanning.com/en/magazine/article/2024/11/11/us-market-is-driving-world-exports-of-pharma-in-first-9-months-of-2024/
[38] Europe’s pharmaceutical industry at risk? What Trump’s policy … https://www.powtech-technopharm.com/en/industry-insights/2024/article/pharmaceutical-industry-facing-challenges-and-opportunities-in-2024
