US Export Plan - Sector Report - Pharmaceutical Services

Exporting to the US

The United States is the largest pharmaceutical market globally, valued at approximately $639 billion in 2024, and projected to grow to $979 billion by 2033. Following reduced vendor spend and a challenging approval environment over the past few years, 2025 has experienced renewed momentum across pharma and biotech.

Scottish Government trade analysis indicates that 28% of Scotland’s pharmaceutical exports are directed to the US with the Export Performance Monitor identifying the US as the top international export destination for the Scottish life sciences sector. This is a higher proportion than the UK average, underscoring the strategic importance of this market.^[12] Scottish Enterprise and ABPI Scotland class the US as a priority market for pharmaceutical services, with trade missions and partnerships aimed at expanding Scotland’s footprint in biologics manufacturing, sterile fill-finish services, and advanced therapy development, particularly with the US’ ageing population.^[13]

A key challenge in this sector is accessing funding and financing. The US venture capital community is significantly more active in the life sciences sector than counterparts in the UK and Europe. For some exporters, engaging with the US market is not just about sales but also around attracting interest from better funded, and often more sectorally aware, investors. This can have a bearing on their geographical focus as they look at not just where markets are, but also where potential investors are located. California saw the most VC investment in the latest data, followed by Massachusetts and then New York.

For both raising funds and for selling in the States, it’s vital to develop a detailed understanding of what the market requirements are. It is important for Scottish businesses to have a strong understanding of health and medical practices in the US to successfully grow their business. The US healthcare system is heavily influenced by private insurers and government programmes, such as Medicare and Medicaid. Furthermore, in the US there is heavy reliance on large distributors, such as McKesson, Cardinal Health, and AmerisourceBergen which dominate supply chains. These organisations handle nearly all medicines delivered to hospitals and pharmacies.

The US is also home to some of the world’s largest pharma groups, with five of the global top ten hailing from the US in 2024. Pfizer and Bristol Myers Squibb are based in New York, Johnson & Johnson and Merck & Co are in New Jersey, and AbbVie is in Illinois. Other locations with large pharma players include Indiana (Eli Lily), California (Amgen and Gilead Sciences), Massachusetts (BioNTech, Vertex and Moderna) and Pennsylvania (Viatris).

International exporters must therefore integrate into these networks effectively in order to successfully sell pharmaceutical services into the relevant part of supply chains for their propositions.

Information compiled by the Observatory of Economic Complexity, evidences that US imports of medicinal and pharmaceutical products from international markets reached $234 billion in 2024. The top exporting activity to the US was led by Ireland ($65.7 billion, 28.1% of total imports), followed by Switzerland ($19.3 billion, 8.2%) and Germany ($17.4 billion, 7.4%). Other major suppliers included Singapore, India, Belgium, Italy, and China, with the UK accounting for only $7.6 billion or 3% of imports in the sector.^[14] Ireland’s dominance is due to its role as a manufacturing hub for US multinationals like Pfizer, J&J and AbbVie, supported by tax incentives and EU regulatory alignment. The EU collectively supplies over 60% of US pharmaceutical imports, with name-brand high-value drugs largely manufactured in the US and Europe, and generic drugs being primarily imported from India and China into the US. The UK’s smaller share reflects less manufacturing scale compared to Ireland and Germany, and less cost competitiveness compared to India or China. Therefore, while a recognised supplier in a range of services and products, there may be headroom for further growth in the areas in which Scotland is most competitive.