Missouri – A little-known part of the pharmaceutical supply chain is drawing scrutiny from Missouri Attorney General Catherine Hanaway and attorneys general across 19 other states. Their concern centers on ingredients used to make some of the country’s most closely watched weight-loss and diabetes drugs, and whether overseas suppliers are getting around safeguards designed to protect U.S. patients.
Hanaway has joined an Alabama-led coalition warning Secretary of State Marco Rubio about what the group describes as a national security risk involving Chinese-sourced pharmaceutical businesses. The attorneys general say gaps in federal oversight have allowed questionable ingredients to enter the United States, with one Chinese business cited in the effort having connections, according to the coalition, to entities involved in fentanyl manufacturing.
The dispute focuses largely on active pharmaceutical ingredients used in compounded GLP-1 products, including semaglutide, tirzepatide and retatrutide. Semaglutide and tirzepatide are ingredients in FDA-approved drugs for certain conditions, while compounded versions themselves are not FDA-approved.
“My office will not stand idly by while Chinese-affiliated entities tied to fentanyl production are exploiting oversight gaps to push unsafe, unapproved drug ingredients into our supply chain,” said General Hanaway.
“We will continue to work for the safeguards needed to keep these knock-off products out of Missouri and ensure uninterrupted access to the safe, legitimate, and lifesaving medications that citizens rely on.”
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At the center of the coalition’s concerns is an FDA system established in September 2025. The agency created a “Green List” under an import alert covering GLP-1 active pharmaceutical ingredients. FDA said the measure was intended to help prevent potentially dangerous ingredients from unverified foreign sources from entering the U.S. while identifying facilities that had been inspected or evaluated and appeared to meet applicable standards.
The attorneys general argue that the system was exploited.
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One case cited involves Harbin Jixianglong Biotech Co., Ltd., a Chinese company placed on the Green List in September 2025. According to an FDA warning letter issued in May 2026, Harbin purchased semaglutide API from a facility that was not on the Green List, labeled the ingredient as if Harbin had manufactured it and shipped the product to the United States. FDA said the conduct may have been an attempt to circumvent safeguards tied to the import alert and could pose risks to consumers.
The Missouri Attorney General’s Office said an on-site inspection also found that products had been repackaged and relabeled, with manufacturing and retest dates changed before distribution into the United States. The coalition describes the episode as evidence that authorities need stronger ways to establish the real source and chain of custody of pharmaceutical ingredients.
Hanaway joined attorneys general from Alabama, Arkansas, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Mississippi, Montana, Nebraska, North Dakota, Ohio, Oklahoma, South Carolina, Tennessee, Utah and West Virginia in signing the letter.
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The coalition is now asking federal officials to address the vulnerabilities it identified while preserving access to legitimate medications. The full signed letter is available through the Missouri Attorney General’s Office.
