The United States pharmaceutical contract manufacturing organization (CMO) market was valued at USD 55.91 billion in 2025 and is projected to grow from USD 59.20 billion in 2026 to USD 77.56 billion by 2031, a 5.55% CAGR. Growth is being driven by rising demand for injectables, biologics and advanced therapies, GLP-1 capacity strain, BioSecure Act-related domestic sourcing, and high-potency API and gene-therapy investment, even as lower-cost Asian and Latin American suppliers intensify pricing pressure.