Are Pharmaceutical Supply Chain Vulnerabilities a Threat to Public Health?

Abstract

Policymakers have deemed the current state of the United States pharmaceutical supply chain a risk to public health and economic and national security. The ongoing issue of drug shortages calls into question the resilience of the pharmaceutical supply chain. High geographic concentration and low redundancy heighten its vulnerability to geopolitical tensions, natural disasters, and public health threats. Underlying these risks is a critical dependence: 45% of finished dosage form (FDF) units and 60% of the active pharmaceutical ingredients (API) used in US medications are manufactured in India or China. Market dynamics have driven the manufacturing of drugs offshore, particularly the key ingredients used in generic drugs. Given these factors, federal trade policies and potential tariffs under the current administration merit consideration, as they could create pharmaceutical supply chain disruptions and consequences for patients and manufacturers.