Strengthening the U.S. pharmaceutical supply chain has become a priority for public health, economic resilience, and national security. The COVID-19 pandemic and recurring drug shortages exposed how heavily the United States depends on foreign sources for active pharmaceutical ingredients (APIs). Addressing these vulnerabilities requires a coordinated, multi-pronged strategy that balances domestic capacity, global diversification, and smarter policy incentives.

PHSL’s December poll asked which change would be most impactful in strengthening the U.S. pharmaceutical supply chain. The options reflect several of the main approaches currently under discussion by policymakers, regulators, and industry: reshoring production, using incentives to shape manufacturer behavior, and improving transparency across the market. Results showed a clear split between two priorities: increasing domestic drug manufacturing and increasing incentives to avoid supply disruptions. These results suggest respondents see the greatest impact coming from direct manufacturing capacity and proactive disruption prevention, rather than quality incentives or market-share reporting alone.

What change would be most impactful to strengthen the U.S. pharmaceutical supply chain?

Increase domestic drug manufacturing: 38%

Increase incentives for quality: 0%

Increase incentives for disruption avoidance: 38%

Increase information sharing on drug manufacturing market share: 25%