Strengthening America’s Pharmaceutical Supply Chain: How IBMSC Is Building a More Resilient Future

When emergencies strike, Americans depend on timely access to lifesaving medicines. Ensuring those medicines are available when and where they are needed requires more than a strong healthcare system — it requires a resilient pharmaceutical supply chain. This is a critical national security issue and is central to the core mission of the HHS Administration for Strategic Preparedness and Response (ASPR).

In August 2025, ASPR’s Center for Industrial Base Management and Supply Chain (IBMSC) was tasked with implementing Executive Order 14336, Ensuring American Pharmaceutical Supply Chain Resilience by Filling the Strategic Active Pharmaceutical Ingredients Reserve. This Executive Order highlights the importance of national preparedness and seeks to address some of the critical supply chain failures experienced in the past. Since it was issued in 2025, IBMSC has worked across government and with industry to establish strategic reserves, strengthen domestic pharmaceutical manufacturing, and advance innovative manufacturing technologies.

Domestic Manufacturing and Establishing the Strategic API Reserve

A resilient medical supply chain begins with ensuring access to active pharmaceutical ingredients (APIs) — the essential components that make medicines effective. Before IBMSC began investing in the domestic manufacturing of these critical components, most were made oversees, again impacting national security and increasing the potential for shortages during future public health emergencies.

Through the ReShoreRx initiative, IBMSC is working with 14 industry partners to support domestic production for more than 30 critical medicines, including key starting materials, APIs, and finished drug products. These efforts include establishing domestic manufacturing capabilities for medical-grade injection devices, including population-scale production of prefilled syringes. ReShoreRx is also supporting scalable production of normal saline IV therapies, with the potential to expand into additional infusion medications for hospitals, pharmacies, and outpatient care settings. One milestone has already been achieved: epinephrine production has been successfully onshored after being manufactured exclusively overseas for nearly four decades.

Supporting the establishment of the nation’s Strategic API Reserve, IBMSC has:

• Partnered with the Executive Office of the President to rapidly identify priority APIs;

• Conducted listening sessions with clinicians, manufacturers, and federal partners to ensure the nation’s highest-priority medicines were identified; and

• Collaborated across the federal government to align strategies, leverage resources, and accelerate implementation.

Those coordinated efforts led to a significant milestone: the successful placement of the first APIs into the Strategic API Reserve at the end of 2025.

Since reaching this milestone, IBMSC has secured initial supplies of critical APIs used to manufacture medications that millions of Americans rely on every day, including:

• Analgesics, which relieve pain in routine and emergency care;

• Antibiotics, which treat bacterial infections;

• Reversal agents, which counter overdoses and certain poisonings or nerve agent exposures;

• Hormones, which treat conditions such as diabetes and thyroid disorders;

• Bronchodilators, which open airways during asthma attacks and other respiratory illnesses; and

• Corticosteroids, which reduce inflammation and treat allergic reactions, autoimmune diseases, and severe respiratory illnesses.

APIs for additional medicines — including anticoagulants — are currently being evaluated and prioritized for future acquisition, helping build a stronger, more resilient pharmaceutical supply chain for future emergencies.

Advancing Innovative Pharmaceutical Manufacturing

Beyond the Strategic API Reserve, IBMSC is also investing in next-generation manufacturing technologies that can produce medicines more quickly, more flexibly, and closer to where patients need them.

Through IBMSC’s EQUIP-A-Pharma (Establishing Qualification Processes for Agile Pharmaceutical Manufacturing) initiative, four organizations are demonstrating innovative manufacturing approaches that use artificial intelligence, automation, and real-time quality monitoring to make pharmaceutical production faster, more adaptable, and more efficient. Some projects are even demonstrating technologies such as 3D printing to manufacture certain medicines at or near the point of care, such as hospitals or military treatment facilities.

By modernizing how medicines are made, these technologies have the potential to reduce drug shortages, strengthen domestic manufacturing, and improve the nation’s ability to respond during public health emergencies.

IBMSC is Delivering Results that Matter and Strengthening National Security

By partnering across government and industry, establishing strategic reserves, expanding domestic manufacturing capacity, and advancing innovative manufacturing technologies, IBMSC is helping strengthen America’s pharmaceutical supply chain, overall national preparedness for future emergencies, and strengthening national security by reducing dependence on international suppliers.

All of these investments are creating the foundation for a more resilient domestic industrial base, expanding American manufacturing, supporting high-quality jobs, and helping ensure critical medicines are available when Americans need them most.