By NextBestFitNational stockpile and onshore production
Keep buffer stocks of essential drugs and fund domestic manufacturing.
Buffer for disruptions.
Review ledgerHow this path connects
This path
National stockpile and onshore production
Concrete changes if chosen
What would actually have to change in law, agencies, payment rules, or systems.
- Maintain buffer stocks of essential drugs
- Fund domestic production of active ingredients
Effects
Each effect has its own page: the evidence, the case that it is or isn't a real cost, and whom it affects.
What it fixes
- Drug shortages of cheap, essential generics
Buffer stocks cushion short disruptions, while domestic manufacturing reduces dependence on a few foreign plants.
What it creates or worsens
- Raises spending or loosens control over it
Drug buffer stocks are expensive, and expiring drugs must be rotated.
- Takes years, or money up front, before it pays off
Funding domestic drug manufacturing involves a slow and costly onshoring process.
Who's affected
Who gains
- People with ongoing or specialist care needs
- Drug shortages of cheap, essential generics: Essential generic shortages interrupt access to chemotherapy and emergency drugs.
- People needing emergency or trauma care
- Drug shortages of cheap, essential generics: Essential generic shortages interrupt access to chemotherapy and emergency drugs.
- Hospitals, clinics, and care organizations
- Drug shortages of cheap, essential generics: Dependence on few factories leaves hospitals exposed to essential drug shortages.
Who loses
- Taxpayers and public budgets
- Raises spending or loosens control over it: Public budgets pay the added spending.
Where it has been tried
- Strategic National Stockpile: Exists mostly for emergencies, not routine shortages.
- United States: In 2020, HHS awarded nearly $2.9 billion in contracts to supply about 198,000 ventilators for the Strategic National Stockpile.