New evidence adds to the growing body of supply chain concerns that the Defense Department’s pharmaceutical pipeline is in danger.

A new report from the DoD Inspector General found that the Defense Logistics Agency deemed its reliance on foreign suppliers of drugs a risk in 2019, however, it did not develop any strategies to mitigate the risk or routinely monitor what country it was buying drugs from for risks.

Furthermore, the Military Health System and the Defense Health Agency did not look into potential disruptions to the supply chain and often used “just-in-time” ordering for drugs, without storing extra products in the case of a disruption or international incident.

“Pharmaceutical supply disruptions could compromise the standard of care to DoD beneficiaries,” the IG wrote. “A disruption of the supply of foreign-made active pharmaceutical ingredients to domestic manufacturers could cause a drug shortage that affects every level of the U.S. health care system. Since the DoD is a consumer of the commercial pharmaceutical market, which is dependent on ingredients from foreign suppliers, the drug shortages would ultimately compromise the standard of care for Service members and DoD beneficiaries.”

DoD also failed to look into contingency contracts that could help with disruptions.

The report reiterates concerns brought up by House Armed Services Readiness Subcommittee Chairman John Garamendi (D-Calif.) and Rep. Vicky Hartzler (R-Mo.), who successfully put legislation in the 2020 defense authorization act to require DoD to report on vulnerabilities faced by a dependence on Chinese drugs, and to only purchase American-made raw materials, medicines and vaccines for the military.

“It is very clear that the Chinese government controls fundamental pharmaceutical drugs that are essential for all of our wellbeing,” Garamendi told Federal News Network. “Drugs that deal with things like infection like doxycycline, drugs that deal with surgeries like heparin and many of the other generic drugs. All of them have ingredients that are made in China and almost exclusively in China.”

In response, DoD and the Department of Health and Human Services awarded a more than $60 million contract to develop a domestic production capability for critical active pharmaceutical ingredients. Another $20 million contract was awarded to develop a domestic production capability for critical active pharmaceutical ingredients.

DoD is still working on a larger assessment.

“We looked at the operational medications that we rely on and are deployed assemblages, and identified which ones rely on ingredients from other countries,” Brig. Gen. Dr. Paul Friedrichs, the Joint Staff surgeon general, told Congress. “We are working with the Food and Drug Administration to obtain ingredients for those where we’ve not been able to identify the source of origin. The next step is to understand fully through the global supply chain, where all of the ingredients come from, and ensure that pharmaceutical companies are able to share that information with us so that we can then identify what risks there is to those medications in our deployable assemblages.”

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