REPLAY: đ„ econVue/HSRI Panel: Bio-Supply Chains at Risk
The Next Critical Resource Challenge | July 10, 12 pm CDT
In this econVue/Hale Strategic panel, David Johnson, Marta E. WosiĆska, and Shannon Morfin examine why Americaâs medicine supply chain is fragile â and what it would take to make it resilient.
â A risk of epic proportions.
â Rosemary Gibson, author of China Rx, on US reliance on foreign upstream materials for medicines, quoted in Goldman Sachsâ 2026 Investment Strategy Report
Panel Recap
While rare earths have been in the spotlight, another critical supply chain is also at risk in the current geopolitical environment: medicines.
The panel examined vulnerabilities in pharmaceutical quality and supply in the US, and the broader policy and economic forces that have left critical medicines and medical devices increasingly exposed to disruption â with potential consequences for almost every American family.
The discussion explored the history and current role of foreign dependence, including China, but also moved beyond a simple âChina riskâ frame. The panelists emphasized that Americaâs pharmaceutical vulnerabilities are product-specific, market-specific, and often buried upstream â in key starting materials, active pharmaceutical ingredients, sterile injectables, antibiotics, hospital drugs, and other medical inputs.
The larger conclusion was clear: pharmaceutical supply-chain resilience is not only a healthcare issue. It is a national resilience issue.
What We Learned
One of the panelâs strongest themes was the distinction between branded and generic drugs.
âBranded and generic drugs are really two different planets.â â Marta E. WosiĆska
Branded drugs dominate the public conversation about prices and innovation. But many of the most serious supply-chain vulnerabilities are in generic drugs â especially low-margin hospital workhorse medicines such as sterile injectables, antibiotics, oncology generics, anesthetics, IV fluids, and other essential inputs.
The panel also explored the economic roots of these vulnerabilities. In a market where purchasers reward the lowest price, no one clearly pays for redundancy, quality systems, reserve capacity, or resilient manufacturing.
âNobody in the supply chain truly internalizes the harm that results from shortages.â â Marta E. WosiĆska
David Johnson placed the issue in the broader context of US healthcare economics, arguing that the problem is not simply lack of spending, but distorted incentives.
âWe spend enough money. We just donât get the results.â â David Johnson
Shannon Morfin emphasized that resilience cannot be solved with vague calls for âmore manufacturing.â The system needs the right capacity for the right products, supported by the right financing and operational visibility.
âA facility that makes medical gloves cannot solve a shortage for penicillin.â â Shannon Morfin
Why This Matters
Chinaâs role in the pharmaceutical supply chain is not limited to finished pills. According to Rosemary Gibsonâs 2026 Senate testimony, China controls roughly 90 percent of the global supply of certain key starting materials â the chemical inputs used to make active pharmaceutical ingredients, or APIs. APIs are the components of medicines that produce the intended therapeutic effect.
That vulnerability extends beyond generics to the broader medicine supply chain, including antibiotics, hospital drugs, injectables, and medical devices.
But the panel also made clear that China is the clearest example of a broader resilience problem. Supply chains can be disrupted by war, export controls, pandemics, earthquakes, cyberattacks, port closures, plant shutdowns, quality failures, or natural disasters. The question is whether the United States has enough visibility, redundancy, and capacity to withstand a serious disruption.
Panelists
Lyric Hughes Hale is editor-in-chief of econVue and founder of the Hale Strategic Resources Initiative, a nonprofit research organization focused on critical resources, supply chains, and national resilience. She moderated the panel.
David Johnson, economist and CEO of 4sight Health, a Chicago-based advisory company working at the intersection of healthcare strategy, economics, and innovation.
Marta E. WosiĆska, PhD, Senior Fellow at the Center on Health Policy at the Brookings Institution.
Shannon Morfin, CEO and Founder of LifeScienceX, focused on life-science, pharmaceutical, CDMO, and healthcare infrastructure, including capital formation and resilient manufacturing capacity.
Additional Reading and References
Recommended by Marta E. WosiĆska
The Economics of Generic Drug Shortages: The Limits of Competition
American Economic Association backgrounder on how intense price competition in generic-drug markets can contribute to shortages, underinvestment, and supply-chain fragility.
The Economics of Generic Drug Shortages
Brookings summary of the economic puzzle of generic-drug shortages and policy interventions for a more resilient U.S. generic-drug supply.
When Medicine Supply Chains Become Weapons: Chinaâs Leverage and How the U.S. Should Respond
Brookings analysis of Chinaâs role in pharmaceutical supply chains, upstream dependence, and policy options to reduce strategic vulnerability.
When Cheap Becomes Fragile: How the Race to the Bottom in Generics Undermines Manufacturing Quality and What to Do About It
Brookings testimony on the relationship between generic-drug economics, manufacturing quality problems, and shortages.
Prescription Drug Shortages and Supply Chain Reliability
Brookings resource page collecting WosiĆskaâs work on drug shortages, pharmaceutical tariffs, DEA-related constraints, compounding, GLP-1s, generic-drug economics, and supply-chain reliability.
Recommended by Shannon Morfin
Rosemary Gibson, Testimony before the U.S. Senate Special Committee on Aging, âForeign Dependence: How China Captured Americaâs Drug Supplyâ
Gibsonâs March 11, 2026 testimony focuses on US dependence on China for medicines and the critical upstream inputs used to make them. She emphasizes that generic medicines are the âworkhorseâ of the US healthcare system and states that China controls approximately 90 percent of the global supply of key starting materials used to make APIs in generic drugs.
Gordon G. Chang, Testimony before the U.S. Senate Special Committee on Aging, âForeign Dependence: How China Captured Americaâs Drug Supplyâ
Changâs testimony frames pharmaceutical dependence as a national-security issue and argues for a mix of onshoring, public subsidies, and market incentives. He cites Chinaâs monopolies or near-monopolies in pharmaceuticals, dependence on Chinese APIs and key starting materials, and the importance of generic drugs in US prescription volume.
Ted Yoho, DVM, Testimony before the US Senate Special Committee on Aging, âForeign Dependence: How China Captured Americaâs Drug Supplyâ
Yohoâs testimony emphasizes quality, inspection, and safety concerns related to foreign-manufactured medicines and pharmaceutical inputs, including the challenges of oversight when production has moved offshore.
Related Hale Strategic Analysis
Audrey Levisay, âFragile by Design: How the IV Fluid Crisis Exposed Americaâs Sterile Injectable Drug Shortage Problem â Part 1â
Hale Strategicâs first article in a series on the fragility of Americaâs medical supply chains. Levisay begins with the 2024 IV fluid shortage, a crisis triggered by Hurricane Helene but rooted in a deeper problem: the lack of redundancy and resilience in the production of essential medical products.
Policy and Preparedness Background
Pandemic and All-Hazards Preparedness Act of 2006
This law strengthened the federal public-health emergency preparedness and response framework, including the role of the Assistant Secretary for Preparedness and Response, medical surge capacity, hospital preparedness, and the Strategic National Stockpile:
Strategic National Stockpile and Strategic API Reserves
The panelâs discussion of resilience also points to the distinction between emergency stockpiles of medical countermeasures and broader supply-chain capacity for essential medicines, including APIs, key starting materials, and other upstream inputs. A central policy question is whether stockpiles are designed merely to store products or to support a functioning, replenishable resilience system.
