We have seen plainly what happens when disasters interrupt domestic healthcare supply chains: from N-95 masks to saline, our healthcare system has struggled in the face of hurricanes and a pandemic, as just two recent examples, to maintain supplies essential to patient safety and care delivery. Cognizant of this history, on Aug.13, 2025, President Trump introduced the Strategic Active Pharmaceutical Ingredients Reserve (SAPIR) through Executive Order.
The initiative, focused on the pharmaceutical supply chain, aligns with the President’s focus on strengthening domestic industry and diminishing reliance on overseas vendors. In his first term, President Trump issued an analogous EO that laid the groundwork for the new EO, and the goal of the reserve is to bolster domestic supply of Active Pharmaceutical Ingredients (APIs).
Through the new EO the President tasks the Department of Health and Human Services to identify and keep fresh a list of more than two dozen critical drugs for which the SAPIR could facilitate emergency pharmaceutical production through a 6-month API stockpile. The order also calls for creation of such stockpiles in at least one SAPIR collection, with another proposed in the same EO.
If the EO is effectuated, healthcare providers may find essential medicines easier to access in times of crisis. Providers are advised to consider how these stockpile shifts might affect their supply chain access.
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