Drug Shortages and the Defense Production Act
Amid the COVID-19 pandemic, US hospitals have faced shortages of critical drugs, including sedatives and neuromuscular blocking agents needed to intubate patients and maintain ventilatory support, opioids for pain control and sedation, antibiotics to address secondary bacterial infections, and bronchodilators to open airways.1 In response to limited supplies of ventilators and personal protective equipment, the Trump administration invoked the Defense Production Act (DPA), but shortages of personal protective equipment remain. Although the DPA-if applied more broadly-could be effective in helping to address remaining shortages of personal protective equipment, using the DPA to address drug shortages is more challenging, and additional government interventions to support the drug supply chain are needed.
The DPA is a Korean War era law that enables the president to manage critical resources in times of scarcity by providing authority to gather confidential business information, allocate existing supplies, expand domestic production, and compel private industry to fulfill government manufacturing contracts.2 Use of the DPA does not require a large-scale crisis but must support the national defense, including the protection of critical infrastructure. For example, in 2011, the government used the DPA to gather information about the US health care sector-considered critical infrastructure- finding a "very high degree" of dependence on international pharmaceutical manufacturers.3 Presidents have also used the DPA to prevent electrical blackouts, combat espionage, and provide adenovirus vaccines to military personnel.