Duke-Margolis ReVAMP Drug Supply Chain Consortium​

Frequent disruptions highlight the need for a more reliable and secure drug supply chain. Supply and demand shocks from manufacturing delays, natural disasters, product discontinuations, bioterrorism, geopolitical issues, and other disruptions all pose threats to U.S. patients in need of life-saving and life-sustaining drugs. Over 200 drugs are on the ASHP drug shortage list as of 2026, and adverse patient outcomes, including associations with increased mortality rates and medication errors, are occurring too frequently.

The Consortium’s mission is to generate effective policy solutions that promote a reliable drug supply chain to reduce the frequency and severity of chronic drug shortages. Based on input from a wide range of experts involved in manufacturing, distributing, purchasing, prescribing, and regulating prescription drugs, the Consortium puts forward policy recommendations and other work products to advance this mission. The Consortium also works with policymakers on implementation of policy steps designed to ensure that patients have access to safe and effective drugs, in adequate quantities, when they’re needed.

The Duke-Margolis ReVAMP Drug Supply Chain Consortium consists of a group of experts in supply chain, manufacturing, regulatory science, national security, and drug shortages from academia, private industry, governmental agencies, and additional relevant stakeholder groups. The Consortium’s mission is to generate effective policy solutions that promote a reliable drug supply chain with advanced manufacturing capabilities and, ultimately, to improve patient outcomes by reducing the frequency and severity of drug shortages.

The Consortium operates on a membership model. All organizations are expected to contribute in-kind participation at the organizational level through routine public and private convenings as well as feedback on Consortium written products. Industry partners also contribute financial support as a condition of membership. The Consortium will advance its mission by convening members on a regular basis, conducting policy research, and developing recommendations for key private and public sector leaders.

Duke-Margolis will engage a consultative group composed of representatives from member organizations around the following four workstreams. 

● Supporting a coordinated and sustained federal effort to promote drug supply chain reliability and advanced manufacturing;

● Proposing measurement and tracking mechanisms for drug supply chain reliability;

● Exploring additional policy and practical approaches to improve drug supply chain reliability; and

● Promoting the increased adoption of advanced manufacturing technologies.

The Consortium will focus on these four workstreams in its effort to reduce the frequency and severity of drug shortages. Policy solutions in these four areas can help reduce drug shortages of both public health emergency response products and legacy products with chronic shortage issues. Duke-Margolis publishes whitepapers, issue briefs, and other publications with policy recommendations for policymakers and private and public sector drug supply chain stakeholders, informed by Consortium members’ comments and insights from workstream activities. 

COVID-19 and other recent supply chain disruptions have focused significant attention on vulnerabilities in U.S. drug supply chains. Shocks or disruptions on the supply or demand side can lead to significant shortages, and they have – over 100 drugs were on the FDA Drug Shortage List in 2022. Shortages can lead to billions of dollars in costs to the healthcare system, and more critically, worse outcomes, even mortality, for patients.

A reliable drug supply chain ensures patients have safe and effective drugs, in adequate quantities, when they’re needed. These “Four S’s” contribute to reliability: a supply chain with sufficient staff, stuff, space, and systems will be more resilient to supply- or demand-side disruptions.

Recommended CMS Actions to Support a Reliable and Domestic Supply of Essential Medicines - Issue Brief, March 2026

Addressing the Root Causes of Drug Shortages: Next Steps for Congress - White Paper, October 2025

Drug Supply Chain Reliability Assessment Programs - Info Sheet, October 2025

Building a Resilient and Secure Pharmaceutical Supply Chain: The Role of International Collaboration - White Paper, September 2025

HHS Should Establish a Prevent Drug Shortages Initiative - Issue Brief, June 2025

Pharmaceutical Tariffs: Potential Impacts and the Need for Vulnerability Assessments - Journal Article, Health Affairs, March 2025

Building a Resilient and Secure Pharmaceutical Supply Chain: The Role of Geographic Diversification - White Paper, November 2024

Duke-Margolis Comment Letter to Senate Finance Committee on the proposed Drug Shortage Prevention and Mitigation Act - Comment Letter, June 2024

Considerations for FDA's New Advanced Pharmaceutical Manufacturing Programs - Issue Brief, March 2024

Demand-Side Reforms To Prevent Drug Shortages: Medicare’s Role In A Successful National Strategy - Journal Article, Health Affairs, January 2024

Addressing Drug Shortages Through Quality Management Maturity and Supply Chain Reliability Programs - Issue Brief, December 2023

Duke-Margolis Comment Letter to CMS on Buffer Stock Proposed Rule - Comment Letter, September 2023

Advancing Federal Coordination to Address Drug Shortages - White Paper, September 2023

Duke-Margolis Comment Letter - Stop Drug Shortages Act - Comment Letter, August 2023

Duke-Margolis Briefing - Demand-Side Incentives for Domestic Production and Reliable Availability of Medical Products - December 2025

Comment Letter on Section 232 Investigation - May 2025

Duke-Margolis Comment Letter to the U.S. House of Representatives Ways and Means Committee on Policy Solutions for Chronic Drug Shortages - February 2024

Duke-Margolis Drug Shortages Request for Information Comment Letter - July 2023

PREVENT Pandemics Act Duke-Margolis Proposal Comments - February 2022

Duke-Margolis presents at Innovations in Pharmaceutical Manufacturing on the Horizon: A Virtual Dissemination Workshop - October 2021

Supporting Resilient Drug Supply Chains in the United States - July 2021 

Building a Resilient Drug Supply Chain Webinar - April 2021

The Consortium will send out regular newsletters sharing our ongoing work and highlighting our members. If you would like to follow along with us, please subscribe to the newsletter here.