In an exclusive interview with Pharmaceutical Executive, members of the Federated Healthcare Advisory Panel—Bob Jansen, CEO of Zensights; David Shulkin, Ninth Secretary of the US Department of Veterans Affairs; General Paul Funk (Ret.); and Major General Dennis LeMaster (Ret.)—discussed the growing intersection of national security and pharmaceutical strategy. The panel emphasized the need for pharmaceutical companies to adopt a preparedness mindset, drawing on military-style war-gaming and contingency planning to address risks such as supply chain vulnerabilities, tariffs, and overreliance on foreign manufacturing.

Preparing for Pharma Tariffs, Sanctions, and Global Supply Chain Disruptions

Pharmaceutical Executive: You were all a part of the session “Beyond the Headlines: What Pharma Leaders Must Know About Tariffs, Supply Chains, and Policy Changes,” at this year’s Asembia Summit. Can you provide a brief synopsis of what the session entailed?

David Shulkin: There’s no doubt that we’re in unprecedented times; there’s a lot going on. As a pharmaceutical reader, it’s important to understand the direction the country is heading. I think with the increased pressure to involve international forces, we’re going to see a number of significant challenges, including tariffs, pressure on international drug pricing, and supply chain initiatives. We’re hoping to provide insight into how pharmaceutical executives should be thinking about these issues—understanding how to develop and implement contingency plans for whatever happens down the road.

Dennis LeMaster: I look at it from a national health security perspective and how tariffs will either improve or hurt the readiness of pharmaceutical supply chains. Our dependence on China for almost all of our pharmaceuticals is a vulnerability. I don’t know if we treat national public health as a strategic asset or if we view pharmaceuticals and drugs as critical assets the way we do petroleum products or submarine production. How do we use them to wean off our dependence on China?

Paul Funk: From my perspective, I look at it through the elements of national power. What we’re seeing here is a competition—and some would say a conflict—as we engage informationally. Militarily, if you look at what we’ve been doing for the last 15 to 20 years, we’ve been war-gaming our way through supply chain vulnerabilities because our job is to fight and win the nation’s wars. We have to get the supplies from wherever they’re going to come from. Now that we’ve applied tariffs, our job is to overcome those. This panel is well positioned to war-game its way through any kind of strategy.

My other thought is that economically, we’re seeing great conflict. Tariffs are one tool, and sanctions are another. Economically, we are engaged in conflicts around the globe. I think companies need to realize that. They need to look through a lens of “What’s best for the nation?” From there, how can we war-game our way through strategies that will allow us to succeed?

Shulkin: It’s often important to know the right questions to ask. Given the particular experience that the US military has had in preparing for any type of scenario and making sure that they’re always ready to respond, that’s the perspective we think pharmaceutical companies need to start thinking with. We work with companies by asking the right questions and helping them understand different solution sets for how to respond. By using this national security perspective, we believe more companies need to begin incorporating it into their own strategic thinking.

Bob Jansen: One thing I do believe is that we’re a nation at risk. The healthcare industry is probably going to be insulated from this. If you read the press, everyone knows about rare minerals and how China has stockpiled those. As we’ve talked to some of our pharmaceutical clients, they want to know how the tariffs are going to affect pricing. They want to know how sanctions are going to impact the supply chain. We’ve been in a cold war from a cyber perspective for over a decade. A significant number of pharmaceutical companies have been hacked, but it’s often not viewed as important. There have been a few exceptions, but typically they just pay the bill. We believe most pharma companies should be war-gaming these potential scenarios to ensure they can make products available for patients and help maintain the population that General LeMaster talked about.

LeMaster: I think pharma needs to look at the opportunity and the threat in how China has postured to weaponize drugs. For example, we know that China has health data on millions of Americans. If they wanted to target certain sectors of the population by restricting exports of certain types of medicine, that would put us at a significant disadvantage. They could use pharma to degrade our public health.

The Mission Behind the Federated Healthcare Advisory Panel

PE: How did the Federated Healthcare Advisory Panel form, and how does this initiative align with broader healthcare ecosystem initiatives?

Jansen: Eleven years ago, Lt. Gen. Rick Lynch and I saw an opportunity to help the pharmaceutical industry develop adaptable leaders with strong moral compasses. We’ve spent the last decade bringing together leaders from the military and government, pairing them with pharma C-suite executives, and sharing best practices around leadership. Along that journey, we met Gen. Mike Garrett. We became friends and began talking. He introduced us to the other members of the panel we have here, as well as two others.

We formed a think tank and asked: “How can the men and women who serve today—and have served—get the best healthcare possible?” We believe we have insights that can help the pharmaceutical industry better understand their needs.

Funk: I believe this has to be a national effort. We all have to get out of our silos and look at this from a broader perspective: What is in the best interest of the United States of America and its people? From our subset, that includes veterans and currently serving personnel. If we look through those lenses and see the broader picture of war-gaming these issues, that’s a big deal. We have to understand that to be part of the solution—not the problem.

LeMaster: We need to approach this as a national strategic health policy plan—one that is integrated across the whole government and includes the private sector. That’s how we’ll have a healthier population. Also, this panel can help explain how to navigate the Department of Defense when companies have new products.

Shulkin: This is not a typical commercial venture. This is a group of people coming together because they share a vision and mission to continue to serve our military and veterans. Our primary goal is to work with pharmaceutical companies that share that vision. We’re very selective about who we work with. We’re not going to work with companies that don’t believe the men and women who’ve served deserve the best this country can offer. As a result, we’re partnering with select groups that want to figure out what they can do to help make this country stronger and give back to those who have served.

Drug Affordability and Policy Reform Through a Veteran Lens

PE: How do you see recent policy shifts in drug pricing or procurement practices impacting patients within the Department of Defense or Veterans Affairs systems?

LeMaster: When I was on active duty, the Department of Defense bought drugs regardless of the cost. They would even compound pharmaceuticals to make very expensive drugs. Shifting to the civilian sector, if drugs become too expensive, access will be denied to parts of the population. We need to bring drug costs down to maintain access.

Shulkin: There’s no doubt that many Americans already can’t afford their medications. We have a significant issue with accessibility and affordability. I think there’s bipartisan support for reducing drug costs, and pharma is willing to be part of the solution by lowering the regulatory burden.

We’re going through a very challenging process to get there. One of the strengths of this administration is its negotiation ability. Sometimes it’s disruptive, but the goal is to increase affordability, and I have no doubt we’ll see action on this issue this year. We want to do it in a way that doesn’t harm the industry, which remains one of the strengths of the American economy.

Funk: Naturally, all of that benefits our veterans and their families. Access to the right medications helps people continue to serve. For example, we have formularies that include ADHD medications that aren’t addictive. That kind of advantage is incredibly important.

We should be the shining stars that lead the industry—and the world—toward better lives. I support anything that improves outcomes for veterans, active-duty service members, and the country.

Building a Resilient Pharmaceutical Future

Jansen: One thing I think is important to recognize is that there’s no silver bullet here. It took us two decades to remove the profitability from generic manufacturing. When we outsourced it, we introduced national risk. Companies like Amgen, Eli Lilly, Novartis, and Johnson & Johnson have committed over $100 billion in US manufacturing capacity. But it’ll take five to eight years to build it out. This isn’t about who’s in office—it’s going to take longer than any four-year term to fix. In the meantime, we’re spending hundreds of billions to reduce dependency on foreign manufacturing. The ultimate goal is affordable medicine and a healthy population, and many policy options are being considered to get us there.

Funk: How we’re addressing it ties back to one of the elements of national power. Let’s tell the story, let’s get out there and communicate at a strategic level how we’re solving this for the nation. The American people need to believe there’s a working plan that will eventually reach mom-and-pop America and give them confidence the country is looking out for them.

LeMaster: That’s also reassuring to our pharmaceutical investor base. It needs to be done carefully over the coming years, in partnership with the government, as we decrease our reliance on imports and increase domestic production. Ultimately, we won’t have to depend on other nations for our pharmaceuticals.