The healthcare manufacturing sector is undergoing a notable shift as pharmaceutical and medical technology companies fast-track strategies to build production plants on American soil.

What started as a steady move towards nearshoring has developed into an extensive overhaul of supply chain structures.

Data from KPMG and PwC suggests that healthcare mergers and acquisitions could experience significant growth.

According to these findings, 73% of life sciences executives expect a rise in deal activity in 2026. This move reflects a desire for regulatory stability and a response to previous global supply chain issues.

Trade policy shapes procurement strategy

While US-based drug production has been discussed for some time, recent tariffs have shortened decision-making timeframes.

Businesses are reviewing international manufacturing footprints with a fresh sense of urgency. On 13 January 2026, Johnson & Johnson reached a deal with the Trump administration.

The company pledged to lower drug prices in exchange for growing its domestic footprint. This arrangement provides an exemption from new tariffs, provided there is continued investment in US plants.

Joaquin Duato, Chairman and CEO of Johnson & Johnson, explains: "Today’s agreement shows that when the public and private sectors work together towards shared goals, we can deliver real results for patients and the US economy."

Joaquin is among several leaders taking this route. AbbVie recently became the 16th major drug manufacturer to settle a similar deal, committing US$100bn to US research and manufacturing over ten years.

Robert A. Michael, Chairman and CEO at AbbVie, adds: "AbbVie’s mission is to make a remarkable impact for the patients we serve around the world through our innovative medicines."

Robert is overseeing these shifts as firms look to secure supply lines. This movement is not only about tariffs but also about operational strength. Biopharma firms are frequently asking for dual-site redundancy across various regions to reduce the risk of supply failures.

Regionalisation of healthcare supply chains

The current administration’s framework aims to tackle global freeloading, where price controls in other nations could mean higher prices for the American public. Manufacturing domestically could simplify Food and Drug Administration validation and quality checks, providing an advantage in regulatory timelines.

For instance, Celltrion bought a site previously owned by Eli Lilly in New Jersey. It intends to double production capacity by 2030 to bolster its US supply chain. Spending is also focusing on high-growth areas like GLP-1 weight-loss medications. BD is spending US$110m in Nebraska to produce glass prefillable syringes.

Novartis offers a clear instance of this trend. On 9 January 2026, the firm announced its fourth US radioligand therapy site in Florida as part of a plan to invest US$23bn within the country. Vas Narasimhan, CEO of Novartis, adds: "Building this new facility in Florida marks an important step in fulfilling the promise of RLT for patients."

Vas notes that this facility ensures they can deliver medicines with speed and reliability. The move to US-based production will take time, with experts suggesting a three-to-four-year period for major capacity changes due to the long lead times required for building sites and getting regulatory clearance.

Future outlook for domestic investment

The pharmaceutical industry is experiencing a structural evolution. The previous model of wide-reaching and potentially fragile global logistics is changing. It is moving towards a system where the ability to manufacture domestically is considered alongside innovation and long-term health.

As companies continue these investments, the focus remains on securing the supply chain against future shocks. Procurement and manufacturing decisions made today will define the sector for the next decade. While the transition requires significant capital, regulatory certainty could mean more stable operations.

This suggests a move away from cost-only procurement towards a value-based domestic model. The ongoing projects in New Jersey, Nebraska and Florida illustrate how the industry is physically reshaping itself to meet new political and economic requirements.

This transformation could mean reliance on overseas pharmaceutical ingredients will decrease as US capacity grows. Procurement professionals are now prioritising local sourcing to ensure they can meet patient needs without the risk of international shipping delays or tariff penalties.