A secure pharmaceutical supply chain is essential for the US Department of Defense (DoD). An inability to obtain high-quality essential medicines for our nation’s warfighters constitutes a significant national security concern. Access to safe, high-quality essential medicines is vital for both military operational readiness and ensuring that the Military Health System (MHS) is able to support its 9.5 million beneficiaries. This study aims to identify recommendations regarding the DoD pharmaceutical supply chain and categorize them according to the DOTMLPF-P framework to identify potential responsibility centers and facilitate actionable discussion to address pharmaceutical supply chain concerns. We performed a narrative literature review of all recently published government publications relating to the DoD pharmaceutical supply chain. Selected publications identified challenges hindering the DoD pharmaceutical supply chain and documented recommendations for improvement. To categorize recommendations, we used the Doctrine, Organization, Training, Materiel, Leadership, Personnel, Facilities, and Policy (DOTMLPF-P) framework developed by the DoD as part of the Joint Capabilities Integration Development System process to identify and address capability shortfalls or gaps. We identified 10 publications and reports and 28 recommendations, for inclusion in this assessment that were published between 2021-2024. Eighteen recommendations were categorized into two or more categories. Key recommendations included increased transparency, specifically sourced manufacturers and suppliers, avoidance of suppliers and manufacturers from adversarial nations, increased domestic supply capacity, and interagency collaboration. Challenges identified by this study are highly complex and require interagency collaboration, thus a whole-of-government approach is needed to strengthen the DoD pharmaceutical supply chain.