Warstopper Program: Comprehensive Cost Estimate Needed to Evaluate Potential Expanded Access to Emergency Medications

What GAO Found

The Defense Logistics Agency (DLA) does not have clearly defined or outcome-oriented goals or effective performance measures for its Warstopper Program, a program designed to prevent shortages of critical items during wartime or other operations.

• DLA's program goals are not outcome-oriented and do not have quantifiable targets to assess program performance. The Warstopper Program goals identify focus areas but are not outcome-oriented statements of aim or purpose that provide direction to the program. For example, one of the Warstopper Program goals is Information Technology, but this program goal does not convey the desired outcome DLA is seeking to achieve. While DLA has strategic objectives associated with each focus area, it has not divided these strategic objectives into specific, quantifiable performance goals with associated performance measures.
• DLA's Warstopper Program performance measures limit a full assessment of performance. In 2023, DLA used three performance measures to monitor the Warstopper Program's performance, but its measures are not balanced across program goals and do not cover all the program's core program activities.

Without well-defined program goals and effective performance measures that align to the goals, DLA cannot adequately assess program performance and accurately report its achievements to decision-makers and stakeholders.

GAO Assessment of the Program Goals, Strategic Objectives, Performance Goals, and Performance Measures of the Warstopper Program

DLA determined that it is feasible to expand the Warstopper Program to include medications for all users of the Military Health System (active duty personnel and their families; retirees; and reservists). However, DLA's assessment did not include all costs related to expanding the Warstopper Program. Furthermore, DLA's assessment did not include a sensitivity analysis, which would have examined how changes to key assumptions might affect the costs, benefits, and risks related to expanding the program. These elements are key parts of effective economic analyses. According to DLA officials, they did not include all costs because they did not have sufficient information to determine all costs, such as the number of people and where they are located. Subsequently, this information has become available. Without a sensitivity analysis, decision-makers may not be able to assess risks associated with the assumptions used in the analysis, or the range of costs and benefits. By developing an updated cost estimate that is based on all costs related to expansion of the Warstopper Program, and accompanied by a sensitivity analysis, DLA could provide more useful, fulsome information to Congress as it decides whether to expand the program.

Why GAO Did This Study

DLA created the Warstopper Program to ensure access to items that are in high demand during wartime but low demand in peacetime, including medications. DOD used the program during the COVID-19 pandemic to obtain large quantities of medical materiel. The pandemic highlighted vulnerabilities in the nation's medical supply chain. Correspondingly, House Report 117-118 directed DLA to study the feasibility of expanding the program to include medications for all Military Health System users and included a provision for GAO to review the Warstopper Program.

This report examines the extent to which DLA (1) established goals, objectives, and performance measures for the Warstopper Program, and (2) followed best practices for economic analyses in its report assessing the feasibility of expanding the program.

GAO compared the Warstopper Program with key practices to help manage and assess the results of federal efforts, and key attributes for successful measures. GAO also assessed DLA's Warstopper Program expansion feasibility report against best practices for economic analyses.