The U.S. is in the midst of one of the largest pharmaceutical manufacturing investment cycles in recent memory.

Pharmaceutical companies have announced hundreds of billions of dollars in new U.S. capital investment as they expand manufacturing capacity, strengthen domestic supply chains and prepare for the next generation of therapies. In 2025 and 2026, the pharmaceutical sector logged over $700 billion in announced U.S. capital commitments.

The scale of the industry’s growth has created significant competition from economic development organizations hoping to attract the next billion-dollar investment.

But pharmaceutical manufacturing is not one-size-fits-all. While many of the notable pharmaceutical manufacturing investments in the last two years have been in multibillion dollar API and biologics facilities of significant scale, some of the most intriguing technologies in pharma are being deployed at a much smaller scale producing targeted, patient-specific therapies.

Traditional chemotherapy for oncology generally circulates throughout the patient’s body. It can attack cancer cells, but it also affects healthy cells. Radiopharmaceuticals use a targeting molecule to seek out a particular protein/receptor on cancer cells to deliver a targeted radiation-based payload directly to the cancer at a cellular level. This precision-based approach enables high-impact cancer treatments to be delivered in manner that aims to limit impact on the patient’s healthy cells.

Pharmaceutical companies have begun to invest heavily in the revolutionary technology. Communities which have been passed up for larger-scale pharma manufacturing investments can position themselves to capture significant investments in this new technology which has significantly different site selection requirements.

Radiopharma Changes the Site Selection Equation

Every pharmaceutical manufacturing project comes with a complex list of site requirements. Radiopharmaceuticals add another challenge: radioactive isotopes decay over time. Depending on the isotope, that half-life can be measured in days or even hours. That means the clock starts ticking well before a finished dose reaches a patient.

This makes logistics one of the primary factors determining where a radiopharma facility can operate, although its importance varies by isotope, product and manufacturing model. The supply chain must move materials through production, quality control, release, transportation and ultimately to healthcare providers and patients within tightly controlled windows.

For communitieshoping to compete, several factors quickly become critical.

• ‍Isotope supply. Reliable access to radioactive isotopes is foundational. Pharma companies understand where isotopes will originate, how consistently they can be produced, how quickly they can reach a manufacturing facility and whether supply can scale with commercial demand. Because the U.S. supplier base is limited, the analysis should consider transportation reliability, supplier redundancy and contingency options alongside physical proximity.‍
• Air connectivity. Access to a major passenger or cargo airport can dramatically expand the geographic area a facility can serve. Nonstop routes, cargo capacity, flight frequency and operational reliability can all matter when every hour in transit reduces the useful life of a product.‍
• Proximity to patients. Geography can also provide an advantage. Sites within reach of large concentrations of hospitals, cancer centers and nuclear medicine programs may reduce dependence on air transportation and allow doses to reach more patients by ground.‍
• The company's network strategy. Not every radiopharma company will solve the logistics equation the same way. Some may pursue a centrally located manufacturing facility capable of serving much of the country. Others may require a distributed network of smaller regional facilities located closer to patients. The product, isotope and delivery model can fundamentally change the geographic boundaries of the site search.

The real estate itself must also support an unusually specialized operating environment. Radiopharmaceutical facilities may require controlled material flows, robust ventilation and contamination controls, secure access, analytical laboratories, specialized waste-handling protocols and equipment capable of remote or highly contained operation. These requirements can narrow the available building inventory and make greenfield development or highly customized facilities more practical than adapting conventional laboratory or manufacturing space.

Regulatory Readiness Matters Too

Radiopharmaceutical manufacturers also operate at the intersection of pharmaceutical manufacturing and nuclear regulation.

Facilities must navigate the requirements associated with producing pharmaceuticals under current Good Manufacturing Practice and U.S. Food and Drug Administration standards while also managing radioactive materials subject to federal or state oversight from the Nuclear Regulatory Commission (NRC).

For communities unfamiliar with the industry, that regulatory environment can create uncertainty and potentially add time to an already complicated development process.

That makes regulatory familiarity a competitive advantage.

That’s not to say economic development organizations need to become nuclear regulatory experts. But states and communities hoping to attract the industry should understand which agencies have jurisdiction, how licensing works, what local approvals maybe required and who needs to be involved early in the process. States with Nuclear Regulatory Commission Agreement State status can be particularly well-positioned, with radioactive materials licensing handled at the state level rather than directly by the NRC. This can create a more coordinated regulatory environment, particularly in states with agencies that have developed deep experience working with the nuclear and radiopharmaceutical industries.

While there are regulatory challenges wholly unique to the radiopharma sector, the objective is the same as it is for virtually every complex manufacturing project today: eliminate surprises and create a clear path from site selection to operation.

A Specialized Industry Requires Specialized Talent

The other piece of the equation is workforce.

Radiopharmaceutical companies require many of the same skills required across advanced pharmaceutical manufacturing. That includes engineering, quality assurance, validation, maintenance, and GMP manufacturing experience.

But they highly specialized capabilities in areas such as nuclear medicine,radiochemistry, radiation safety, and nuclear pharmacy.

Those skill sets are not evenly distributed across the country.

Communities evaluating their competitiveness should therefore look beyond the number of existing pharmaceutical workers in their labor shed. They need to understand whether nearby universities, hospitals, research institutions and training organizations can produce the specialized talent these operations require.

More importantly, they need to determine whether those institutions are willing to build programs around future industry demand.

Indiana Offers a Model

Nowhere is that dynamic more visible right now than in Indiana.

Central Indiana has rapidly developed one of the country's most significant concentrations of radiopharmaceutical activity.

Bristol Myers Squibb's RayzeBio opened a 77,000-square-foot Indianapolis manufacturing facility in 2025,and announced a $173 million facility in Whitestown, Indiana . Cardinal Health has built significant nuclear medicine and theranostics capabilities in the region, while SpectronRx has continued expanding isotope production and radiopharmaceutical manufacturing elsewhere in the state. Novartis operates its largest and most advanced radioligand therapy manufacturing facility in Indianapolis and is expanding the campus to add isotope production.

Indiana’s advantage is also reinforced by the presence of Eli Lilly and Company. Calling Indianapolis home since its founding in 1876, the company has become a key player in the radiopharma sector in recent years.

In 2023, Lilly acquired POINT Biopharma. The Indianapolis-based radiopharmaceutical company operated a 180,000-square-foot manufacturing campus in the city before Lilly acquired it in 2023, giving Lilly an entry point into next-generation radioligand therapies. The deal illustrates another way mature clusters compound their advantages: promising companies can grow alongside major industry players and, in some cases, ultimately become part of them.

The cluster’s growth is not driven by one incentive package or one available building. Indiana has assembled an ecosystem in which companies can find pharmaceutical expertise, isotope capabilities, specialized workers, logistics infrastructure and an increasingly sophisticated understanding of the regulatory environment.

Its central U.S. location also matters. Indianapolis International Airport’s FedEx hub (the second largest in its network) and the state's broader logistics network provide access to a large share of the U.S. population within relatively short transportation windows.

Indiana already had nuclear isotope capacity, providing a foundation for radiopharma investment. From there, each new investment strengthens the ecosystem: companies create specialized talent, suppliers follow customers, universities and training organizations respond to workforce needs, as Purdue University did by announcing a new graduate degree in radiopharmaceutical manufacturing degree in 2025, regulators gain experience with increasingly complex projects and new infrastructure becomes easier to justify. Each addition builds on the last, making Indiana’s ecosystem stronger and the state more credible to the next company considering an investment.

While Indiana’s radiopharmaceutical cluster continues to grow, the industry’s demanding supply chain means production cannot be concentrated in one place. With many radiopharmaceuticals constrained by short half-lives and tight delivery windows, manufacturers need facilities positioned close enough to reliably serve patients across the country. Novartis, despite its significant Indiana presence, has reflected that need by expanding its manufacturing network with new sites in Texas and Florida. As the industry continues to grow, we are likely to see other major radiopharma players add other nodes to their network to serve other regional geographies.

A credible cluster is more than a concentration of company names. Its value comes from the relationships among manufacturers, isotope producers, hospitals, research institutions, specialized vendors, regulators and training organizations. Communities assessing their position should map those connections and identify whether the ecosystem can solve operational problems collectively, not simply count the number of life sciences employers in the market.

For regions hoping to replicate that success, the question should not be, “How do we become the next Indiana?” Instead, it should be, “Do we have the fundamentals to compete as the industry’s geographic footprint expands?”

Know What a Location Can Change and What It Can't

Some of the most important radiopharma location factors are difficult, expensive, or impossible for a community to create through economic development policy alone.

A community cannot move itself closer to major patient populations or create proximity existing isotope producer. These realities can eliminate otherwise strong life sciences markets from certain radiopharma searches. For instance – the Research Triangle in North Carolina, usually seen as pharmaceutical manufacturing darling attracting billions in new investments, has a very limited presence of radiopharmaceutical companies due to limited isotope suppliers and airport connectivity limitations in Raleigh-Durham. Conversely, the Charlotte region, less known for pharmaceutical manufacturing compared to the Triangle, could be better positioned for a radiopharma manufacturing facility given its large airport hub and multiple nuclear power reactors in the region to draw talent and experience from.

Other competitivefactors, however, can be influenced.

• ‍Air connectivity can improve. Communities and states can work with airports to expand routes, cargo capacity and transportation infrastructure. Those investments can support not only radiopharma but advanced manufacturing, logistics and other time-sensitive industries.
• ‍Talent can be developed. Partnerships among universities, community colleges, hospitals and employers can create specialized programs in radiochemistry, nuclear medicine, pharmaceutical manufacturing and radiation safety.
• ‍Sites can be made ready. Utilities, permitting, zoning, infrastructure and development timelines remain critical. Communities that understand the requirements in advance can reduce uncertainty once a project emerges.
• ‍Regulatory coordination can improve. States and local governments can establish strong relationships with regulatory agencies and federal regulators while building institutional knowledge required to execute.  

For communities, this is where strategy becomes more important than aspiration.

The goal should not be to chase every fast-growing industry. It should be to understand where a region has structural advantages, where targeted investments can close competitive gaps and where resources would be better deployed elsewhere.

The Fundamentals Still Win

Radiopharmaceuticals may represent one of the most specialized location decisions in life sciences, but the lessons extend well beyond the sector.

Speed to market and site readiness increasingly separate communities that make a short list from those that do not.

Radiopharma adds an unusually difficult layer to that equation. Its isotope supply, logistics, regulatory and workforce requirements mean it simply will not fit every market.

The communities best positioned to capture America's next wave of life sciences investment are not necessarily those chasing the industry's highest-profile projects. They will be the ones that understand their competitive advantages, invest deliberately in the fundamentals and pursue the projects they can execute better and faster than anyone else.