Ripple effects of Hurricane Maria cause pharma shortages
The ripple effects of Hurricane Maria’s destruction have far exceeded previous expectations. Puerto Rico’s electrical grid was nearly wiped out after Maria. Surprisingly, in a statement made December 8th by the Puerto Rico Power Energy Authority (PREPA), the grid is still only functioning at 68% of its capabilities. Among the millions who lost power, were the islands’ hundreds of pharmaceuticals and medical suppliers. According to a recent FDA economic analysis, Puerto Rico produces more pharmaceuticals for the mainland than any of the 50 states and more than any single foreign country. This has developed into a major issue for hospitals and medical professionals across the United States and has the possibility to worsen. Specifically, it has caused an extreme shortage of intravenous fluids and amino acids for injection.
Intravenous fluids like saline and dextrose, are the lifeblood of hospitals. They’re needed to deliver medications and rehydrate patients.
Amino acids are used to feed very ill patients, including preemies, causing a supply shortage affecting the US’s most tiny and vulnerable patients.
Baxter, a major US manufacturer of intravenous fluids and amino acid medical products, has three factories in Puerto Rico. In an email, a spokesperson at Baxter said 10 weeks after the hurricane hit the islands, one of their factories in Puerto Rico is still being powered by a diesel generator. The other two factories are back on the electrical grid, but power is intermittent. Severe damage to roads and bridges is also slowing the recovery. In response to the medical supply shortages, many hospitals have implemented conservation tactics, using replacements and alternatives when necessary and available, but a serious threat to the safety and quality of patient care still looms.
The Food and Drug Administration’s commissioner, Scott Gottlieb recently made a statement saying, “Power is being restored across the island and, importantly, some major medical product manufacturing facilities are coming back online and stabilizing their production.” The FDA has been working closely with federal and local authorities to get companies such as Baxter and numerous other medical manufacturers to full production and mitigate these shortages in their Puerto Rico facilities by facilitating temporary importation of products from other countries and to make sure that medical manufacturers get their electricity restored first.
Although the FDA and the Department of Energy are giving priority to restoring power to these facilities first and foremost, the threat of potential shortages continue. The FDA’s commissioner explains, “We’re monitoring approximately 90 medical products manufactured in Puerto Rico (which include biologics, devices and drugs) that are important to patients. Mitigating medical product shortages will require a sustained effort by industry, the agency and other partners as we work with manufacturers to return to production levels that adequately meet the needs of patients. We at the FDA are committed to seeing the hurricane response through to the island’s recovery and doing all we can to address these shortages.”
Cancer drugs and HIV medication are among the many other products manufactured on the still-devastated island and it’s difficult to prepare for and predict potential shortages since the FDA does not require companies to disclose where their drugs are made. WIth the numerous other plants in Puerto Rico that make drugs, the next shortage could be just around the corner and no one knows indefinitely.
Hospitals claim patient care is currently not being compromised, but they don’t expect the shortage to let up until at least early next year. Until then, the burden and stress of these drug shortages will fall on the health care providers and hospitals to prepare for an unseen event to ensure that the real victims don’t end up being the patients who desperately need medical care.