Prescription drug disruptions may arise in Puerto Rico amid Fiona’s damage

Approximately 10% of the U.S. drug supply was manufactured in Puerto Rico in 2017, including products like cholesterol drug Lipitor, blood thinner Xarelto, pain drug Nucynta ER and nerve pain drug Gralise, according to Everstream Analytics. The U.S. territory serves as the main hub for companies including Viatris, Bristol-Myers Squibb Company and Johnson & Johnson.

SAN JUAN, Puerto Rico – As damage assessments and utility restorations continue in Puerto Rico in the wake of Hurricane Fiona, the island could now face the possibility of interruptions for many prescription drug and medtech exports to the U.S., according to an industry-leading analyst forecasting operations for energy, agriculture and supply chain logistics.

According to Everstream Analytics, approximately 10% of the U.S. drug supply was manufactured in Puerto Rico 2017, including products like cholesterol drug Lipitor, blood thinner Xarelto, pain drug Nucynta ER and nerve pain drug Gralise. The U.S. territory serves as the main hub for companies including Viatris, Bristol-Myers Squibb Company and Johnson & Johnson.

"Although there aren’t currently reports from these companies indicating any product disruption, flooding could hurt their daily operations due to impassable roads or traffic diversions," Everstream Analytics' chief meteorologist Jon Davis said.

A senior manager for Pfizer's global media relations told FOX Weather that the company transferred all their manufacturing sites in Puerto Rico to Viatris, and it is still too early to understand the full impact to other manufacturers and what the broader implications may be -- if any. 

Johnson & Johnson said operations have been restored following Fiona at all of their sites in Puerto Rico.

Local authorities described the flooding as historic after dropping more than 20 inches of rain across the U.S. territory. Fiona sent 1.5 million into darkness, with about 300,000 now restored. Thousands are still left without running water. 

HURRICANE FIONA LEAVES TRAIL OF DESTRUCTION ACROSS PUERTO RICO, DOMINICAN REPUBLIC

However, with power outages across the islands, Davis said pharmaceutical companies that aren’t well-equipped will likely continue to face business disruptions. And any disruptions in distribution and production will have implications for the U.S. and globally.

In addition, nearly all (99%) of all cardiac pacemakers in the world are manufactured in Puerto Rico. And more than half of the world’s top 10 bestselling prescription drugs are manufactured in Puerto Rico including Lyrica for epilepsy and Humira and Enbrel to treat rheumatoid arthritis. 

"The overall decrease in output for medical drugs, devices and pharmaceutical items will be felt in the short to medium term," Davis said.

Depending on the severity of flooding, disruptions to manufacturing could take months to recover from, according to Davis.

Puerto Rico hurricanes have caused drug shortages before

Fiona made two landfalls as a Category 1 hurricane, the first one Sunday afternoon along the extreme southwestern coast of Puerto Rico and the second one early Monday morning in the eastern Dominican Republic. 

Fiona hit Puerto Rico near the island’s five-year anniversary of Hurricane Maria, the third-costliest hurricane to hit the U.S. – it also cost the lives of 2,975 Puerto Ricans. 

FIONA VS. MARIA: HOW THE TWO HURRICANES COMPARE IN PUERTO RICO

Following Maria’s landfall on Sept. 18, 2017, the U.S. faced drug shortages, especially shortages of IV fluid bags, that lasted four to five months.

The bags are used to mix and deliver liquid medications or salt/saline water to patients through an intravenous line. 

According to Everstream Analytics, medtech company Baxter Healthcare accounted for 43% of the U.S. IV solution market in 2017, and produced the majority of the supply in Puerto Rico. The company has multiple plants in Puerto Rico. 

Overall, the IV bags were in short supply until at least February 2018 as most of the production was halted for weeks in Puerto Rico, and only gradually normalized in the following months.

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Maria was a Category 4 hurricane when it made landfall in Yabucoa with maximum sustained winds of 155 mph. Fiona was a Category 1 with 85-mph winds.

Fiona will continue to strengthen through Wednesday night and is forecast to remain a powerful Category 4 hurricane into Friday as it moves toward the north or north-northeast.

According to the FOX Forecast Center, Hurricane Fiona could approach Bermuda from late Thursday into early Friday, although the center of the hurricane is predicted to remain west of the archipelago.

FOX Weather reached out to Viatris and Bristol-Myers Squibb Company for comment and have not heard back.

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