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    Pharmacy Supply Lines Are Still Shaking After Storm Passes

    Two hurricanes devastated the U.S. supply chain, affecting pharmacies all over—and leaving many to wonder what’s next.

     

    The Devastation and the Power Failure

    by the numbersAlthough they left vast areas of destruction on the rest of Puerto Rico, Hurricanes Irma and Maria did not do large amounts of damage to most pharmaceutical plants; most reports said the factories had only minimal damage.

    However, it is not so much the damage to the factories, but lack of electrical power that will be the confounding factor in any recovery to the industry on the island. Puerto Rico’s entire energy grid went down and it is still largely disabled. At press time, weeks after the storm, the power grid was reported to be operating at just over 40% capacity. The failure of the electrical grid means that even factories with no damage are using generators to remain semi- operational. Gottlieb reported that most firms were operating at 50% or less of capacity in his testimony.

    Related article: Could Compounding Pharmacists Solve the Sodium Bicarbonate Shortage?

    “For the moment, they are trying to use generators, but generators are designed to last a couple of days, not months and years, to power factories,” Friend told Drug Topics. Emergency generators also need fuel that has to be shipped in and then trucked to the plants, he added.

    Even after the power grid comes back online and electricity is restored to the pharmaceutical manufacturing plants, getting them back up to being fully operational is not going to be swift or easy, Gottlieb said.

    The FDA is working with HHS and the Army Corps of Engineers to prioritize a handful of critical facilities, but that the power problems may last into the first quarter of 2018.

    Pharmacies on the island were also affected. Walgreens has 120 retail pharmacies in Puerto Rico, according to Phil Caruso, Media Relations Manager with the chain. Nearly all pharmacies have a permanent backup generator, he noted, and by late October, 90 had reopened.

    Which Products Will be Affected?

    No list of drugs and devices that could be affected has been issued. The names of the drugs and devices that could go into short supply or become unavailable is proprietary and neither the industry nor the FDA will make them public. “This compounds the problem,” said Friend. “We don’t know what the shortage is or when it is going to hit.” It is possible some drug shortages will not be known until they occur, he added.

    Joseph M. Hill, ASHP’s Director for Government Relations, said the lack of information does not help. “Just not knowing what is manufactured on this island is a little bit concerning,” he told Drug Topics. “We could benefit from knowing what else is going into short supply.” He called the situation “awfully frustrating.”

    Related article: Managing medication shortages: The pharmacist’s role

    One company with production in Puerto Rico is Baxter. Baxter’s three manufacturing sites in Puerto Rico sustained minimal structural damage from Maria, and were able to resume limited production using diesel generators, according to a company statement.3 In Puerto Rico, Baxter makes Mini-Bag and Mini-Bag+ diluent bags in 50 and 100 mL sizes, used primarily in health-system pharmacies for compounding or admixing.

    “The big thing on everyone’s mind is the shortage of Mini-Bags,” Hill said, “That shortage has gone into full effect.”

    Valerie DeBenedette
    Valerie DeBenedette is Managing Editor of Drug Topics.

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