Puerto Rico’s Healthcare Supply Chain Responds to Hurricane Fiona

As Hurricane Fiona reached Puerto Rico late Sunday evening, flooding the archipelago and plunging its dilapidated energy grid into a blackout, health industry leaders and government agencies braced for impact.

The Category 1 storm left the island in a lingering state of emergency. All of Puerto Rico’s 3.1 million people lost power. Another 60% of residents have lost access to drinking water. The Port of San Juan was temporarily closed to commercial vessels on Monday and travel advisories restricting movement of residents were put in place while damage assessments are made. It was yet another blow to US territory plagued by failing infrastructure overexposure to the weather.

Five years ago, almost to the day, Hurricane Maria ravaged Puerto Rico, killing 3,000 people and significantly crippling its infrastructure. Healthcare providers across the United States grappling with medical device and drug delays as manufacturers there recovered from the wreckage.

Hurricane Maria hit medical device company Baxter International particularly hard. Its Puerto Rican facilities were largely responsible for manufacturing small volume IV bags, while large volume bags were manufactured on the mainland. Hospitals have resorted to larger bags to deliver drugs to patients, which has increased the demand for this product. Baxter’s fourth-quarter revenue fell $70 million due to manufacturing disruptions following the 2017 storm.

Today, Puerto Rican manufacturers of medical devices and pharmaceuticals, which account for more than half of the territory’s exports, are better positioned.

Learning from Hurricane Maria, pharmaceutical and medical device manufacturers have invested in backup generators, fuel, community services, food and water that help them meet operational challenges . Some companies have started to expand their manufacturing facilities across the country to build resilience against regional climate disasters.

Puerto Rico has hosted the production of medical devices and pharmaceuticals for half a century. Multinational companies operate 52 Food and Drug Administration-approved pharmaceutical factories in the territory. The island, roughly the size of Connecticut, is also home to nearly 70 medical device makers, developing pacemakers, surgical instruments, lab equipment and other essential products, according to Development Department data. economy and commerce of Puerto Rico.

The FDA said it was “actively monitoring” the situation on the island. The American Hospital Association said it is awaiting damage assessments from the Department of Health and Human Services and the Federal Emergency Management Agency to understand what effects the storm may have on the hospital’s broader operations. ‘industry.

Shortages of drugs and medical devices could mean delayed procedures, fewer treatment options and increased costs. But amid flooding and a power outage, many companies say their Puerto Rican locations are up and running.

Most of Baxter’s facilities in the Caribbean restarted Tuesday with power to generators and fuel supplies, but its ability to be fully operational depends on the accessibility of local roads and bridges. At this time, Baxter said it has “healthy inventory levels for the majority of products manufactured in Puerto Rico and the Dominican Republic for U.S. customers,” according to a company statement.

Pharmaceutical company Amgen said measures taken before the storm helped ensure that its flagship site in Juncos, Puerto Rico, would continue operations.

“Prior to the storm, we activated our well-rehearsed business continuity plans, which included proactive switching of site power to generators. We have sufficient generator and fuel capacity to support ongoing operations,” said a spokesperson for Amgen, which also has smaller manufacturing sites in the United States, Ireland, the Netherlands and Singapore.

With the island devastated, Amgen said it was checking in with the 2,400 staff working at its largest manufacturing site and offering assistance.

Abbott planned the destruction by sending employees home with disaster relief kits and food. He also distributed supplies to the oncology department of a local pediatric hospital. None of Abbott’s facilities were damaged during the hurricane, a spokesperson said.

The medical device and pharmaceutical maker has invested in food banks, community health clinics and infrastructure such as generators, wireless hotspots and cold storage to prepare for long-term emergencies.

Device maker Boston Scientific has also stocked up on generators, water and chainsaws for its employees. Brad Sorenson, executive vice president of global supply chain, said the company’s manufacturing facility in Dorado, Puerto Rico, switched to independent water and power systems before the arrival. of the hurricane. The plant can operate for up to two months with emergency supplies, he said.

“We came off the grid on our own power 36 hours before the hurricane made landfall,” Sorenson said. “We are doing it on our schedule. We’re not sitting there waiting for the lights to go out.

Prior to the storm, Boston Scientific leaders ensured adequate product and inventory availability and sent employees home for two days while the storm wreaked havoc. Nearly 90% of their employees were at work Wednesday, Sorenson said. The plant will operate at peak capacity to compensate for losses.

“It will take a few weeks, but we can make up for the two days we proactively closed,” Sorenson said.

In the aftermath of Hurricane Fiona, the American Society of Health-System Pharmacists became concerned about the opacity of the pharmaceutical industry. Michael Ganio, senior director of pharmaceutical practice and quality for the business group, wrote in an email that his main concern was the lack of transparency from drugmakers about factory locations and production quantities.

“Having this information in advance will help organizations prepare for possible shortages and discourage mitigation strategies such as hoarding, which can lead to further disruption,” Ganio added.

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