Idle Pharmaceutical Factories In Puerto Rico Raise Concerns Of Drug Shortages

NPR's Robert Siegel talks with reporter Katie Thomas of The New York Times about how Hurricane Maria may cause shortages of essential drugs due to idled factories.

ROBERT SIEGEL, HOST:

When Hurricane Maria crashed into Puerto Rico, it dealt a powerful blow to the pharmaceutical industry. The island is an important exporter of drugs. Pharmaceuticals are a $15 billion business there. And that includes some medicines that are produced only in Puerto Rico, which raises the prospect of shortages here on the mainland. Reporter Katie Thomas wrote about this in The New York Times, and she joins us from Chicago. Welcome to the program.

KATIE THOMAS: Thank you.

SIEGEL: Put the Puerto Rican pharmaceutical industry in some perspective. How does it rank as a drug producer?

THOMAS: Well, it's one of the top drug producers in the world. Drug companies and device manufacturers started building plants there decades ago thanks to tax breaks and plentiful available - of skilled labor there.

SIEGEL: You wrote this week that there are 80 pharmaceutical factories in Puerto Rico. Do we know how many of them are up and running at this stage?

THOMAS: We don't. And I should say that those are a mix of factories. They're pharmaceutical products. They're also medical device makers and medical supply manufacturers. And we don't have an exact tally, at least not one that's being released. But several of the companies have told me that they're either not back up and running, or they're just barely starting to get into limited production.

SIEGEL: What kinds of problems are those people experiencing in Puerto Rico? What have they told you about?

THOMAS: Well, there's been a host of problems. The biggest one is actually just getting employees to come in to work. These residents have lost their homes. They're still struggling with many of their basic needs.

The second obstacle is electricity. You know, most of these plants are running on diesel generators. And while the companies say that they're pretty comfortable and - with the fact that those are up and running and they're working, there's questions about how long they will last. If this is a long-term problem, and if it goes on for months, you know, will they run out of diesel fuel? Will the generators start breaking down? So that's also a big concern.

SIEGEL: What are some of the drugs that are produced in Puerto Rico and, for that matter, only produced in Puerto Rico?

THOMAS: So the first thing I'll say is that companies generally don't give a list of which drugs and products they make in certain factories. And that's been a problem for people in the U.S. and around the world in hospitals who are tracking this and anticipating shortages and trying to plan for it.

So we don't know who makes these products exclusively in Puerto Rico. But some of the biggest drugs that are manufactured there - although they could be manufactured elsewhere as well - include Humira, which is the world's top-selling drug, Xarelto, which is a blood thinner that prevents strokes. Even Tylenol is made in Puerto Rico.

SIEGEL: As you've said, Puerto Rico is also a place where many medical devices are made. What are you hearing about that?

THOMAS: So the device industry is just as concerned as the pharmaceutical industry is. And I heard today that if conditions continue as they are and they don't measurably improve, they're worried that there are some products there that could eventually go into shortage as quickly as three to seven weeks from now. One specific example that I was given was catheters for trauma surgery.

SIEGEL: Well, if, say, production of Humira, which is a rheumatoid arthritis drug - if it were interrupted in Puerto Rico, are pharmaceutical companies equipped to shift production to another place? Do we know if they're that nimble?

THOMAS: So publicly they say that they are. And in their statements to us, they've been putting the most positive spin possible on this. They are mindful of their investors, and this is a very delicate situation for them. But we know that the FDA commissioner, Scott Gottlieb, has testified this week that he's very concerned about potential critical shortages. He said that there are 40 drugs that are made by 10 firms that they're closely watching. He didn't list which drugs those were specifically, but it's something that everyone is keeping a close eye on.

SIEGEL: That's Katie Thomas, who covers the health care industry for The New York Times. Thanks for talking with us.

THOMAS: Thank you.

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