Following Hurricane Maria's catastrophic hit across Puerto Rico in September, one anticipated consequence was a widespread shortage of drugs and medical supplies. At least a dozen pharmaceutical companies manufacture products on the island for human and veterinary use.
But nearly three months since the Category 4 storm ripped through the U.S. territory, crippling communication and utility networks and destroying roads and buildings, the effects on veterinary products have been minimal, at least so far.
“There were no animal drug shortages that occurred as a result of the recent hurricanes,” U.S. Food and Drug Administration spokesperson Lyndsey Meyer told the VIN News Service by email.
Since the Sept. 20 storm, the FDA has braced for fallout in the medical sector. According to an agency statement on Oct. 6, nearly 10 percent of drugs consumed by Americans are manufactured in Puerto Rico. Production of pharmaceutical and biological products and medical devices account for some 30 percent of Puerto Rico's gross domestic product, the FDA said.
Among common drugs and medical products produced there are the anesthetic gases isoflurane and sevoflurane; sterile intravenous solutions; insulin; gabapentin; and tramadol.
Companies with facilities on the island include Abbvie, Baxter, Eli Lilly, Merck and Pfizer.
Hospitals have experienced shortages of products such as Baxter Mini-Bag solution, used to compound or aid in delivery of medications. Human hospitals reportedly are affected by the shortage more keenly. Veterinary hospitals use the product, too, but to a lesser extent.
The small bags of sterile IV solutions are on a national back order, according to Nicole Torrech, a veterinary technician who works the emergency department at VCA Southpaws Veterinary Referral Center in Rockville, Maryland, and in the surgery department of Veterinary Surgical Center in Leesburg, Virginia.
“My husband, who is an RN, was the one who mentioned this to me,” she said by email. “We use the small saline bags in vet med, too, of course, but nowhere near as much as they do in human medicine, so the shortage was not yet obvious at my jobs compared to my husband’s.”
Sarah Wilcox, practice manager at Canyon Animal Hospital in Laguna Beach, California, reported that her clinic, too, has experienced shortages of IV solution.
Baxter's communications department said by email that the company is working with the FDA to address the situation and has been given permission to temporarily import certain products from Baxter facilities in Ireland, Australia, Canada, Mexico and England. The company also is bringing an additional volume of sterile IV solutions to the United States through a recent permanent approval from FDA for fluids produced in one of the company's Americas plants.
FDA Commissioner Scott Gottlieb, MD, issued a statement on Nov. 30 that the agency has approved IV-solution products from two other companies, Fresenius Kabi and Laboratorios Grifols, to mitigate the shortage.
“We now believe that the shortage related to IV saline products will improve by the end of 2017,” he said.
Baxter also manufactures inhaled anesthetic gases such as isoflurane and sevoflurane in Puerto Rico. The company maintains that it has an adequate supply available to customers.
Eli Lilly products include the insulin glargine, a drug made for people that also is used in dogs and cats to treat diabetes. Company spokesperson Tammy Hull said by email, “Our operations have restarted at our Lilly manufacturing sites in Puerto Rico, and there was no interruption to our global product supply for patients.”
How long businesses in Puerto Rico will be running at less than full capacity is unclear. According to Gottlieb’s statement: "Power is being restored across the island and, importantly, some major medical product manufacturing facilities are coming back online and stabilizing their production. However, until the grid is reliably restored, many firms will continue to run on generator power or require generators as a backup and production levels will not return to their baseline levels."
Baxter reported that its three manufacturing sites suffered minimal damage and that production lines are operating. Two of the facilities and the distribution center have been reconnected to the electric grid, while the third facility is using diesel-powered energy.
“We continue to maintain diesel generation backup across all facilities because grid power can be intermittent on the island,” the company said by email. “The speed of recovery is impacted by the severe damage to the roads and bridges ...”
With daily life for many Puerto Ricans constrained by storm damage, the company also has helped employees procure necessities such as gas, food, water and toiletries, the representative said, adding: “We have distributed gas-powered generators and propane cooktops, and we’ve installed laundry facilities at our manufacturing facilities to support employees’ personal needs. And we are continuing to provide access to potable water for our employees and the communities around our manufacturing facilities.”
The FDA said it continues to monitor approximately 90 drugs, biologics and devices manufactured on Puerto Rico and to work with manufacturers as needed to address shortages.