Tornado damage to a key Pfizer factory in Rocky Mount, N.C. on July 19 underscores potential vulnerabilities of the supply chain for medicines used in US hospitals.

Damage Assessment: A tornado tore off the roof and caused considerable damage at a Pfizer factory.
* The site manufactures dozens of essential hospital drugs, prompting panic-buying by hospitals nationwide, even without knowledge of the specific drugs affected or expected duration of shortages.

Drug List: While pharmaceutical companies traditionally keep production details confidential, records from the National Institutes of Health helped identify medicines produced at the factory.
* The factory manufactures a variety of intravenous painkillers and anesthetics, naloxone (used for reversing opioid overdoses), and vitamin K (used to prevent newborn bleeding).
* Approximately 8% of all sterile injectables used in US hospitals are produced at this Pfizer site.

Supply Concerns: Despite the damage, interim supply disturbances are not anticipated as alternative products or sufficient inventory are available in other Pfizer warehouses.
* Certain medications manufactured solely at this factory, like Vitamin K1 and aminophylline, are considered “backbone” therapies without real alternatives, according to Boston University health economist Rena Conti.
* FDA is actively working with Pfizer to assess and address the situation, with no anticipation of significant immediate supply disruptions.

Mitigation Measures: Pfizer effectively limited hoarding post-disaster by restricting hospitals to their customary order volumes.
* Pfizer’s preliminary damage assessment indicated that production areas remained mostly unscathed, while the warehouse had suffered significant damage.
* The company identified 65 products that might experience disruptions due to existing inventory and market share conditions.

Future Concerns: The incident underscores climate change risks for the US pharmaceutical supply, with potentially harmful weather events impacting areas traditionally used for pharmaceutical manufacturing.
* Conti suggests maintaining redundancy in the drug supply chain to mitigate production halt instances like this one at factories.
* Despite the recent damage, Conti claims that the high-quality, resilient US drug supply remains the international gold standard.

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