Tornado damage at Pfizer facility threatens to make critical drug-supply shortages even worse, experts say 

The Pfizer site in Rocky Mount is one of the world’s largest facilities making sterile injectable medicines that are sold to hospitals, and nearly a quarter of Pfizer sterile injectables used in U.S. hospitals are made at the site, which covers 250 acres and has more than 1.4 million square feet of manufacturing space, according to the company’s website. 

The damage to such a large facility focused on sterile injectables raised alarms among drug-supply experts because many of these key medicines in everyday use at hospitals were already in short supply. Products made at the Pfizer facility include anesthesia, therapeutics, drugs for treating infections and neuromuscular blockers that can be used in surgeries and mechanical ventilation of patients. About 43% of the new drug shortages this year are injectable medicines, according to data from the University of Utah Drug Information Service. 

“The most common group of drugs to have shortages are sterile injectables,” in part because there are only a few manufacturers in the market for these largely generic and generally not very profitable products, said Stephen Schondelmeyer, co-principal investigator of the Resilient Drug Supply Project at the University of Minnesota’s Center for Infectious Disease Research and Policy. A recent Pfizer injectables product availability report shows that 47% of the more than 500 products listed are “depleted” or in “limited supply.” 

The natural disaster underscores the need for longer-term policy solutions to support the availability of generic pharmaceuticals, drug-supply experts said. “We have these chronic market failures that we know about and don’t think about until a crisis hits,” Schondelmeyer said. “The effects of this tornado on the Pfizer plant could be much less if we had better long-term policies for sterile injectables and generic drugs that don’t leave them so vulnerable in the first place.” 

Although it’s not yet clear exactly which products are made at the Rocky Mount facility, “we have so many injectable products that are already in short supply, and many of them are Pfizer products,” said Erin Fox, a drug shortage expert at University of Utah Health. Wednesday’s damage “means we’ll see the shortages we already had last longer and probably worsen.” 

Pfizer makes many of the emergency, life-saving medicines routinely used in hospitals, like epinephrine for treating allergic reactions and naloxone for reversing opioid overdoses, Fox said.  

“We are assessing the situation to determine the impact on production,” Pfizer said in a statement. “Our thoughts are with our colleagues, our patients, and the community as we rebuild from this weather incident.” 

As of the end of June, the American Society of Health-System Pharmacists was tracking 309 active drug shortages–close to an all-time high, said Dr. Michael Ganio, the group’s senior director of pharmacy practice and quality. With news of the tornado, he said, “most of the healthcare world is just holding its collective breath, wondering what the impact will be.” 

“What’s most concerning is the broad portfolio of drugs” made at the Rocky Mount facility, “and just how basic they are” to the everyday care provided at hospitals, Ganio said. While large health systems may have a team available to effectively manage any shortages, “the smaller hospitals may not have the means to have more drugs on the shelf or to respond as quickly,” he said.

Pfizer’s Rocky Mount facility has never manufactured or stored the company’s COVID-19 vaccine or COVID treatment Paxlovid, a Pfizer spokesperson said. 

Based on the limited information available, some products produced at the facility “seem to be some legacy products with limited other production locations making the damage to the facility and response more important than if some others had been hit,” Raymond James analyst Chris Meekins wrote in a research note Thursday. 

The extent of the impact on drug shortages will depend in part on whether any production lines were damaged in the disaster. “This isn’t like making blue jeans or candy,” Schondelmeyer said. “You can’t just set up a new production line somewhere in a week or two.” 

If only warehouses and shipping spaces were damaged, the U.S. Food and Drug Administration will give Pfizer leeway to use other facilities to ensure there isn’t a major shortage, Meekins wrote in the research note. 

Pfizer shares were up 0.9% on Thursday and have declined 28% in the year to date, while the S&P 500
SPX,
+0.03%
has gained 18%.

Katie Marriner contributed to this article.