Majority of pharmaceutical plants located in disaster-prone areas, study shows

Most pharmaceutical manufacturing facilities in the US are situated in regions prone to hurricanes, wildfires, and other natural disasters, placing the supply chain in significant jeopardy, according to a research letter published in JAMA.

“These disaster events posed risks of disruptions to facilities active in all aspects of the supply chain, from active pharmaceutical ingredient manufacture to packaging, disruptions that could be further magnified by the time needed for FDA reinspection of damaged facilities,” Mahnum Shazad of Harvard Medical School and colleagues wrote.

The authors used the Food and Drug Administration (FDA) Drug Establishments Current Registration Site database to identify the location of all facilities that manufactured drugs distributed in the US from 2019 to 2024, cross-referencing them with Federal Emergency Management Agency (FEMA) disaster declarations in the same time. Climate-related disasters in counties included fires, hurricanes, storms, tornadoes, and floods.

They identified 10,861 active drug production facilities during the study period. Over the 6-year period, there were 6,819 active facilities (62.8%) in counties when a disaster was declared. On average, 2,146 active facilities (33.8%) were impacted by a disaster declaration.

The authors noted that there is a need to identify these vulnerabilities in the supply chain and devise disaster risk management strategies to avoid these supply chain disruptions.

“A limited number of facilities manufacture significant shares of key therapeutics, increasing the risk of care disruption due to supply chain disruptions. These findings underscore the importance of recognizing climate-related vulnerabilities and the urgent need for supply chain transparency, for strategic allocation of production, and for disaster risk management strategies to prevent health care disruptions in the US,” they wrote.

In an interview with Focus, Shazad pointed out three key insights from the study. One is the need for increased transparency in the drug supply chain. “Right now, we don't have a good record of which drugs are produced where and how much of the US demand is being sourced by single facilities.”

The second lesson is the need to diversify the supply chain. She said that “Hurricane Helene hit a Baxter facility, which produced about 60% of the IV fluids used in the US. With the risk of disasters, it is important that production is less concentrated.”

The third lesson is that “disasters are frequent and likely increasing in frequency, and so we should think about disaster risk management plans for these facilities to ensure resilience.”

Shazad stressed the importance of having multiple facilities producing essential medicines so that if one facility experiences a disruption, it won't affect patient care.
JAMA article

Majority of pharmaceutical plants located in disaster-prone areas, study shows

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