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Here are the drugs that could be in short supply after a tornado hit a Pfizer factory

MARY LOUISE KELLY, HOST:

OK, to a different extreme weather event - tornadoes, and specifically the tornado that ripped through a critical Pfizer factory in Rocky Mount, N.C., last week. It could mean more drug shortages in a year that has already seen scarcity of Adderall and amoxicillin and chemotherapy drugs and more. NPR pharmaceuticals correspondent Sydney Lupkin has obtained records that show what was being made at this Pfizer facility and who might be affected by the damage. Hey, Sydney.

SYDNEY LUPKIN, BYLINE: Hello.

KELLY: Hi. So what was being made at this Pfizer facility? Tell me more.

LUPKIN: Yeah, sure. So I have to say that it's not easy information to figure out. Companies are reluctant to disclose exactly what they make where. The information is often blacked out on FDA inspection records, for example. But NPR was able to use records from the National Institutes of Health to compile a list of dozens of drugs that are made there, and they include a lot of painkillers and anesthetics that are used in hospitals and given intravenously. And there are also a lot of drugs like naloxone, which is used to reverse opioid overdoses, and vitamin K, which is used to prevent bleeding in newborns. According to Pfizer, this site makes about 8% of all sterile injectables used in hospitals across the U.S.

KELLY: OK, so all kinds of things being made there. When a factory site like that goes down, it would have very serious implications, I imagine.

LUPKIN: Right, and hospitals panicked. I spoke with Erin Fox, a pharmacy director for the University of Utah Health's hospitals.

ERIN FOX: Every hospital buyer across the country - the second they heard about that tornado, everyone was just, like, buy, buy, buy, buy, buy (laughter).

LUPKIN: They went overboard, and it resulted in some attempted hoarding. But Pfizer shut that down fairly quickly by working with wholesalers to limit what hospitals could buy to no more than 100% of their usual orders. Pfizer declined my request for an interview, but Fox praised the company for its handling of the situation.

KELLY: So Pfizer's not talking to you. Have they said anything at all about the situation?

LUPKIN: So they sent a letter to health care providers explaining that only the warehouse areas were damaged. Production areas seem to be OK. Pfizer also sent a list of 65 products that it thinks might have disruptions based on existing inventory and market share. A lot of them were already in shortage, which is good news and bad news. The bad news is those shortages will continue for things like certain formulations of lidocaine, which is a local anesthetic. But the good news is hospitals already know how to cope. Here's Erin Fox again. She's also a national expert on drug shortages.

FOX: There had to be this tornado. It seems like this is probably one of the best-case scenarios where, you know, manufacturing lines aren't impacted, and it was an area of the facility that can be fairly quickly rebuilt. And so it's not a time to panic.

LUPKIN: She expects the ripple effects of this to last a few months rather than a few years.

KELLY: Are there takeaways, Sydney - lessons to be learned from this?

LUPKIN: There are, and they relate to the drug shortages that happened a few years ago when Hurricane Maria hit Puerto Rico. Health economist Rena Conti at Boston University told me this tornado at Pfizer is just another reminder that pharmaceutical factories are vulnerable to climate change. A lot of drug manufacturing requires access to water which puts the factories in harm's way in places like Puerto Rico or the Gulf States.

Redundancy is also important in the drug supply chain so that when something strikes a factory - a tornado, a hurricane, mold, a bad inspection, whatever - it's not the end of the world. Still, there are a few products that are only made by Pfizer and only at that one facility, but they have been in such short supply for so long that doctors have learned to use alternatives anyway. In many ways, we're lucky the situation wasn't worse.

KELLY: NPR's Sydney Lupkin. Thanks for bringing us up to speed on the situation.

LUPKIN: You bet.

(SOUNDBITE OF RINI SONG, "SELFISH (FEAT. BEAM)") Transcript provided by NPR, Copyright NPR.

NPR transcripts are created on a rush deadline by an NPR contractor. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.

Sydney Lupkin is the pharmaceuticals correspondent for NPR.