A tornado on Wednesday wreaked havoc on a Pfizer drug manufacturing site in Rocky Mount, NC, threatening critical supplies for hospitals across the country.
The company estimated that one-fourth of the injectable drugs it supplies to U.S. hospitals are made on the Rocky Mount property, including drugs used during surgery and other procedures to suppress pain, keep patients sedated and fight infection.
While the company has yet to disclose the extent of the storm’s impact, video footage of the site and interviews with the Nash County Sheriff and those with knowledge of the damage indicated that the tornado caused the worst damage in the company’s warehouse.
On Thursday, Pfizer declined to comment on the affected drugs or the portion of the supply destroyed in the tornado, which could be significant since many of these drugs required careful manufacturing and handling to ensure sterility.
It was also unclear to what extent the destruction would exacerbate existing national drug shortages, which have reached a 10-year high in recent months. Hospitals are on high alert because cheap generics manufactured on site, such as the sedative propofol, are already among the scarcest products on the market.
“From a healthcare provider’s point of view, I just hold my breath,” says Michael Ganio, senior director at the American Society of Health-System Pharmacists.
The tornado swept through a 16-mile swath of the Rocky Mount area about 50 miles east of Raleigh about 12:30 p.m. Wednesday. It snapped trees at the base and knocked houses 20 feet off their foundations, according to a National Weather Service summary. The tornado reached wind speeds of up to 150 miles per hour before tearing large pieces off the metal roof of a Pfizer building and flipping over large trucks in the parking lot. Sixteen people were injured, but no deaths were reported.
Several people said the tornado did the most damage to a company warehouse; the impact on the plant — and its ability to continue producing drugs — is not yet clear, according to Mittal Sutaria, a senior vice president of pharmacy contracts at Vizient, which provides drug contracts to hospitals.
She said Pfizer and the Food and Drug Administration had teams on site to assess the damage.
Dr. Sutaria, who said Vizient had been in contact with Pfizer, added that the Rocky Mount site made anesthetic products including propofol, which is used to calm patients during surgery, as well as fentanyl and morphine, which are used in IVs for pain management. It also makes vancomycin, an antibiotic given to fight serious infections, and muscle blockers, including succinylcholine, which are also used in surgery.
Keith Stone, the sheriff of Nash County, where Rocky Mount is located, told local news reporters Wednesday that much of the Pfizer building was splintered, the roof crushed and as many as 50,000 pallets of medicine destroyed.
About 100 vehicles were also damaged, including forklift trucks scattered on nearby rail lines, Sheriff Stone said in an interview Thursday. “It’s just amazing what can show up so quickly and do so much damage and be gone so quickly,” he said.
Steve Danehy, a spokesman for Pfizer, said Thursday that the company’s Rocky Mount team was “working very hard to address and assess the situation,” but did not provide details. The company said staff survived the tornado without serious injuries.
Pfizer is expected to report its findings to the Food and Drug Administration, which tracks deficiencies.
“We are closely monitoring the situation as it evolves and are working with the company to understand the extent of the damage and potential impact on the country’s drug supply,” said Chanapa Tantibanchachai, a spokeswoman for the agency.
Founded in 1968, the Rocky Mount factory employs 4,500 people and has 24 filling lines and 22 packaging lines. While not as large as Pfizer’s manufacturing complex in Kalamazoo, Michigan, the North Carolina site spans 1.4 million square feet of manufacturing space. The drugs made on the site are also shipped to Japan, Canada, Brazil and other countries.
The specific products made in the Pfizer factory – and the market share they represent – are typically not public information. However, the company sells dozens of injectables, including IV antibiotics, seizure medications used in brain surgery, and even an antidote for coral snake venom.
Many of Pfizer’s drugs were already in short supply before the tornado: About 130 products marketed to hospitals were listed as “used up,” and about 100 others were in “limited supply,” according to the company’s list of 660 products.
Pfizer has other plants in Kansas, New York, Massachusetts and Wisconsin, where the company could potentially relocate some production to alleviate any shortfalls from the Rocky Mount destruction.
Soumi Saha, a senior vice president at Premier, a company that provides contract drug services to hospitals, said Pfizer had a strong track record of building in redundancy so that products were manufactured in more than one location.
If the storm damage is confined to the warehouse and doesn’t affect production schedules at the factories, that could reduce potential shortages, she said.
Dr. Ganio recalled other drug shortages caused by disasters in manufacturing areas.
Hurricane Maria hit Puerto Rico in 2017, leaving hospitals scrambling for IV bags. Another occurred last year when a region of China hard hit by Covid experienced a backlog in producing contrast dye for CT scans and other medical imaging. And in recent months, doctors have warned that the survival of some cancer patients is at risk because of a production halt at a factory in India after the FDA cited serious quality defects.
Given the worrying shortages that affect so many lives — and which have led to the hoarding of certain drugs and bartering between lawyers who trade and find scarce medicines for the most desperate — policy experts, lawmakers and federal officials have been discussing solutions in recent weeks.
On Thursday, Senate lawmakers passed a pandemic preparedness bill passed by a major health committee. It had provisions aimed at reducing shortages and increasing reports from drug companies to alert the FDA to conditions that could lead to shortages so the agency could help prevent them.
The bill also requires a report from the FDA within 90 days of the legislation being passed on the agency’s ability to deal with shortages and whether it needs more help from lawmakers.
Still, the natural occurrence of a tornado was a stark reminder of the need to better manage shortages.
“This reinforces the need for resilience in our supply chain and a real focus on preparedness, not just for the next pandemic,” said Dr. Saha, “but for any unforeseen circumstance that causes shocks in our supply chain.”
