Pharmacy Needs After a Natural Disaster — Puerto Rico, September–October 2017.
January 10th, 2019Lavery AM, Patel A, Boehmer TK, et al. Notes from the Field: Pharmacy Needs After a Natural Disaster — Puerto Rico, September–October 2017. MMWR Morb Mortal Wkly Rep 2018;67:402–403. DOI: http://dx.doi.org/10.15585/mmwr.mm6713a4.
- After Hurricane Ivan made landfall near Mobile, Alabama, in 2004, an assessment of its impact on pharmacies in the affected areas found that 53% had depleted supplies and at least 26% had to prioritize distribution to patients because of limited supplies
- A 2005 study of Hurricane Katrina evacuees in San Antonio, Texas, found that disaster medical assistance teams were more prepared to provide for acute than chronic illnesses although more than two thirds (68%) of patients requested drugs to treat chronic conditions
- On September 20, 2017, Hurricane Maria made landfall in Puerto Rico as a Category 4 hurricane. Five days later, only approximately 29% of pharmacies reporting to Healthcare Ready, an organization that provides information on access to pharmacies during an emergency, were open.
| Therapeutic category | No. (%) prescriptions |
|---|---|
| Cardiovascular | 971,234 (20.7) |
| Psychiatric | 554,839 (11.8) |
| Analgesic† | 449,532 (9.6) |
| Lipid lowering | 349,533 (7.5) |
| Diabetes | 346,104 (7.4) |
| Gastrointestinal | 342,146 (7.3) |
| Neurologic | 287,038 (6.1) |
| Thyroid | 234,982 (5.0) |
| Antibiotics | 225,009 (4.8) |
| Pulmonary | 150,525 (3.2) |
| Other§ | 781,241 (16.6) |
| Total | 4,692,183 (100.0) |
- During June–August 2017, the top categories of drugs prescribed were for
- cardiovascular (average = 21% of prescriptions filled),
- psychiatric (12%), and
- analgesic (10%) drugs.
- Among the cardiovascular drugs prescribed, a majority were angiotensin II receptor antagonists (29%), beta blockers (20%), and angiotensin-converting enzyme (ACE) inhibitors (18%).
- The most frequently dispensed individual drugs were thyroid replacement hormones (230,324 prescriptions dispensed, 5% of total dispensed), gabapentin (144,114 prescriptions dispensed, 3% of total), and metformin (141,734 prescriptions dispensed, 3% of total).
- Ninety percent of prescribed drugs were for oral administration.
- The IQVIA database used in this analysis is limited to retail facilities and does not include hospitals or other institutions such as nursing homes.
- Furthermore, some critical drugs might not be represented in this data set, including insulin, which can also be purchased over the counter; hence, some of the prescribed quantities in this data set could be an underestimate of medication needs. Although insulin was not a most frequently purchased or prescribed drug, it is a daily need for persons with insulin-dependent diabetes and should be prioritized.
- To have a more complete picture of important drugs that might be needed after a disaster, multiple data sources, including drug sales data to hospitals, clinics, and nursing homes, as well as information provided by third-party claims adjudication data, could be analyzed to inform public health activities and guide collaborations with drug suppliers to respond to and recover from large-scale disasters.