ATLANTA — Climate-related disasters are threatening the stability of the U.S. pharmaceutical supply chain, according to new research from the American Cancer Society (ACS) published in JAMA.
The study found that nearly two-thirds of U.S. drug production facilities are located in counties that experienced at least one climate-related disaster between 2019 and 2024, including hurricanes, wildfires, floods, and storms. In total, 6,819 active facilities — representing 62.8% of all production sites during the period — were located in disaster-affected areas.
Past events have already demonstrated the risks: Hurricane Maria in 2017 and Hurricane Helene in 2024 both led to nationwide shortages of intravenous fluids after damaging key manufacturing plants.
“Drug shortages following weather disasters demonstrate how the pharmaceutical supply chain is not yet resilient to climate-related disruptions,” said Dr. Leticia Nogueira, ACS scientific director of health services research and senior author of the study. She noted that limited numbers of facilities often produce significant shares of critical therapies, leaving patients vulnerable to care delays.
The findings suggest that relocating facilities is not a viable solution, since counties with and without drug production sites were equally likely to experience disasters. Instead, researchers and ACS experts stress the need for transparency and disaster risk management strategies across the supply chain.
“These findings underscore the importance of recognizing climate-related vulnerabilities and the urgent need for supply chain transparency that allows integration of disaster risk management strategies into strategic resource allocation throughout the pharmaceutical supply chain,” added Nogueira. “Moving forward, threats must be examined and proactively mitigated to prevent critical health care disruptions.”
“Life-saving cancer drugs, especially older generic sterile injectables, have faced chronic shortages due to a combination of economic factors and natural disasters,” said Mark E. Fleury, PhD, of the ACS Cancer Action Network. “This study illustrates the need for redundancy in the drug supply chain.”
“Life-saving cancer drugs, especially older generic sterile injectable drugs, have been in chronic shortages due to a combination of factors, including economic reasons and natural disasters. The American Cancer Society Cancer Action Network (ACS CAN), ACS's advocacy affiliate, has been working with lawmakers and federal agencies to address systemic vulnerabilities and create a more resilient system to ensure patients can access the medications they need without disruptions to their care. This study illustrates the need for redundancy in the drug supply chain,” said Mark E. Fleury, PhD, Principal, Policy Development - Emerging Science at the American Cancer Society Cancer Action Network.
ACS CAN is currently leading a multi-organization drug shortage task force aimed at developing data-driven solutions to reduce supply chain vulnerabilities and protect patient access to essential medicines.
