Two of every three dollars leaving are medicine

In 2025, 42,260 million dollars of pharmaceutical products left Puerto Rico: 67.69% of everything the island exported. Medical devices added 5,674 million and food 3,324.

An export economy concentrated like that reads two ways and both are true. It is an enviable position, because these are products of enormous value per kilo and whoever makes them does not move easily. And it is an enormous exposure, because the decisions that move that figure are taken in corporate boardrooms and tax policy committees, not on the island.

The contrast with what gets eaten is the interesting part. The island exports two thirds in medicine and imports nine tenths of its food. They are two flows passing through the same docks in opposite directions, and only one of them comes up when somebody talks about the economy.