Medicine shortages are having a marked impact on pharmacies with more than 90 per cent reporting frequent delays in patient treatment due to low stock. There are currently 428 ongoing medication shortages 36 of which are critical for conditions including diabetes, ADHD and menopause.
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00:00It can be really distressing for patients who are unable to access their medicines.
00:06Just recently, in the last few days, I've worked in the pharmacy and, you know, it's
00:11quite often that you're having to say to people, I can't supply your medicine, I can try and
00:15contact your doctor or another pharmacist to get you your access to your medicines or
00:20an alternative.
00:21But yeah, it's definitely quite challenging out there.
00:25So why are medicine shortages so bad?
00:28So currently, Australia is in a unique position where 90% of our medicines come from overseas.
00:35And because of that, we're sort of at the mercy, I guess, of the overseas marketing
00:39and getting medicines into Australia can be quite challenging, especially when, you know,
00:44perhaps there's a natural disaster or maybe there's some manufacturing issues.
00:49That's what contributes to the shortages here most of the time, but also demand as well.
00:54We've seen an increasing demand of some types of medicines, which has led to significant
00:58shortages here.
00:59Like what?
01:00Which medicines are those?
01:01So some medicines for weight loss and also some medicines for attention deficit hyperactive
01:07disorder or ADHD.
01:09So these shortages have been going on for a while?
01:12Yeah, so some medicine shortages have been going on, I guess, since the beginning of
01:16COVID or even beforehand.
01:18At the moment in Australia, menopause medicines, particularly with patches, are quite hard
01:23to get for hormonal treatment of menopause.
01:26And that's been going on for at least two years now.
01:29And the same story for some of the weight loss medicines as well.
01:33You spoke about your experiences.
01:34How often can you offer an alternative to people if you don't have the prescribed drug
01:39in stock?
01:40Yeah, it really depends on what we have and what's currently coming through from the wholesalers.
01:46Most of the time, we can try and source something or an alternative for the patient.
01:51But it really depends on, I guess, which wholesalers we have access to.
01:55And also the different, I guess, regulatory approvals in place at the time, because we
02:01need special approval from the TGA if we're going to swap a dosage form of a medicine,
02:06say, a tablet to a capsule or the different strengths of the medicines as well.
02:11Are pharmacists also able to direct people to other outlets which do have particular
02:16drugs?
02:17Is there a central database that lists the drug stock of other pharmacies?
02:21At the moment, there is no central database.
02:24There is the medicines shortages database, which tells us which medicines are out of
02:28stock nationally and which brands they are.
02:31However, I probably would advocate for some sort of centralised database which doctors
02:36and pharmacists could access to see who nearby actually has stock.
02:40That would be very beneficial.
02:42And how often can you offer an alternative to people if you don't have the prescribed
02:46drug in stock?
02:48Yeah, so most of the time, we try and keep a number of brands in stock where possible.
02:52But as I said, it really depends on how many brands are on the market in Australia.
02:57Yeah, that's probably one of the main things that is a factor, is which
03:02brands we have in stock and how many are listed on the PBS as well.
03:07And are pharmacists told when national supply of a drug is running low so that they can
03:12prepare, you know, as much as you can?
03:15Yeah, we can sign up to the alerts from the medicine shortage database.
03:19So we are told about when they're coming.
03:21But obviously, we can't predict every shortage and neither can the medicine regulators
03:25either. So, you know, from time to time, there are instances where we just can't get
03:30ahead of the situation and, you know, ensure that we have enough
03:36stock before, you know, the patients are affected.
03:40Right. And as a pharmacist, Jack, do you have to ration supply, perhaps not fill out a
03:45full script, but give people enough so that they're not completely without the drug that
03:49they need?
03:51From time to time, that has been something that some pharmacists and some pharmacies
03:55have implemented in the past year.
03:58So that that has happened in consultation with the patient and their doctor where it's
04:02needed to happen. But where possible, we try and get them their full supply as soon as
04:07we can.
04:07Yeah. And can some of these short supply drugs be made locally here in Australia?
04:13So sometimes they can be made by compounding pharmacies.
04:16But again, that comes with an additional cost because that item would no longer be covered
04:20by the government. It would be what we call a private supply.
04:25I guess manufacturing medicines on a larger scale here in Australia comes with a
04:29cost sort of onward effect there that, you know, is maybe not
04:35as justifiable as, you know, making medicines in mass production overseas
04:39and importing them into Australia.
04:42So nationally, Jack, what's being done to address these drug shortages?
04:47Yes, so just in the last few days, the Australian Medicines Association or the AMA
04:52and the Pharmacy Guild have put forward a submission to the TGA to
04:57reinstate the Medicine Shortage Working Group, which was disbanded, I think, in
05:012021. And so hopefully that would be able to provide some more high level, I guess,
05:06information and strategies for helping to deal with medicine shortages in Australia.
05:11Isn't there, though, a national stockpile of drugs for use in health emergencies?
05:15Has that been dipped into?
05:18Yeah, so there is a national stockpile, but that's more for critical medicines.
05:22So potentially antibiotics and life-saving medicines as well.
05:26So not every medicine is on the national stockpile, unfortunately.