Asthma medication shortages reported as Victorians bunker down

Doug Hendrie

10/07/2020 3:55:05 PM

Stockpiling and wholesaler restrictions are leading to localised shortages, forcing patients to go hunting for the vital medications.

medication in a shopping trolley
Patients are finding it hard to get hold of asthma medication in Victoria, GPs say.

newsGP understands some Victorian wholesalers are experiencing temporary shortages of salbutamol (sold as Asmol and Ventolin), though there is no shortage of supply at a manufacturer level.
Head of communications for GlaxoSmithKline Australia Kristin MacLaren told newsGP supplies of salbutamol are being prioritised for hospital pharmacies.
‘Unprecedented and unpredictable high consumer demand for Ventolin inhalers across Australia in March and April is still impacting availability in some areas of the country at a pharmacy level,’ she said.
‘We now have good stock levels of Ventolin inhalers but we still have allocation procedures in place with our pharmacy wholesalers to make sure supplies are distributed to where they are needed.’
A pharmacist in the inner-city Melbourne suburb of Richmond told newsGP there are issues with wholesalers restricting supply of asthma inhalers.
But a pharmacist at a large discount chemist in the same suburb said they have seen no shortages of either Ventolin or Asmol since April. 
Richmond GP Dr Cathy Andronis told newsGP the shortages are the largest she’s seen, though different medications and pharmacies are being affected each week.
‘It’s so widespread. I’ve had patients who had to ring three chemists just to get Ventolin. It’s causing havoc for a lot of patients at the moment,’ she said.
‘It’s become common since the pandemic started.
‘At the moment, people all over the world are stockpiling medications. For anyone on a less common medication, it’s a bit like the toilet paper issue – they get worried they’ll run out, which means they do run out. It’s a self-fulfilling prophecy.
‘People hear about shortages so their reflex action is to go and fill up all scripts as soon as they can. That exacerbates the problem.’
Dr Andronis’ patients have also reported difficulty obtaining common blood pressure medications such as diltiazem.
GP and Melbourne University senior lecturer Dr Caroline Johnson told newsGP she has also had patients ring up in panic, unable to get the specific medication they require.
But she has not seen any insurmountable issues, only localised shortages she attributes to panic buying.
‘People might want a little bit more security, as it contributes to anxiety, not being able to get your medications,’ she said.
‘We can reassure patients that pharmacies are unlikely to run out and say that panic buying could actually make the problem worse, rather than more manageable.’  
The issue of localised shortages is not confined to Victoria, with Adelaide GP Dr Kerry Hancock reporting sporadic shortages of contraceptives such as ethinylestradiol and norethisterone (sold as Brevinor) and antihypertensives.
A Therapeutic Goods Administration (TGA) spokesperson said the demand for medications has increased markedly during the COVID-19 pandemic, particularly in early March.
‘This resulted in pharmacies and wholesalers temporarily reporting some product lines as “out of stock”. In most cases these are not national shortages but rather temporary, local-level stock outs which resolve when the supply chain “catches up”,’ the spokesperson said.
‘Patients should always contact their healthcare professional if they have any concerns regarding the supply of their medicines. In most situations, healthcare professionals will be able to recommend an alternative brand of the same medicine, or another medicine that could be used as a substitute.’
newsGP contacted wholesalers Sigma Pharmaceuticals and Barrett Distributors for comment, but they did not respond prior to publication.
Supplies dry up for Nardil patients
Meanwhile, patients relying on the antidepressant phenelzine sulfate (sold as Nardil) have been left scrambling after the supplier told the TGA they could ‘no longer supply this medication in Australia due to global issues with the manufacture of the active pharmaceutical ingredient’.
The news came as a blow to long-term users of the medication, with some even reportedly flying to the coronavirus-stricken US to secure supplies.  
In a joint statement, the TGA, Royal Australian and New Zealand College of Psychiatrists and the Society of Hospital Pharmacists of Australia called on patients to see their doctor as soon as possible.
‘Importantly, a number of patients will have used phenelzine for many years, often with a resolution of symptoms no other anti-depressant has achieved,’ the statement reads.
‘There will be considerable anxiety and distress in this community about this discontinuation. GPs are advised to consult with a psychiatrist regarding treatment options and transition.
‘Ideally, a patient on phenelzine should be reviewed by a psychiatrist.’
Dr Andronis, who is the Chair of the RACGP Specific Interests Psychological Medicine network, said Nardil is a relatively uncommon second line medication, but of real importance to its users. 
‘For someone to be on Nardil, it’s usually because they haven’t responded to other medications. This means they could be left with alternatives that are inadequate or not suitable,’ she said.
‘[Losing access] can be really disappointing, especially when people with a long history of poorly controlled anxiety and depression find something that works.
‘If you’re an anxious person in the COVID world, there is already lots of uncertainty and unpredictability, so losing your ability to go to the chemist and get the medication that works for you is quite a blow. It can even cause a relapse if there aren’t many alternatives.’
Dr Andronis said anyone affected should return to their regular GP as soon as possible.
‘It may be a good opportunity to have your mental health reassessed and medication reassessed,’ she said.
‘This is not always a bad thing – it can get people out of their comfort zone and potentially into something better.’
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Dr Kathryn Anne Kirkpatrick   11/07/2020 8:16:28 AM

I believe it is HUNKER not bunker.

Dr Maureen Anne Howard   12/07/2020 5:01:03 PM

yes I agree with hunker down

Dr Maureen Anne Howard   12/07/2020 5:02:30 PM

It's just like people saying 'chomping' at the bit when the correct expression is 'champing' at the bit.