Pandemic challenging Australia’s medication supply chains

Morgan Liotta

20/01/2021 3:33:22 PM

COVID-19 has severely impacted global medicine supply chains, presenting the potential for ‘real patient harm’.

Pharmacy shelves with shopping basket
Australia imports around 90% of its medicines from overseas – and there are concerns it is too reliant on global supply chains.

The ongoing shortage of medications resulting from the pandemic continues to present issues to prescribers and patients alike.
Recognising the critical role healthcare professionals play in mediating the effects of medicine shortages on patients, the Therapeutic Goods Administration (TGA) provides interim solutions such as access schemes, and advises patients to discuss with their doctor or pharmacist about possible substitute medicines.
But some prescribers are wary.
Dr Michael Tam, GP, Conjoint Senior Lecturer in the School of Population Health at UNSW Sydney, and RACGP Expert Committee – Quality Care member, warned of potential substitutes. 
‘There are not always good choices of substitute medications,’ he told newsGP.
‘Short-term changes risk real patient harms, which could be from more minor issues like mild medication side-effects, to more serious ones such as poor control of the disease.
‘Medication shortages are problematic and disruptive to chronic disease care.’
Australia imports around 90% of its medicines from China and India, as locally produced medication struggles to compete with offshore manufacturing on costs, prompting recent concerns that the country is ‘dangerously dependent’ on imported medicines.
NPS MedicineWise estimates more than nine million Australians take daily prescribed medicines, meaning that prescribers need to more closely manage patients’ health conditions with the current shortage of regular medications.
The TGA underlines that some disruptions cannot be avoided, with the issue of medicine shortages not unique to Australia. Factors contributing to shortages include manufacturing issues, difficulties in procurement, political instability, economic crises, pandemics, and natural disasters.
But the current situation means patients are facing no alternative but to pay extra for essential medication or lower their dose until they can get a prescription filled, with short supply at local pharmacies meaning hiked-up prices on generic brand medications and pharmacists ringing overseas suppliers to source medication.
‘This potentially increases the anxiety and administrative load for GPs, and the patients they care for,’ Dr Tam said.
‘For instance, it wouldn’t be uncommon to contact multiple pharmacies to try to find one that may still have some of the specific medication on their shelves, though, this might just be kicking the can down the road if the medication shortage is sustained.’
The TGA’s current list of critical medicine shortages, among many, includes:

  • the antibiotic gentamicin, used to treat several types of bacterial infections
  • hydralazine hydrochloride, used to treat high blood pressure
  • carbimazole, used to treat hyperthyroidism and thyrotoxicosis
  • levodopa/carbidopa 200 mg/50 mg, for the treatment of Parkinson’s disease and syndrome.
In August last year, The Guardian reported a shortage of antidepressants and contraceptives, while the previous month saw a shortage in essential asthma medications in Victoria, when the state was about to be plunged into a second COVID lockdown.
The TGA said it is likely that steps will need to be taken to prevent and manage critical medication shortages. This may include restrictions on GPs’ prescribing rights, the dispensing rights of pharmacists and/or the purchasing rights of consumers.
Medicine Shortages Working Party, GP and Australian Medical Association Vice-President Dr Chris Moy recently said that the pandemic revealed Australia’s system for monitoring medication shortages is ‘too slow’.
‘They [medications] have been so easy to get [in the past] there hasn’t been this real need sometimes to monitor shortages and also be proactive about obtaining medications,’ he said.
One aim of the Medicine Shortages Working Party is to address this issue by monitoring supply of critical medicines, in order to identify and respond to medicine supply issues as they arise.
Dr Moy also agrees that the pandemic has shown Australia is too reliant on offshore manufacturing of medicines.
‘Over time, what we need to do is really nail down supply sources, but also consider in the future the ability to have the capacity to either manufacture on an ongoing basis, or to be able to manufacture them on relatively short notice if there were supply problems,’ he said.
While he is unable to offer a solution to the issue of medication shortages, Dr Tam observed that more focus is needed on supply chains in general.
‘Interruptions to the supply of commonly used medications have occurred in recent years, even prior to COVID-19,’ he said.  
‘My view is that there really needs to be some investment in the security of our medicines supply chains in Australia.’
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Dr Peter JD Spafford   21/01/2021 12:04:17 PM

This is all the result of the Government doing too much meddling and regulation in private business . Their motto is "buy cheap" and then feebly attempt to say they are concerned about quality. You can seldom have both.