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.
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