From STIs to severe pain: Australia has a medicine shortage 'problem'

Shortages of key medicines are affecting some of Australia's most vulnerable patients, a peak medical body says, including children with neurodevelopmental disorders and those in palliative care.

A man at a chemist prescription counter

The Therapeutic Goods Administration (TGA) currently lists 420 drugs as being in "short supply" Source: AAP / Lukas Coch

Key Points
  • The Royal Australasian College of Physicians has highlighted a growing problem regarding medicine supply in Australia.
  • Experts are calling on the federal government to better manage medicine shortages and do more to prevent them.
  • The Therapeutic Goods Administration lists 420 drugs as in "short supply", including antibiotics and opiates.
Experts are raising the alarm over nationwide medicine shortages, calling for urgent action to address the increasing lack of supply.

Professor Jennifer Martin, president of the Royal Australasian College of Physicians (RACP), said shortages of key medicines were affecting some of the country's most vulnerable patients, including children with neurodevelopmental disorders, palliative care patients and patients with sexually transmitted infections.

"Medicine shortages are becoming more of a problem in Australia, and we need to see a comprehensive strategy from government about how to prevent shortages and how to manage them better when they do occur," Martin said in a statement on Thursday, noting that Australia — a country which imports about 90 per cent of its medicines — is particularly vulnerable to supply chain disruptions.

"Government needs a better strategy to redirect existing critical medicines supplies within the country to priority groups and patients. Current approaches often get very difficult for both patient and physician and need to be fixed, urgently."
Martin described the uneven and inadequate distribution of medicines as "a major national health equity concern", and said that medication shortages and discontinuations were not only putting patients at risk of poorer clinical outcomes, but also fuelling anxiety among those left fearing for their health and quality of life.

"Medicine shortages are impacting patient health right now," she said. "Every day that goes by without a strategy to stop, prevent, and manage medicine shortages, we are leaving patients stranded."

Drugs of concern

The Therapeutic Goods Administration (TGA) currently lists 420 drugs as being in "short supply", 40 of which are facing critical shortages and discontinuations nationwide.

Martin on Thursday pointed to the RACP's March submission to the TGA, in which it highlighted a series of medicines that were experiencing particularly concerning shortfalls — many of them typically prescribed to some of Australia's most vulnerable patient groups.

These included long-acting Ritalin, benzathine penicillin — an antibiotic used to treat upper respiratory tract infections such as diphtheria and syphilis — and a number of opiates used for pain relief.

One of those opiates, Ordine — an oral liquid morphine used to manage severe pain and laboured breathing in oncology and palliative care settings — has been unavailable since February and is not expected to be back in supply until late August.

The TGA said this was due to a pharmaceutical company discontinuing supply, and advised patients to seek out substitute treatments in the interim.

An ongoing issue

While recurrent medicine shortages have long plagued Australia, Dr Danielle McMullen, vice president of the Australian Medical Association and a Brisbane-based GP, told SBS News: "The past few years certainly feel more challenging."

"At the moment it really does impact my ability to treat people with diabetes in particular," she said. "I can't get Ozempic to treat their diabetes, or a couple of other similar medications that really would help improve their health and their quality of life."

McMullen explained that she will always check a medicine's supply with the TGA before prescribing it to patients, to avoid sending them on "a bit of a goose chase for medicine".

She also noted that the TGA has implemented changes to try and make it easier to check what medicines are in short supply.

"But it's still a challenge on the ground," she said.
While some of the factors fuelling medicine shortages — such as manufacturers' business decisions — are beyond the control of Australian stakeholders, experts are urging authorities and government bodies to do more.

Part of the problem is the fact that Australia, according to the Royal Australian College of General Practitioners, is "dangerously dependent" on imported medicines.

Because the cost of locally produced medication struggles to compete with medication manufactured offshore, Australia imports about 90 per cent of its medicines from China and India.

This over-reliance has led to issues before. In 2023, Australia faced a national shortage of its most commonly prescribed antibiotics — amoxicillin, cefalexin and metronidazole — due to disruptions in the global supply chain.

Amid that shortage, experts and industry leaders called on the federal government to invest in the development of a domestic manufacturing industry as a long-term solution.

While stating that AMA is supportive of moves to increase domestic manufacturing of medicines, McMullen explained that this alone is unlikely to completely solve the problem.

"It's probably unfeasible to manufacture every medicine onshore here," she said. "So we do need some more onshore solutions but also looking at refinements of other TGA processes around shortages, and how do we quickly get alternatives available or information to prescribers and pharmacies about how they can access alternatives so that we're not interrupting supply unnecessarily."
Every day that goes by without a strategy to stop, prevent, and manage medicine shortages, we are leaving patients stranded.
Professor Jennifer Martin
The RACP is calling for similar changes.

In a statement published on Thursday, it called for "a list of critical, life-sustaining medications in Australia to be developed and minimum stock levels maintained for potential national public health crises", and for the "local production of medications to be stimulated and incentivised".

It also highlighted the need for "international suppliers of medicines critical to the health of Australians to be encouraged to enter and remain within the Australian market through TGA-driven incentives", and called on medication manufacturers to advise the TGA of a shortage or discontinuation well in advance.

"This is a major vulnerability in our healthcare system," Martin said, "and it must be addressed with urgency".

SBS News approached Australia's Minister for Health and Aged Care for comment, but did not receive a response before publication.

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6 min read
Published 24 May 2024 5:38am
By Gavin Butler
Source: SBS News



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