Drug shortage puts Aussies at risk

The Royal Australasian College of Physicians (RACP) has called for change amid a major prescription drug shortage. The Therapeutic Goods Administration (TGA) lists 420 drugs as being in short supply, and the Royal Australasian College of Physicians (RACP) says this is a growing problem.

RACP president Professor Jennifer Martin said the drug shortage affected many Australians, including some of the most vulnerable, such aschildren with neurodevelopmental disorders, palliative care patients and those with sexually transmitted infections.

“Medicine shortages are becoming more of a problem in Australia,” Prof. Martin said in a statement last week. “We need to see a comprehensive strategy from government about how to prevent shortages and how to manage them better when they do occur.”

Individual Aussies affected by the drug shortage

As someone who has ADHD, I was some years ago prescribed a drug by my psychiatrist to manage the condition. The drug, dexamphetamine, worked quite well but a year or so ago he suggested another drug might be better still. 

The alternative drug, Vyvanse, works as a slower-release medication. I gave it a go and, while I wasn’t convinced it was better, decided to stick with it for a while. But I hit a hurdle when I went to refill my prescription. My local pharmacist was out of Vyvanse.

Before long, I discovered most pharmacists were similarly devoid of stock. And that my problem was one familiar to many Australians looking to fill their prescriptions, not just of Vyvanse. I discovered it was one of many medications affected by a countrywide drug shortage.

After another chat with my psychiatrist, we agreed that dexamphetamine might work better for me in any case. So I switched back and the dexamphetamine continues to work well. 

That makes me one of the lucky ones. What becomes of those who have no alternative to their prescribed drug? And why have so many medications been caught up in this drug shortage?

The reasons behind Australia’s drug shortage

Part of the problem Australian patients are facing is that the vast majority of our prescription drugs are manufactured overseas. About 90 per cent of them, in fact. This makes them immediately vulnerable to supply chain disruptions.

But there are other factors, too. Production of some drugs has slowed – even been discontinued permanently – as part of a manufacturer’s business decisions. I have also experienced the effects of one of these decisions. Glaucoma prevention eye drops I was using were discontinued. Again, I was fortunate, as a suitable alternative was available.

A drug shortage problem caused – or at least influenced – by business decisions is far from ideal. And such decisions can adversely affect a vulnerable minority. One such minority is pregnant women. The RACGP recently reported pregnant women missing out on essential medications because of a “near total lack of trial data”.

The Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) made its thoughts on the matter clear recently. “The systemic failure to include pregnant women in therapeutic clinical trials … has resulted in a dearth of newer, potentially more effective agents for common conditions in pregnancy,” it said in a statement earlier this month.

Sometimes the cause of a drug shortage can come from left field. One such example has been very much in the news lately – Ozempic. Originally developed as a treatment for diabetes, Ozempic is now known to assist many with weight loss, too. With no shortage of Australians looking to lose kilograms, Ozempic is now also on the lengthy drug shortage list.

Solutions

One seemingly obvious solution would be to have the affected drugs manufactured locally. Both the RACP and the Australian Medical Association (AMA) have called for this, but it is easier said than done. 

The two organisations acknowledge this. AMA vice-president Dr Danielle McMullen said: “It’s probably unfeasible to manufacture every medicine onshore here.” But it should not be impossible to locally produce at least some of the medications affected by the drug shortage.

To that end, the RACP last week called for the “local production of medications to be stimulated and incentivised”.

In the meantime, Dr McMullen said there was a need to refine “other TGA processes around shortages”. This was echoed by the RACP, which said a list of critical, life-sustaining medications in Australia needed to be developed. It also called for minimum stock levels to be maintained for potential national public health crises.

With such a long list, an individual level of proactivity might also be a good idea. If you are taking prescription medication, raising the subject on your next GP visit could be useful. Ask your GP about any potential shortages, and also possible alternatives.

Have you been affected by a drug shortage? Were you able to find an alternative? Let us know via the comments section below.

Also read: Next generation weight-loss drugs a game changer

Disclaimer: This article contains general information about health issues and is not advice. For health advice, consult your medical practitioner.