By Nial Wheate, Associate Professor of the Sydney Pharmacy School, University of Sydney
and Elise Schubert, Pharmacist and PhD Candidate, University of Sydney First published in The Conversation You’ve just come from your monthly GP appointment with a new script for your ongoing medical condition. But your local pharmacy is out of stock of your usual medicine. Your condition is serious, and without it, your health is likely to suffer. What can you do?
While medicine shortages happen from time to time, researchers and the media report COVID-19 is causing more shortages than normal for many life-saving medicines. In Australia, media reports indicate this includes some medications used to treat hyperthyroidism, high blood pressure, or allergies.
Unfortunately, you’ll only likely find out if this applies to you when you reach the pharmacy. If that happens, there are a few ways you may be able to obtain your prescription.
But if the stock shortage will last for an extended period of time, and you cannot find a supply, your doctor may need to consider prescribing a different medication.
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There’s not always enough medicine to go round. And shortages can affect a patient’s health. Why are there shortages?
Unfortunately, medicine shortages are an all too common problem of the modern health-care system. When our medicines come from a global supply chain — where raw ingredients are made in one country, processed into medicines in another, then freighted by sea or air to Australia — a single break in the supply chain can result in medicines going out of stock.
So there have been calls for Australia to set up its own medicines manufacturing base. But even if we do, that doesn’t help now during COVID.
Medicines shortages is a growing issue globally. That’s because of increasing demand, higher quality standards and fewer manufacturing sites.
Shortages have also been exacerbated in 2020 due to COVID-19. When workers are locked out of the factory because of a local outbreak, medicines don’t get made. And when we restrict the number of flights into Australia, that prevents medicines from arriving.
When a manufacturer knows there is likely to be a medicine shortage, for any reason, they are required to inform the Australian Therapeutic Goods Administration (TGA) so pharmacies can make other arrangements, such as stocking up on alternatives or sourcing supply from other companies.
When the medicine shortage is considered to have a critical patient impact, or if it is in the interest of the public to know about the shortage, then the information is added to the TGA’s shortages website, which the public can search.
But this information is only useful at the government and wholesaler level; local GPs and community pharmacists don’t have the time to check the site every day.
Dealing with shortages efficiently is important because their impacts are wide ranging. Shortages result in higher costs to patients when they have to buy branded rather than generic formulations; more drug errors due to the different strengths and brands dispensed; more side-effects and higher death rates because of changes to less appropriate medicines; and more complaints from patients.
What if your local pharmacy is out of stock?
It is best to speak to your pharmacist about your options when your medication is out of stock. There may be other brands still available and appropriate to swap. Alternatively, your pharmacist could dispense a different strength of the same medication. Regulations brought in during the pandemic have allowed pharmacists to do this to help with medicine supply.
If there are no appropriate substitutes, in rare instances a local compounding pharmacy can manufacture certain products in store.
If none of your local pharmacies stock your medicine, your next option is for an Australian online pharmacy to fill your script. It may be able to ship your medicine from another city or state.
It is not legal or safe for you personally to order prescription medications from online overseas suppliers. This is because they may not have been manufactured to Australian standards, and may be unsafe. But your pharmacist may do so on your behalf, under a special provision called section 19A.
If all else fails, you may need to contact your doctor about changing to a different medication. There are often many alternatives in the same drug class that work in the same, or very similar, way.