17 March 2020

TGA warns on drug shortages as pharmacists, patients stockpile meds

Drugs Government Patients Pharmacy

Doctors must reassure patients there is no need to buy up medications, the TGA says in a warning over COVID-induced local drug shortages, while rural pharmacists say the whole PBS system may need a “rethink”.

Pharmacists have been over-ordering medications and consumers have been over-buying them, the regulatory body said in an update yesterday, saying stockpiling could leave other patients short of medication.

The over-ordering and buying has already resulted in “some temporary local level out-of-stock situations, which we expect will resolve in the coming week or two”.

This is not the same as a national shortage, it adds.

However, the “large spike in orders from some pharmacies has resulted in other pharmacies not getting the stock they need. This means that consumers may be unable to get the medicines they need”.

“We call on consumers not to purchase more medicines than they need, and we urge health professionals to reassure patients that there is no need to buy more than is necessary.

“Health professionals should also avoid prescribing or dispensing multiple months of supply of prescription medicines to patients where there is no clinical need to do so.

“We call on pharmacists to avoid over ordering medicines, to help ensure that medicines are available to all Australians who need them.”

The Pharmacy Guild of Australia has publicly rebuked the Victorian Chief Medical Officer, Professor Andrew Wilson, for telling people to stockpile a two-month supply of their medications.

The guild’s Victorian president Anthony Tassone, according to 7news.com.au, said officials should consult experts before issuing advice.

“I do ask the Chief Medical Officer of Victoria, before doing any future call-outs to the public around medicines, consult the experts first,” he said.

“Unfortunately today we’ve had panic amongst Victorians. Pharmacists are trying to do the right thing by their own professional obligations and also ensuring there is going to be enough medication in the network to go around.”

Pharmaceutical companies are legally obliged to tell the TGA about any anticipated shortages of prescription and some over-the-counter medicines.

To date it has received no notifications of a shortage due directly to the pandemic.

Drugs that are – for whatever reason – currently unavailable or in limited supply in some or all formulations include the antibiotics phenoxymethylpenicillin, vancomycin and gentamicin; epinephrine; interferon gamma1b; morphine; lidocaine; and the rabies vaccine.

Yesterday the Rural Pharmacy Network Australia issued a statement calling on the agency that administers the Community Service Obligation to investigate the “unprecedented run on wholesale stocks of PBS medicines” since the month began, and blaming “deep-pocketed players” in the pharmacy sector.

TMR reported last week that rural pharmacies were experiencing shortages.

The RPNA said order volumes were “six to seven times normal ‘beginning of month’ volumes and that such quantities cannot be justified on any public health grounds”.

“Our members have reported serious medication shortages including stock unavailability, orders cancelled by wholesalers without explanation and missing deliveries of PBS medicines following unconfirmed but credible reports of some large pharmacy groups placing orders far in excess of reasonable needs.”

The RPNA wants the agency to assess the volume of PBS scripts dispensed against the volume of purchasing. The situation may even require “a complete rethink of how the CSO works”.

“It’s clear that on this occasion, the ‘first-in-best-dressed’ nature of the PBS wholesale distribution system has proved to be a vulnerability that has endangered PBS access in rural and some metropolitan areas,” it says.

The National Pharmaceutical Services Association executive director, Elizabeth Cuming, told Pharmacy Daily today that CSO wholesalers were working to ensure the integrity of the supply chain.

NPSA members were working with suppliers “to replenish stock as it becomes available and has a range of contingency measures in place”, she said.

“[M]easures were put in place last week to limit order quantities and help ensure equitable access to medicines … These measures are under hourly review as the situation evolves.”

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