Medicine shortages in Australia: causes, impact and management strategies in the community setting

Abstract

Background Medicine shortages are an ongoing global problem. The Therapeutic Goods Administration (TGA) dedicated a website for monitoring of medicine shortages in Australia in May 2014, as part of the Medicine Shortage Information Initiative. This study aimed to explore the views of pharmacists regarding medicine shortages in the community setting and the impact of the TGA website in Australia. Setting Community pharmacies in New South Wales, Australia. Method Twenty semi-structured interviews were conducted with community pharmacists. Data collected were analysed thematically utilising the framework analysis method. Main outcome measure Qualitative analysis conducted using the framework approach. Results Findings clearly indicated that medicine shortages were experienced on a regular basis, but most participants were unaware of the TGA website. Medicine shortages reportedly impacted both pharmacists and consumers; and various workarounds were undertaken to manage the issue. The "price disclosure policy" was found to be a prominent contributing factor in emerging shortages. Suggestions were made for ways to improve the growing occurrence of shortages. Conclusion Overall, the study found that there was a lack of familiarity with the TGA website, despite experiencing regular shortages of medicines in practice. Also highlighted, was the importance of pharmacists prioritising patient care over business decisions. To reduce prescribing of out-of-stock medicines notifying doctors about shortages was also considered important, to allow for early action to be taken at higher levels of the supply chain. Findings of this study may help direct future policy-making around the world, as medicine shortages is a problem shared by healthcare providers in most countries around the world.

The reasons behind medicine shortages from the perspective of pharmaceutical companies and pharmaceutical wholesalers in Finland

“…They may result in medication errors, inefficiency in medical care, and side effects [7–12, 14]. Furthermore, patients may suffer from delays or may not receive the recommended treatment at all [9–10].…”

“…Furthermore, patients may suffer from delays or may not receive the recommended treatment at all [9–10]. Shortages may also add to the workload of physicians and pharmacists [6, 9–10, 12–14] and increase the cost of medical care [9–11]. …”

Medicine shortages in Fiji: A qualitative exploration of stakeholders’ views

“…Semi-structured interviews were conducted with stakeholders involved in the medication supply chain. A standardised interview-protocol was used, based on available literature and studies objectives, adapted from a similar Australian-based study [19] (S1 File). …”

Editorial: Medicine shortages in Australia - what are we doing about them?

“…shortage after prescribing when they are informed by a community pharmacist or when hospitals receive notification from a wholesaler after placing an order. 2,5 The current system leads to duplication of effort, inconsistency and creates a vicious cycle of local stockpiling leading to shortages of therapeutic alternatives within the wider health system and potential inequity of access to critical drugs across Australia. 2,4 The lack of inclusive, robust and timely information prevents effective system-wide strategies from being put in place.…”

“…The strategies adopted to date have focused on anticipating, identifying and managing shortages. 2,5 Strategies to extend existing supplies have included minimising waste and prioritising patient need in addition to providing a different formulation or a therapeutic alternative. This is in some respects a form of local rationing.…”