Australia ‘vulnerable’ to meds shortages

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The number of drug shortages in Australia rose by 300% when the COVID-19 pandemic hit, but what was the real cause? Two pharmacists analysed the data

Australia’s medicines supply was seriously impacted by the COVID-19 pandemic, but it was not unduly impacted by shortages in the US, according to new research.

In response to suggestions that Australia is heavily reliant on the US as its primary source of medicines, pharmacy researchers Eliza Cameron and Mary-Jessimine Bushell from the University of Canberra analysed drug shortages reported in both countries in 2019 and 2020.

They found that in 2019, prior to the COVID-19 pandemic, only 4% of US drug shortages were reported in Australia. This rose to 7% in 2020.

The 2020 corresponding shortages predominantly consisted of cardiovascular drugs; anaesthetic, sedative, or nerve agents; corticosteroids; neuropsychiatric drugs; analgesics and anti-inflammatories; gastro-intestinal or anti-emetic agents; and antibiotics.

“These figures demonstrate a weak correlation between the quantity and nature of drug shortages in the US and Australia. However, threats to supply chain integrity as a result of COVID-19 was the likely impetus for the stronger correlation in 2020,” wrote the pharmacist authors in Research in Social and Administrative Pharmacy.

Between 2019 and 2020, the number of US drug shortages increased by 37% while the number of Australian drug shortages increased by 300%.

The number of drug shortages in the US declined by 5% and 4% between the last quarters of 2019 and going into the first quarter of 2020, respectively, before slowly increasing by 3% and 4% in the second and third quarters of 2020.

Meanwhile Australia’s drug shortages showed a more “dramatic” escalation, increasing by 10%, 25% and 55% between each quarter of 2019 respectively, said the authors.

The number of drug shortages in Australia increased by 50%, 66% and 61% between each quarter from the end of 2019 to the third quarter of 2020, respectively.

According to the TGA, Australia accounts for only 2% of the global pharmaceutical market and imports over 90% of its medicines, making Australia “particularly vulnerable to medicine shortages arising from factors outside our control”.

“The results of this study indicate that the Australian pharmaceuticals market is indeed more vulnerable to drug shortages, particularly in the event of a global pandemic such as COVID-19,” said the authors.

“However, these shortages are not exclusively influenced by the US drug market.”

They suggested more direct impacts from trading partners such as India, China, Germany and Switzerland.

“Further investigation … is required to determine the exact determinants of Australia’s market fragility and how policy may be utilised to help secure its drug supply in the future,” they concluded.

A recent report by the Productivity Commission, covered by the AJP here, found that Australia imports most of its pharmaceutical goods from Europe and the United States, who rely increasingly on Active Pharmaceutical Ingredients (APIs) manufactured in India and China.

With China producing 40% of APIs globally and India supplying 20% of global exports of generic medicines, early in the pandemic “disruptions to Indian and Chinese production of APIs led to concerns of shortages in Australia”, it said.

However Medicines Australia contended that despite these concerns, the Australian pharmaceutical supply chain was “strong and stood up well to the challenges posed by the COVID-19 pandemic”.

The Therapeutic Goods Administration also worked with industry through the Medicine Shortages Working Party to manage medicine shortages. Concerns about supply were resolved when Chinese manufacturing recovered quickly and India removed export bans, the report found.

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