A compulsory reporting system for medicines is vital, say politicians, citing PSA and patient frustration with the existing system
Tony Zappia, member for Makin and the Shadow Assistant Minister for Medicare, told the House of Representatives this week that the current system, “which is basically a voluntary reporting system, has proved to be unsatisfactory”.
Mr Zappia quoted the PSA’s submission to the consultation on a mandatory scheme, which said that “despite the launch in 2014 of the Medicine Shortages Information Initiative (MSII) to assist with information on prescription medicine shortages, generally pharmacists have not found it to be the most helpful resource in terms of the currency and timeliness of information”.
“It has not adequately supported professional practice for pharmacists who have a core role in assisting with continuity of therapy and care for patients,” the PSA said.
“Repeatedly pharmacists have reported of a mismatch between information made available through the MSII and the actual medicine stock availability situation they have encountered through wholesalers.”
Mr Zappia quoted the PSA’s concerns regarding:
- Medicines that were indicated as “out of stock” on wholesaler portals, but which were not on the MSII list;
- The fact that updating the MSII seemed to happen infrequently; and
- That the expected supply date on the MSII was often inaccurate and did not reflect expected stock availability dates indicated by wholesalers.
The PSA said that timely information about availability was critical for pharmacists, as was understanding why any shortages were occurring.
The situation is exacerbated when pharmacists cannot advise their patients when they can expect stock or steps that could be taken to source alternative medicines, said the PSA.
Accurate, timely communication with prescribers was vital, it added.
“That sums up why we need to have a compulsory reporting system in place,” Mr Zappia told the House.
“As the Pharmaceutical Society quite rightly point out, information about medicine availability is critical and medicine shortages can be very stressful to patients.”
He warned that with increased globalisation and overseas manufacturing of pharmaceuticals, it is likely that such shortages – including situations where a number of brands are all made in one facility and go into shortage at the same time – were likely to occur more often in the future.
“It is obvious that knowing as soon as possible about medicine shortages or discontinuations of supply will enable patients, health professionals and public health authorities to source alternatives earlier or at least better plan for and manage the shortage,” he said.
“For all of these reasons, and given that the voluntary scheme is unsatisfactory, a mandatory scheme is considered necessary.”
Member for Macarthur and paediatrician Dr Mike Freelander also spoke on the issue, outlining frustrating situations for patients and their parents.
“Up until fairly recently, in spite of there being some legislation involving medicine shortages, it’s been very difficult to deal with,” he said.
“As an example, as a practitioner, I’m not infrequently required to ring the PBS Authority’s hotline to request a phone approval for the use of a medication. The classic one has been methylphenidate, or Ritalin, and its derivatives, for use in children with ADD.
“I’ve been required to ring the hotline to get an authority number. You often have to wait on the phone a considerable period of time, sometimes 15 to 20 minutes, to get that authority number.
“So I’ve done that and got the authority number for the patient that I’m seeing, only for the patient to come back 20 or 30 minutes later to say that the medication has not been available from the pharmacy, and we would then have to go through the procedure again to get an alternative medication which, as you can imagine, is extraordinarily frustrating and time wasting for myself, the patient and the pharmacist.
“This has happened time and time again.”
A particular example was the shortage of Ritalin LA over the last couple of years, he said.
“We’re usually given very little notice by the pharmaceutical companies that this is the case.
“In fact, sometimes, the first time that we know that there’s a shortage of medication is when the patient returns from the pharmacist or the pharmacist rings and says, ‘I’ve not been able to get this medication anywhere’.
“This legislation will require better notification of medication shortages, and it will also enact significant penalties for the pharmaceutical companies themselves for not informing the government and, secondarily, medical practitioners and pharmacies about the medication shortages.”