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Concerns raised that Indian lockdown could soon add to our medicine supply woes 

Concerns have been raised about the possibility of medicine supply shortages due to a COVID-19 lockdown being implemented in India.

The Indian lockdown, and reliance on sole suppliers has led to a medicine shortage in New
Zealand while Australian manufacturers say they are “working closely with Government” on the issue, according to industry newsletter BioPharmaDisptach.

There are concerns the lockdown is likely to impact on manufacturing and supply.

A significant proportion of Australia’s medicines supply is sourced from India, BioPharmaDispatch said, adding that despite a lockdown exception for medicines, media in India had reported disruptions.

In a joint statement, Medicines Australia and the Generic and Biosimilar Medicines Association said they
are “working closely with Government to actively monitor the temporary restrictions in place to some
APIs and the impact on Australia’s medicines supplies.

At present, there are no immediate or urgent needs – this is being closely reviewed with the TGA. India is currently facing US pressure to lift restrictions for all countries”.

“At the same time, China is ramping up its manufacturing of APIs [active pharmaceutical ingredients].
This is also being closely monitored with Government and how this reactivation will flow into the global
manufacturing chain,” the statement said.

“On a global level, companies are carefully tracking and managing not only the delivery of their
medicines to Australia but also, for those that manufacture, they are working across all the goods
required to continue their manufacturing processes.”

 

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4 Comments

  1. Michael Ortiz
    07/04/2020

    The 21 day Indian lockdown will mean that manufacturing of some active molecules could stop for several weeks. This will result in medicine shortages. It is important that Government monitor drug shortages and that guidelines be developed for therapeutic group substitution by pharmacists.

    More problematic will be shortages of drugs where there is no therapeutic alternative. Using salbutamol inhalers as an example, what are the alternative treatment options and how can patients continue treatment if there are no salbutamol inhalers? Some patients may be able to use terbutaline inhalers, while others can use LABA/steroid combination inhalers. What is the best way to decide what is best for each patient?

    Clear boundaries need to be defined for pharmacists changing patient therapy and how Pharmacists should work with doctors to modify treatment if their drug is not available. Guidelines must be developed now and before shortages become a problem so that patients do not panic if their medication is not available.

    Wholesalers will need to find a way to better allocate medicines in short supply. There are rumours that preference has been given to large franchise groups. What should not happen is for wholesalers to give bigger quantities to the larger pharmacies at the expense of smaller regional and remote pharmacies. Do CSO guidelines need to be suspended?

    • Debbie Rigby
      07/04/2020

      Good comment Michael. Proactive not reactive.

      Re: salbutamol inhalers – I’d like to see a decision algorithm developed (codesigned with NPS MedicineWise, medical & asthma groups) that incorporates evidence of diagnosis (as per TGA rules), assessment of current asthma control (using ACQ), presence of concomitant allergic rhinitis and treatment, and previous Rx for ICS/LABA.

      It’s also an opportunity to advocate for pharmacists to develop asthma action plans and budesonide/formoterol prn for mild asthma as S3.

      • Karalyn Huxhagen
        07/04/2020

        I think NPS needs to be very clear with GPs that this is an opportunity to be reviewing patient management of their supposed airway disease. Many of the people i have been refusing Ventolin sales to and sending them on to GPs have not had their airway disease reviewed since childhood.

        There are so many that Never use a preventer or say ‘mum said I had asthma’ . These people need a thorough overhaul as we have never had such a good stick to make them be reviewed.

        Problem is with GPs in lockdown mode most are just getting a Rx via telehealth without spirometry or exercise tolerance testing.

        Catch 22 time again

        • PeterC
          07/04/2020

          All excellent comments (as you’d expect from these three excellent pharmacy minds)

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