Call to empower pharmacists to help improve medicine supply through therapeutic substitutions and continued dispensing
Supply issues raised by the international COVID-19 pandemic were top of the agenda at the annual State of the Industry panel at APP2021.
All speakers on the panel – representing the Pharmacy Guild, Medicines Australia, Generic Biosimilar Medicines Association (GBMA), Consumer Healthcare Products Australia (CHP) and the National Pharmaceutical Services Association (NPSA) – emphasised the collaborative way the industry had come together in the face of the pandemic to mitigate shortages enforced by overseas supply chain difficulties.
However, Guild national president Trent Twomey said steps also needed to be undertaken to allow pharmacists to use their full scope of practice in dealing with supply difficulties.
“There are things we can do, but we need a coordinated approach with all the bodies we have on stage,” he said.
“A combination of reinvesting in domestic manufacturing so we’re not reliant on imports, having critical medicines stockpiles.
“But it’s also about our scope of practice. Continued dispensing is a very real solution that we can have to ensure someone doesn’t have to run out because they don’t have another piece of paper,” Mr Twomey said.
“Therapeutic substitution: while John Skerritt (TGA chair) is not an advocate of therapeutic substitution by pharmacists in Australia, it is something that is completely within our scope of practice. It is performed safely within hospital settings and could be performed safely within the current regulatory and professional environment that is community pharmacy.
“If someone runs out of something we should be able to substitute within the therapeutic class without having to ask for a prescription. It is safe, it is being done in other countries.”
Mr Twomey also took issue with the process through which the TGA currently calculates and rates medicine shortages.
“There are far more medicine outages than are revealed in the TGA reporting. The thing that frustrates me about the TGA medicine shortage process is that a medicine must be nationally out before they consider it to be an outage,” he said.
“That’s just rubbish in such a large, geographically diverse country. Something may be out of stock in regional Australia or in Western Australia before its out of stock in Canberra and the TGA realises it.
“The system is not working, and too much of the burden in ensuring that the number one preventable hospital presentation when it comes to medicines – ‘the patient ran out of their medicine’ – is placed on us at the end of the supply chain.”