Medicines shortages have huge impact: study

Dr Betty Chaar

Medicines shortages in community pharmacy are having a huge impact on pharmacists and patients, potentially driving patients to seek their medicine overseas, according to a new study presented as a poster session at the National Medicines Symposium 2016.

The University of Sydney’s Dr Betty Chaar participated in the 2013 Toronto FIP summit which led to the establishment of the TGA’s medicines shortages website; she says that upon noticing that most of the talk about medicines shortages concerned the hospital setting, she was keen to investigate how shortages affect community pharmacy.

“We never came across them before, but sometimes we read about them now – and yesterday we’ve seen that Metformin XR is in shortage,” Dr Chaar told the AJP. “So I thought it was worthy of investigation.

“By the tenth interview we got the clear message that pharmacies in the community setting are experiencing shortages that are affecting their workload, affecting patient satisfaction, and pharmacists are struggling.

“They’re struggling around collaboration with doctors, they’re wanting more collaboration, and perhaps urging someone out there to please notify the doctors that this medicine they’re prescribing isn’t around!”

Dr Chaar says she has three key recommendations arising from the study.

“The TGA should promote the website better,” she says. “They should notify doctors clearly that there is a shortage, please don’t prescribe, and try to help out with how we can mitigate the impact.”

Pharmacists have not been adequately informed about the website, she says: one pharmacist interviewed only heard about it from an intern, and another from a patient.

Medicines shortages have a significant impact on patients, she says.

“We’re going to have a shortage of Metformin XR now, and that’s major. That’s going to have a huge impact because it’s extended release: are we going to have the same compliance with the ordinary release?

“It’s difficult, and patients are paying a price because they’re the ham in the sandwich. They don’t want to argue with pharmacists, but some are going to extreme lengths to get their medicine.

“We heard from a pharmacist that one patient went through every single state in Australia to get a box of something, they found one in Queensland and paid for the postage. Antabuse, that was.”

Patients may be driven overseas – including to online pharmacies of dubious authenticity – in the search for their medicines, Dr Chaar warns.

“We don’t know if they end up finding their medicines, but that’s not the way we want it. It’s not a safe alternative. We’re driving our own customers overseas.”

She urged pharmacists to familiarise themselves with the TGA’s medicines shortages website.

“Pharmacists would be better off if they knew about the website and went to it when needed, and in some cases find out the possibility of when the stock might come back in or what to do; some of the companies do give you tips on what to do.”

The study found:

  • Shortages are common and increasing.
  • Multiple causes and impacts on both pharmacists and consumers.
  • Pharmacists devised workarounds, some of which were time-consuming and added heavily to workloads.
  • Lack of familiarity with TGA Website.
  • Suggestions regarding notifications, especially to doctors, were made.

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