Critical medicine shortages are a pressing issue, especially for pharmacies in rural and remote areas, and locating the nearest available source can be an added challenge. 

There are currently 419 medicines on the short-supply list according to the Therapeutic Goods Administration (TGA), including blood pressure, diabetes, and HIV medication. 

A medicine shortage occurs any time pharmacies are unable to meet the customers' needs in terms of supplying their prescriptions and the problem is not disappearing any time soon.

The University of South Australia recently revealed that more than 90% of pharmacists have reported frequent delays in patient treatment due to low stock.

Their survey results paints a concerning picture: medicine shortages are increasing patient stress as well as pharmacists’ workloads, with 89.5% of pharmacists being forced to source medicines from non-regular wholesalers at least weekly.

Now, the Australian Medical Association (AMA) is calling for a dedicated medicine shortage forum to improve co-ordination and communication by giving pharmacies and patients a comprehensive overview of what medications are available and where.

“The Therapeutic Goods Association does a good job of managing medicine shortages and discontinuations, which we know can be very unpredictable, but there is room for improvement, and the TGA has recognised this,” AMA President Dr Danielle McMullen said.  

The TGA has a publicly available medicine shortage database. The AMA is hoping for an expansion of the current system that would help point patients in the direction of the right pharmacy. 

“One issue that persists is the challenge of timely, accurate, and consistent communication regarding medicine shortages," Dr McMullen said.

"These shortages affect so many people in our community, including doctors, pharmacists, and crucially, patients.”

Patients often have to hope there is an alternative solution available to them.

"Patients can contact the doctor asking them to prescribe an alternative medicine, approach different wholesalers other than their regular suppliers, or refer the patient to a different pharmacy, hoping they can help them. It’s not an ideal situation," University of South Australia pharmacy lecturer Dr Jack Janetzki said. 

"In rural areas, it can be even harder because there might be delivery delays."

Nonetheless, medicine shortages can affect all pharmacies including in bigger centres such as Dubbo and across the city of Sydney. 

One patient in Coonamble reported having to call pharmacies in other towns along the commonly travelled routes from Orange and Armidale to Coonamble in the hope that they would have something in stock to 'tide her over'.

"This was a commonly-used treatment for menopause, not some rare drug, so you can imagine how many women in the west are in the same boat," she said. "I eventually found it in the third pharmacy I called in Armidale, after trying every town closer, and they only had one packet left in stock.

"On another occasion I had to go back to my doctor three times to get scripts for possible alternatives that might be in stock somewhere in the region.

"I worry for the people who can't get to a doctor in that way or who need a more urgent prescription for something that could seriously affect their health straight away."

Lecturer of Pharmacy and Pharmacology Dr Jack Janetzki. Photo: University of South Australia

Medicine shortages can often not be predicted and change continuously, Gulargambone pharmacy owner Kris Chaudry said. 

"It can happen at different times with different medications," Mr Chaudry said. 

The problem can start with getting medications into Australia which imports 90 percent of medications. 

"Bigger countries like America, the UK, and some Asian countries have bigger markets, so the companies pay more attention to them," Mr Chaudry said. 

Currently, the pharmacy owner said he is struggling to source medication such as Timolol, an eye-drop medication for which there are few suitable alternatives. 

Ozempic, used to treat type 2 diabetes, is another drug of which there is a global shortage due to its reputation as a weight loss medication. 

Increases in diagnosis of Attention Deficit Hyperactive Disorder (ADHD) has also contributed to shortages of medicines used to treat ADHD.

Raw materials to make medications are also in short supply, exacerbated by manufacturing and transportation issues.

Mr Chaudry said he has noticed an increase in medicine shortages since the introduction of the 60-day prescription, allowing people to get twice the medication on a single prescription. 

Medicine shortages in small country towns are further exacerbated by the fact that pharmaceutical distributors prioritise big companies that can buy in bulk. 

The AMA suggested a traffic light system that indicates how much stock a pharmacy has left of a medication. 

 For example, a “yellow light” could indicate to practitioners to continue current patients on a particular product, but not prescribe any new patients.

"That would certainly be useful in terms of pointing patients in the right direction," Dr Janetzki said.

“Maintaining an inventory of medicines across all pharmacies would minimise impacts on customers because staff could quickly identify where medicines are available rather than having to call neighbouring pharmacies to determine whether they have medicines on hand."

The TGA is also looking at how and when international drug companies are required to notify Australia of when drugs are expected to be discontinued or in short supply.