Medicines survey reveals hospitals ‘short-shelved’, pharmacists in the dark

A snapshot survey of pharmacists across Australian hospitals has revealed shortages are more prevalent than previously thought, are only flagged by pharmaceutical suppliers 15 per cent of the time and negatively affect patient treatment in one third of cases, prompting calls for urgent improvements in medicines supply.

The de-identified results gathered by directors of pharmacy and members of the Society of Hospital Pharmacists of Australia (SHPA) from 280 metropolitan, regional and rural health service facilities revealed stop-gap solutions such as ordering medicines from overseas or using emergency stock were commonplace, and information about current or impending shortages was highly unreliable.

SHPA President Professor Michael Dooley says the results of the Tuesday 4 April survey show the extent of medicines shortages across Australian hospitals is broad – and worsening – and processes for monitoring are struggling to keep up.

‘Hospital pharmacists’ reported 1,577 individual shortages across a wide range of medicine classes, almost 40 per cent being antimicrobial medicines, with anaesthetics, cardiology medicines, endocrinology medicines and chemotherapies rounding out the top five.

‘When we cross-referenced the responses with warnings and alerts available that day through government websites, including the Therapeutics Goods Administration’s Medicine Shortages Information portal, 85 per cent of reported shortages were not listed by their respective companies.

‘There are also worrying signs beyond the data – anecdotally, many pharmacists contacted SHPA saying they wanted to list additional shortages, but ran out of time.’

Professor Dooley says corrective action reported in response to medicines shortages adds time and significant cost to hospital and impacts patient care.

‘Seventy per cent of respondents retrospectively found out about medicine shortages when trying to order stock, prompting them to switch brands or drugs, use emergency stock or procure stock through the TGA’s Special Access Scheme, which increased costs in 93 per cent of cases.

‘Just over 32 per cent of shortages were reported to have a direct impact on patient care through swapping in a less effective medicine, changing the administration due to a different formula, or a lack of available alternatives.’

SHPA Chief Executive Kristin Michaels says while hospital pharmacists are working to manage shortages at the coalface, regulating supply and demand is a national issue.

‘Withholding information on your available stock might make good business sense, but clearly the important medicines Australians need are not typical commercial products.

‘Hospitals are bearing the burden of this lack of medicine supply regulation, and the more time pharmacists spend on the phone chasing limited or replacement stock, the less time they can spend with care teams advising and caring for patients.

‘Government action to address this issue has precedent, with Canada and Slovakia recently regulating the reporting of shortages of medicines and vaccines by manufacturers and wholesalers.’

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