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Common medicines hit with shortages as COVID supply issues worsen

Australians are being forced to take desperate measures to track down prescription medications they need as experts warn drug supply issues are at their worst point since the pandemic began.

Australia’s most commonly used antidepressant, sertraline, is the latest medicine to be hit with supply issues here in Australia, with all brands, including Zoloft, affected by a global shortage.

The Therapeutic Goods Administration (TGA) last week issued an alert about the shortage of sertraline, which is used to treat depression and anxiety, saying supply is likely to be affected until April.
Zoloft is one of several brands of sertraline antidepressants which are in short supply.
Zoloft is one of several brands of sertraline antidepressants which are in short supply. (Andrew Meares)

Almost 2.5 million prescriptions were filled for sertraline under the Pharmaceutical Benefits Scheme (PBS) in the past 12 months to January, government figures show.

However, this does not include private prescriptions.

Peer-reviewed journal Australian Prescriber recently put the number of sertraline prescriptions at 4.7 million per year.

Pharmacist Chelsea Felkai, who is based in Newcastle, NSW, said as well as sertraline there were several other common medications still caught up in supply chain issues linked to the COVID-19 pandemic.

Blood pressure medications, such as olmesartan and irbesartan, were in short supply, as was the thyroid medication carbimazole and hormone replacement patches, she said.

Another medication pharmacists are finding it hard to come by is the contraceptive pill Norimin.

“A lot of patients need to specifically use Norimin because they find it works really effectively, particularly if they have had issues with other oral contraceptive pills,” Ms Felkai, who is the NSW president of the Pharmaceutical Society of Australia, said.

“That one in particular, it’s been six to 12 months of intermittent supply. We will get some in and then, almost as soon as we get it, it goes out the door and we can’t get any more in.”

While shortages in medications had been a problem since the start of the pandemic, things were now worse than they had been in the beginning of the COVID-19 outbreak, Ms Felkai said.

“Initially, it was short-term and related to people panic buying but within a couple of weeks to a month we kind of got back on track and people settled down,” she said.

“What we are seeing now is the effect of COVID on a global spectrum.

“Even though we don’t feel like we are in the middle of the pandemic right now we are actually seeing the consequences of a years’ worth of lockdowns in other countries.”

Chelsea Felkai, NSW President of the Pharmaceutical Society of Australia, said patients leave at least a week spare before coming in to fill prescriptions.
Chelsea Felkai, NSW president of the Pharmaceutical Society of Australia, said patients leave at least a week spare before coming in to fill prescriptions. (Supplied)

‘It’s scary to say the least’

Ilina Lovely, from Sydney’s inner-west, experienced the stress of trying to fill her script for sertraline last week.

Ms Lovely said she was shocked when she went to her local chemist, only to be told they had none in stock.

Ilina Lovely has been having trouble filling her prescription for sertraline.
Ilina Lovely has been having trouble filling her prescription for sertraline. (Supplied)

“My pharmacist told me there is a mass shortage at the moment,” she said.

“It was a Chemist Warehouse and they looked to see if there were any other stores with stock. They said there may be some at one store that is quite far away but we can’t confirm it because it is low stock and could just be an error.”

Ms Lovely said her situation was made even more difficult because she was only able to take one brand of sertraline.

“I can’t take any other brand because last time I did I went into hospital from a reaction to it. I am hypersensitive to the changes in the different brands,” she said.

“I think the majority of people can move meds easier than I can but, for the people like me who simply can’t, it’s scary to say the least. I don’t want to end up in hospital again.”

After visiting four chemists, Ms Lovely said she managed to get hold of two weeks’ supply of sertraline.

Pharmacists ‘hamstrung by legislation’

Ms Felkai said current laws did not permit pharmacists to make straightforward substitutions of medication, such as dispensing double the number of 50mg tablets of sertraline in place of 100mg tablets.

The TGA has issued a Serious Shortage Substitution Notice (SSSN) for sertraline tablets, theoretically allowing pharmacists to make the substitution with the consent of the patient and without a new prescription.

However, each state and territory must then enact legislation for pharmacists to make the swap, a process which is yet to happen in NSW.

“For something that is so simple, there are a huge amount of legal requirements that go into allowing pharmacists to be able to substitute with an appropriate alternative. We are hamstrung by the legislation,” Ms Felkai said.

Substitutes were also not covered under the Pharmaceutical Benefits Scheme (PBS), making them more expensive for patients, she said.

‘Tip of the iceberg’

Australian Medical Association Vice President Chris Moy said while medicine shortages in Australia had no doubt been made worse by the pandemic, they were an ongoing issue, even before COVID-19.

AMA Vice President Dr Chris Moy says Australia should be looking at its dependence on international pharmaceutical suppliers.
AMA Vice President Dr Chris Moy says Australia should be looking at its dependence on international pharmaceutical suppliers. (Australian Medical Association)

“It’s a pre-existing problem because Australia is extremely reliant on its day-to-day medications from overseas suppliers,” Dr Moy said.

“I think somewhere in the order of 89 percent of all day-to-day prescription medications are supplied from overseas; they often say ‘patented in Australia’ but they are actually made overseas.”

Dr Moy said Australia should be looking towards how it could reduce its reliance on overseas pharmaceutical suppliers in the long term.

As well as the supply issues thrown up by the pandemic, Australia’s medical needs could be threatened by trade wars or international conflicts, Dr Moy said.

“A lot of our medications are made in China and India. Sovereign capability and protecting supply of our medications is something that should be seriously considered.

“What we are seeing now could be like little spot fires that may be there to warn us about where we are going.

“This is potentially the tip of the iceberg in terms of us looking at our medication supply in the longer term.”

Contact reporter Emily McPherson at emcpherson@nine.com.au.

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