Pharmac admits it isn’t able to directly contact the countless people affected by drug shortages.
There are shortages and supply delays for 47 funded medicines. The drug-buying agency insists patients won’t even notice most of the problems, because Pharmac has secured alternatives. In comparison, it says Australia lists 321 medicine shortages, of which 47 are critical.
But Pharmac does acknowledge there are some supply problems that have affected fairly large groups of people in NZ, such as shortages of the blood pressure medication Accuretic, and anxiety drug Ativan.
People reliant on hormone replacement therapy Estradot, such as women going through menopause, have been unable to fill their prescriptions – which the agency admits has long-term consequences. Stuff reports that women have been told to cut their hormone patches in half to make them last longer.
Pharmac says it doesn’t have contact details to directly engage with people who may be affected, so it relies heavily on busy doctors and nurses to share information about the shortages. Its staff are also meeting regularly with other arms of the new national Health NZ agency, Te Whatu Ora.
Te Whatu Ora chair Rob Campbell says they’re following the supply issues carefully. “It is an important aspect of global supply shortages and one which we think, given the depth and complexity, Pharmac has handled well.”
From Te Whatu Ora’s point of view, the most important thing is to keep primary care providers well informed. “They rightly hold the relationships with people they are treating and often there are multiple medications involved in that which need to be considered when advising,” he tells Newsroom. “So our teams are keeping general practice teams, pharmacies and others as up to date as we can, and primary health organisations also provide this service.”
Campbell reveals that Te Whatu Ora is developing a central store of patient information, which it plans to have up and online from late 2023. “Our team is working on a national primary care data warehouse which might be capable of direct contact if that was appropriate.”
“But still the best contact with consumers is direct at point of treatment. That of course does not rely on face-to-face contact. and tele-options are real.”
Pharmac’s operations director Lisa Williams says the ongoing Covid-19 pandemic has been an “unprecedented challenge” for global medicine and devices supply chains. Increased demand, and interruptions to local and international manufacturing and distribution caused by millions of people being unwell have all contributed to these problems.
“Our team knows how distressing it can be to learn that a medicine or device you use might not be available,” she says.
Williams claims Pharmac’s unique behind-the-scenes arrangements with suppliers means NZ has been less affected by ongoing supply disruptions than other countries. She gives the example of the worldwide shortage of the colourless dye used for X-rays: Australia and the US got down to one week’s supply after a factory closure, but Pharmac’s single-supplier contract required two months of usual national demand to be held in the country, so NZ patients weren’t affected.
But the two-month requirement hasn’t helped with drugs such as lorazepan (branded Ativan) – there is barely a week’s supply left in NZ for those prescribed it to treat anxiety and sleep disorders. Pharmacies have been told to dispense no more than seven days’ supply at a time to avoid running out.
Te Whatu Ora has been forced to hit the ground running this month, with critical shortages of staff. Now it’s having to deal with shortages of drugs as well – hardly the beginning Health Minister Andrew Little and chair Rob Campbell were hoping for.
Writing last week for Newsroom Pro, Campbell said teams were actively working on recruitment, training and planned care to address shortages of doctors and nurses.
The problems had been been years in the making: “There is no magic pill.”
Now, it’s not just magic pills that he’s running short of.