After visiting 10 pharmacies in search of Stelazine, the patient was getting desperate.
Melbourne pharmacist Elysia Chow did her best to help her. But the drug is out of stock until December at best. And the patient would not accept an alternative.
Ms Chow phoned the manufacturer, hoping to access an emergency supply. But manufacturers no longer keep emergency stock.
The patient eventually found a pharmacist able to help — 30km away.
“She got the last box,” says Ms Chow.
This scenario is becoming common for Australian pharmacists, who are using up valuable time trying to track down medications in short supply.
Often they have to call the doctor to discuss medication alternatives.
To make matters worse, the alerts system is unreliable.
“It’s just a pain,” Ms Chow says.
“You contact doctors to let them know what’s happening and then the reps but you don’t really get a straightforward answer.”
Supply chain issues with Estradot and Estalis patches are the latest to hit the headlines.
But for pharmacists, it’s an ongoing problem.
At present, there are also serious issues with carbimazole and the meningococcal B vaccine, Bexsero.
Melbourne pharmacist Mehul Mehta says a number of parents have been seeking Bexsero.
“Our first expected supply date was the start of April. Now it’s mid to late May.”
Mr Mehta says that in the past pharmacists could call the manufacturer for emergency stock, but that’s no longer the case.
“You call the manufacturer now and they say ‘don’t talk to us’.”
“The patients suffer the most as they have been on something stable for a while and suddenly they don’t have it.”
For many patients, medicines shortages are also expensive.
One alternative is compounding, but this can be expensive.
“This doesn’t suit everyone and it is also very expensive in comparison,” says Jarrod McMaugh, whose pharmacy does a lot of compounding.
He has worked with patients and their doctors to come up with short-term solutions until the HRT patches are available again.
There are downsides to changing to alternatives as well.
When the original drug comes back in stock, patients can become confused, as happened to some people after last year’s metformin shortage.
A number of pharmacists admit to hoarding stock. But this contributes to further shortages. It also reduces cash flow and puts pharmacies at risk of being left with expired products.
Click here to access the TGA list of unavailable medicines