I’m on drugs. The legal kind. Earlier this year one of my specialists suggested to me I fill my prescription whether I needed a refill or not as there was a nationwide shortage of the drug. In Australia? Yes. So I dutifully filled my prescription. Doing so required a number of visits to local pharmacies, but one had a small supply left. The next time I needed a repeat, I was given a substitute drug. I didn’t think too much of all this at the time, but my experience then shows this is not now a new problem.

Last week I needed two drug prescriptions refilled. Pharmacy 1 – no supply of either. Pharmacy 2 – no supply of either but could order Drug A in for collection the next day from another pharmacy. Pharmacy 3 – no supply of either. Pharmacy 4 – had Drug A (so I kept that in mind in case Pharmacy 2’s order failed) and was able to substitute Drug B for me with another brand, something Pharmacy 3 had specifically told me they could not do without another prescription.

So I eventually got both drugs but it took two days, four pharmacies and a substitute drug. Not to mention the time and the travel costs involved. Yes, I could have called around, but I was already out of the house, so just kept going. Had no local pharmacy been able to supply, I’d have gone home and hit the phone.

Tell me again, I do live in a rich western country, don’t I?

When I returned to Pharmacy 2 the following day to collect Drug A, I asked why were these shortages occurring. The pharmacist told me it is because the government has lowered the prices they will pay the pharmaceutical companies to the point there is no profit in selling the drugs to Australia. Consequently they send their production to countries where sales are more profitable. If demand is higher elsewhere, Australia misses out.There is no profit in drugs for the pharmacy either, I was told. That explains why pharmacies are selling so much other “stuff” these days.

The pharmacist pointed to several heavily laden shelves. “Diabetes drugs”, I was told. Ordered in bulk to protect the health of their regular diabetes patients, because the pharmacy expects a drug shortage.

I don’t understand how the system works. Maybe I should, but I don’t – and I suggest the majority of the population don’t know the finer details. We get a prescription, we go get it filled, we take the drugs. We cringe if it is something not on the PBS. That’s about all of the process most of us delve into. I did read the following on the PBS website, titled “Setting an approved ex-manufacturer price for new or extended listings“. At that point I decided I wasn’t the woman for the job.

Price negotiations with the responsible person for new or changed listings are undertaken by the Pricing Section on behalf of the Minister, following a positive PBAC recommendation.  A Cost Information (PB11b) form is required to be submitted by the responsible person as part of the initial application to the PBAC.

 

After a price has been negotiated, the responsible person is requested to submit a Request for Approved Ex-manufacturer Price (PB11a) form in order to formalise the price offer.  The responsible person is then notified by email when the Minister has formally agreed to the negotiated price.

Who pays for the drugs? The government or the pharmacies? Do the pharmacies act as distribution centres? I thought the PBS provided subsidies: perhaps I am wrong. I’m not sure I want to understand. What I do know is that as a patient prescribed medication by my medical specialists, I expect to be able to get that medication without the risk of politically induced shortages – or pharmaceutical company avarice. I don’t begrudge the companies achieving a profit, businesses running at a loss don’t stay in business for very long. Greed is not good, despite Gordon Gekko‘s beliefs – or the current competition on Melbourne’s Gold 103.4 radio station.

The first time I experienced a shortage with Drug A, I asked the specialist was there an alternative. He said yes, there was, but the side effects were pretty undesirable (my words, not his) and he’d prefer to avoid prescribing it.

I think of all the chronic condition patients in this country and wonder what the future holds.

In 2007-08, around 15% of people in the 0-24 age group reported having either asthma, type 2 diabetes, coronary heart disease, cerebrovascular disease, arthritis, osteoporosis, chronic obstructive pulmonary disease, depression or high blood pressure.

We read about the horrific medical costs in the USA and watch the Australian government undermine universal health.

I only questioned one pharmacist but what I heard was enough to cause concern and I have no reason to doubt the sincerity of the speaker. Is there a mainstream investigative journalist who will take up the challenge to find out the truth? Do readers have similar experiences to share?