00:02There's a bunch of critical shortages listed on the TGA website, so these shortages cover
00:07a range of medications, but some of the more frequent ones on there would be generic injectable
00:14drugs covering antibiotics, antivirals, antifungals and chemotherapy agents as well.
00:21Okay, so which conditions are they needed for?
00:25So we're talking, the ones I just mentioned, for intravenous use, so you'd be talking for
00:29seriously ill patients in hospital and obviously also cancer patients.
00:34How long have they been in short supply?
00:37There's many answers to that question, it depends on which medication we're talking about, but
00:41some of these shortages have been recurring, some shortages have gone on for many months
00:45and a small number of those have even lasted for years.
00:48All right, and why are we seeing the worst numbers for supply, Peter?
00:54We are seeing probably around, it's the generic injectable drugs is where we see most of the
00:58issues and that's usually because with the generic drugs at a very low margin on those
01:04and so they rely on economies of scale, so a large volume.
01:09Also you've got the characteristics of Australia's market in that we are a very small participant
01:15in the global pharmaceutical market, only accounting for about 2% and we're also geographically
01:20isolated somewhat, we're at the end of some very long supply lines.
01:23So not many manufacturers of these drugs, some critical points of failure in those supply
01:28lines which means any one of those points failing can lead to a shortage.
01:32And what does this mean for the people who need these medicines?
01:37The TGA works hard to find suitable alternatives, so they do some approvals for temporary use
01:45of drugs, not on the Australian Register of Therapeutic Goods but registered in other countries.
01:50They ensure they are safe and so they allow them to come into the country and be used in
01:55times of shortages.
01:56Our clinicians also use alternatives, some second line therapies as well.
02:00So if most shortages are due to manufacturing issues, Peter, and most of the manufacturing
02:07is done outside Australia then what's the answer?
02:11Look, there's, looking at this problem you've got short term solutions and longer term solutions
02:16so in the short term we probably need to get better at how we get notified about those
02:21shortages and therefore plan ahead of those.
02:24As you pointed out, over 90% of our medicines are imported and not domestically.
02:30So consideration of stockpiling is certainly one way to go.
02:34In the longer term, most of the active ingredients are made in India and China with manufacturing
02:41plants also throughout the US and Europe.
02:42So perhaps a more regional focus on manufacturing would help, given that Australia is such a small market.
02:48There are some regional neighbours with larger populations that may be able to help us out
02:52and have joint interests there.
