HEIDI MURPHY, HOST: Vaping, the big change to the rules what 11-12 days ago now? Illegal to sell them anywhere but a chemist and currently only accessible through the chemist with a script from the GP. Now, I don't know about you, but every vape shop I pass in this city is still open, is still advertising its wares, is still selling these things. I said yesterday, a big change like this is all well and good but will be pointless if there's no enforcement. I’ve been trying to get to the bottom of what the Victorian Government plans are in that space for a couple of weeks, you know, will it be police? Will it be health officers? Will it be local council inspectors? No one seems to know or I mean, seems to be particularly enthusiastic about finding out. Premier Allen told me yesterday it's a question better directed to the Federal Health Minister. We asked to speak to that Minister, and I am delighted to say he's on the line now. Mark Butler, Federal Health Minister, thanks for your time this afternoon.
MINISTER FOR HEALTH AND AGED CARE, MARK BUTLER: Hi, Heidi. How are you?
MURPHY: I’m all right. What is the enforcement plan?
BUTLER: When we first started looking at this more than 12 months ago as a group of health ministers really, in response to just increasing calls, particularly from parents and school communities who were really at the end of their tether about vaping in their schools, vaping in the bedrooms of their kids and they wanted some action taken. They were pretty angry, frankly, they're saying they didn't understand how it had come to a situation where as many as 1 in 6 high school students were vaping. Vaping was starting to become common in primary schools, and school communities were saying it was the number one behavioural issue in all of their schools, primary and high schools as well. We started to look at what our options were and initially we thought we would have to pass laws through every single parliament in the country, which, as you can imagine, your listeners can imagine, is no small feat. We then got advice that we could just pass a single law in the Commonwealth Parliament, The Therapeutic Goods Act, which governs, as its name suggests, medicines and other therapeutic products, and every state and territory is able then to enforce that Commonwealth law. Now, every jurisdiction does that a little differently. Some of them do it, most of them do it through state health authorities. They'll call in the police if they think there's the involvement of some particularly bad guys, organised criminal gangs or something. But by and large, it's done by state health authorities or in my state in South Australia, the Consumer Affairs Department. But I think in Victoria it's done more by local councils, is my understanding.
MURPHY: Has anybody told the local councils this?
BUTLER: All of the jurisdictions have had delegated authority. This has not been a secret. There's been a pretty strong public debate about this for some time. I announced our intention to do this more than 12 months ago. What I'm being advised of by the federal authority, which is the Therapeutic Goods Administration, the TGA, that manages medicines and other drugs and therapeutic goods in the country - is that they are ramping up enforcement activity with different states and territories. New South Wales was probably first off the mark. They were doing quite a bit of enforcement activity over the last week or ten days.
MURPHY: Yeah, I am particularly interested in what Victoria is doing because it seems to be a fat lot of nothing.
BUTLER: Look, I can't tell you exactly what all the local councils in Victoria, if I'm right, that it is the local councils who do this but this is only 11 days old. It had been years really in the making this problem. We had legislation passed in the last couple of days of the last parliamentary sitting, which was a fortnight ago now. Immediately we went up to the Governor-General to have the law approved, so it would take effect on the 1st of July. We've delegated all those authorities to the different states and territories. Most of them have been communicating with all of their tobacco outlets.
MURPHY: The state has said to me to take it up with you - what Victoria's going to do in terms of enforcement. Yes, you've passed the laws, you've made the case for it, you've passed the legislation. But who's checking it's being put into place in Victoria, who's following it through? Who's going into the vape shops and shutting them down?
BUTLER: The Commonwealth won't be going into vape stores. That's not how the framework works. We are enforcing these arrangements at the border. We have been since January. We've seized more than well over 3 million of these vapes that have been coming into the country for the last several years, with no control on them at all. We'd been receiving reports for some months now that supply was starting to be choked off, vape stores were having difficulty getting their hands on products. But in terms of the laws that passed a couple of weeks ago, it's always been very clear the enforcement of those laws is a matter for states. As I said, different states do it differently. Some of them use health authorities, some use local councils. The TGA is working with all of the states and territories to do that in a joint way and they've been ramping up that activity over the last several days.
MURPHY: So, the enforcement has been delegated through the TGA to each state jurisdiction?
BUTLER: That’s right.
MURPHY: It has been?
BUTLER: A formal instrument has to be signed to that effect and that's happened over the last few days.
MURPHY: There's obviously that change to come in October and I know there's been significant pushback from the chemists. Are you still getting a lot of push back from the chemists about them becoming vape retailers in October?
BUTLER: Look, I'm getting a mixed response really. The important thing to say is that pharmacists dispensing vapes is not new. It's important for us all to remember, vapes were presented to our community and to other communities around the world as a therapeutic good. They were supposed to be another smoking cessation device that would help harden smokers kick the habit like other nicotine replacement therapies like gum, patches and so on. Pharmacists have been dispensing them for, a considerable period of time as part of the work they've been doing for years now with their patients to help them get off cigarettes. What we decided to do as a country was to return vapes to what they were always intended to be, which is a therapeutic product. They were never sold to us as a recreational product, and especially not one that would end up being targeted so deliberately at our kids. I mean, nine out of ten vape stores are located within walking distance of schools, and that was deliberately chosen by them because schools are generally their target market.
MURPHY: Yeah.
BUTLER: The idea of returning this back to a therapeutic good available in a therapeutic pathway after a conversation with a health professional, whether that's a doctor, or a nurse practitioner, or a pharmacist, is not new. And that's what they were promoted as being. Now some pharmacies will decide to do this and some won't. I've made the point over the last week or so there are many, hundreds of pharmacies, for example, who have chosen not to offer vaccinations in spite of the fact that we now pay them to do that. Many pharmacies decide not to offer methadone treatment, many do. This is a decision for individual businesses. I'm getting responses from pharmacies who say they will do that, and I'm also being told by a number of pharmacies that they don't intend to do that and that's ultimately a matter for them.
MURPHY: Okay, Minister, on the subject of pharmacies, are you concerned about some reports of shortages that we are getting that I'm sure you're getting as well. Is it a supply chain thing? Is it a chemist thing? what is happening?
BUTLER: There's always quite a number of medicines on the medicines shortage list that we maintain again through the TGA, A very hard-working federal government body. There always have been. They were obviously more extreme during COVID when all of those supply lines were shut down. But there are a number of drugs that are in shortage right now. I know they're causing a lot of distress out in the community. Some of the menopause drugs, the hormone replacement therapy patches have been in short supply for some time. I'm told they're expected to return to normal supply over this quarter, so between July and September. But I know that's been causing women in menopause particularly real distress. That is a global issue. That's an example of global manufacturing just not keeping up with supply. We don't make those patches here in Australia. We import them from overseas. So along with a number of other things, your listeners might be familiar with the shortage of Ozempic, which has traditionally been a diabetes treatment but is now being used, I say informally because it's not on the PBS for this purpose, for weight loss That is a definitely a global shortage. Demand for Ozempic has exploded over the last couple of years, and the only company that makes it Novo Norsdik, just simply doesn't have the factories that are able to keep up with that global demand. So in some cases, it's a global shortage.
The TGA, working with doctors and pharmacists, try to work out alternative medicines or treatments that people can use and give the proper authorities to do that. And we do what we can to resolve that supply shortage as quickly as we can.
Frankly, Ozempic is likely to be in short supply for the rest of this year, we're told by Novo. America’s been told the same. Europe's been told the same. The hormone replacement therapy patches, I'm told that should resolve over the coming weeks.
MURPHY: Just very quickly, Minister, because we are almost out of time. I promised caller Lisa I would raise this with you. Is there any scope to limit prescriptions of HRT or Ozempic to specific emergency cases rather than have it so open? Is there any scope to do that at all?
BUTLER: Usually, what will often happen is the TGA will communicate with doctors about the way in which their prescribing supply of medicines in shortage and put them on notice that there's a shortage and ask them to prioritise patients as much as possible. That was certainly the case with Ozempic, for example, because the shortage of that drug was causing very real concern for diabetes patients who need it for the treatment of often severe conditions. Yes often in an informal way the TGA is keeping in very close contact with doctors to make sure they are aware of shortages and are tailoring their prescription accordingly.
MURPHY: Alright thank you so much for your time this afternoon. Mark Butler there the Federal Health Minister.
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