ROS CHILDS, HOST: Australia is experiencing a severe shortage of antibiotics, particularly ones that treat common ailments like chest or urinary tract infections. But some experts say these shortages are nothing new and that ongoing supply chain problems need to be urgently addressed.
With more, here's Professor John Skerritt, who's the deputy secretary of the Health department and head of the Therapeutic Goods Administration. Francisco, thank you so much for joining us this afternoon. So…
ADJUNCT PROFESSOR JOHN SKERRITT, THERAPEUTIC GOODS ADMINISTRATION: Good afternoon.
CHILDS: Good afternoon. As head of the TGA what are your responsibilities when it comes to ensuring supply of antibiotics to Australia?
SKERRITT: So firstly, companies have to report either current shortages or upcoming shortages to us. That enables us to look at other alternatives, either within Australia or overseas. And it also enables us to work together with the prescribers and the pharmacists on alternatives and on making those alternatives available.
CHILDS: How bad is the current shortage in antibiotics?
SKERRITT: It's worrying, particularly for four antibiotics, but on one hand it's worrying because they're quite common antibiotics, amoxicillin, cefalexin and trimethoprim sulfamethoxazole. These, as most pharmacists and doctors will know, are really the bread and butter of many main antibiotics.
However, there are alternatives. Firstly, alternatives of the same products brought in from overseas that we may not have approved but we have looked at the data and let's say, for example, been approved in countries like Germany.
And secondly, there are other antibiotics that doctors can prescribe and pharmacists can dispense for those. So, it's a bit of a two-edged sword.
CHILDS: So, what's behind the shortages?
SKERRITT: A range of things. It's a global shortage. So of course, in the northern hemisphere, as we may eventually come into summer here in the south, they're coming into winter and so the usual respiratory infections that occur as you come in the winter are hitting various countries in the northern hemisphere.
There's also been problems with manufacturing. What's happening increasingly with medicines in general, and also in antibiotics in particular, is that there's only one or two factories that actually make antibiotics even though they might have ten or 12 different brands.
They all go back to one factory, maybe in China or Eastern Europe or in Western Europe. And when that factory has a challenge with its supply, then globally there's a shortage of that product.
CHILDS: These shortages aren't new though, are they John? To a sudden indication that the present arrangement just isn't working?
SKERRITT: It's an indication that supply chains have become more focused internationally. And it is a problem with antibiotics because antibiotic development is not very profitable by drug companies compared with other types of medicines.
And so globally, there's been a number of initiatives that really are trying to stimulate new antibiotics coming to the market in Europe and the US. And Australia will pick up on those because when those products do come to the market in the coming years, for example, in the US, the companies will also bring them to Australia.
But we do have a challenge at the moment and that's why we are actively seeking overseas alternatives, bringing them in very rapidly, working with doctor and pharmacist groups on alternatives, and allowing pharmacists to dispense a different strength but the same products.
So, for example, two tablets of half of strength will give the patient exactly the same amount of antibiotic.
CHILDS: So as things stands then would you say that some pharmaceutical companies have a monopoly in supplying certain drugs to Australia? And isn't that the problem?
SKERRITT: No actually, these antibiotics that are in shortage are largely generic products. In other words, there's no limitation on the number of pharmaceutical companies because their patents on these products have expired.
And so, for example, for amoxicillin, there's more than a couple of dozen brands on the market, but the actual raw material is made in one or two factories globally.
That's not because of patents. It's just because the market has determined that it's only profitable for one or two companies to actually manufacture those products.
CHILDS: And we don't make antibiotics here ourselves, do we?
SKERRITT: None of the main commercial ones. And Australia is not a very large manufacturer of these values of prescription medicines. We make a number of complementary medicines and some over-the-counter medicines but not very many prescription medicines anymore. And antibiotics are largely prescription medicines.
CHILDS: So, in the meantime, if patients need one of the antibiotics that's in short supply, what's your advice to them if they're alarmed by this news?
SKERRITT: Well, firstly. When they get a prescription filled, go to their pharmacist and go, you know, as soon as you can after your prescription is written. Because if a doctor warrants prescription for an antibiotic, it is important to start early anyway. So go and see your pharmacist.
If a pharmacist doesn't have it, it might be one where they can dispense two tablets of the half strength one and basically give you the same product but a different strength.
Or alternatively, they can see if other pharmacies in their chain have the product, or they can also contact the companies on their 1800 numbers. Failing that, because of these antibiotics do have quite effective alternatives, they can contact the GP who can then SMS through an alternative prescription for an alternative antibiotic that will be in stock in Australia.
CHILDS: So there shouldn't be any patients left untreated, is what you're saying?
SKERRITT: We don't believe that there should be patients left untreated and not able to have any antibiotic that can treat the disease. One of the advantages of antibiotics is there’s a reasonable degree of overlap in the sorts of things they treat, whether it’s a chest infection or a skin infection or an intestinal upset.
CHILDS: John Skerritt, thank you so much.
SKERRITT: Thank you very much.