About you
1. What is your name?
Name
Rosalie Schultz
3. Which of the following best describes you?
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Medicine sponsor/manufacturer/wholesaler representative organisation
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Health professional representative organisation
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Consumer representative organisation
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Government agency
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Research/academia/media
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Individual sponsor/manufacturer/wholesaler/retailer
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Individual health professional, please specify type
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Individual consumer/general public/community member
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Other, please specify
Other, please specify
GP in Aboriginal community-controlled health service
4. Organisation name:
Organisation name
Ngaanyatjarra Health Service
5. Size of organisation:
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Small (20 employees and under)
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Medium (20-199 employees)
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Large (over 200 employees)
6. Have you been affected by a medicine shortage or discontinuation in the last 12 months?
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Yes
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No
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Unsure
7. If yes, please list which medicine shortage(s) and/or discontinuation(s).
Which shortage
Procaine penicillin
Benzathine penicillin - this is most critical for us, there is no alternative for treatment of syphilis and prevention of rheumatic heart disease
Tenecteplase
Semaglutide
Dulaglutide
Warfarin
Benzathine penicillin - this is most critical for us, there is no alternative for treatment of syphilis and prevention of rheumatic heart disease
Tenecteplase
Semaglutide
Dulaglutide
Warfarin
Planning for medicine shortages and discontinuations
8. What do you do to plan proactively for a medicine shortage or discontinuation? Select all that apply.
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Monitor medicine availability (supply, demand)
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Seek out information about shortages and discontinuations
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Manage stock levels
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Plan for alternative treatments in case of shortage
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Change the way medicine is prescribed/dispensed/taken (e.g. rationing)
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Other
9. Please explain in more detail how you plan proactively for a medicine shortage or discontinuation, including any barriers or challenges you experience.
Prepare: elaborate
We run eight clinics and we can manage stock across clinics. Sometimes clinics hold extra stock based on fluid population numbers and this has enabled us to go through shortages with no impact.
10. [Pharmaceutical companies only] What measures do you use to monitor and predict medicine supply including disruptions and increases in demand? Are there any barriers or challenges?
Prepare: monitor and predict
NA
Responding to medicine shortages and discontinuations
11. Please outline how you respond to a medicine shortage or discontinuation, including any barriers or challenges you experience.
Responding: response
Identify stock
Quantify need and whether there are other options for some indications
Consider alternative options - either standard items or emergency options (eg Orspec Benzathine penicillin)
Quantify need and whether there are other options for some indications
Consider alternative options - either standard items or emergency options (eg Orspec Benzathine penicillin)
12. Please describe in detail where any of the following have helped you to respond to a medicine shortage or discontinuation:
Responding: helpful
We have accessed emergency sources of benzathine pencillin to ensure critical need for rheumatic heart disease prevetion and syphilis treatment
Communicating about medicine shortages and discontinuations
13. Where do you get information about a medicine shortage or discontinuation? Select all that apply.
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Health professional organisations
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Patient organisations
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Industry organisations
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The TGA and other federal government agencies
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State and territory government agencies
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The media, including social media
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Other sources, please specify
Communicating: information source: other
Our contracted pharmacy
14. What information or updates about a medicine shortage or discontinuation do you find most helpful and from where?
Communicating: information most helpful
Early warning and dates of anticipated shortage
Alternative supplies
Alternative supplies
15. What challenges do you face when receiving information about medicine shortages or discontinuations?
Communicating: challenges when receiving information
Some shortage never affect us (eg warfarin)
Remote Aboriginal population has distinct need for benzathine penicillin that is not recognised in mainstream
We are at the very end of global supply chains, so when shortages are brief, they do not affect us, but prolonged shortage such as semaglutide is devastating.
Remote Aboriginal population has distinct need for benzathine penicillin that is not recognised in mainstream
We are at the very end of global supply chains, so when shortages are brief, they do not affect us, but prolonged shortage such as semaglutide is devastating.
16. What challenges do you face when sharing information about medicine shortages or discontinuations?
Communicating: challenges when sharing information
Mobile population
17. What do you think about the information on the TGA website about medicine shortages and discontinuations?
Communicating: TGA website
Clear, unbiased, easy to access, readily available
18. Do you have any suggestions to improve the TGA’s communication of this information?
Communicating: TGA suggestions
Role of TGA vs other agencies needs to be clear
Impact of medicine shortages and discontinuations
19. Over the past 12 months, how much time did you spend on medicine shortages or discontinuations? What activities took the most time?
Impact: time
About 20 hours
Auditing stock
Considering options
Educating staff and patients
Auditing stock
Considering options
Educating staff and patients
20. What were the most challenging activities and why?
Impact: most challenging
ON-going uncertainty about semaglutide
21. Tell us about the health-related impacts of medicine shortages or discontinuations.
Impact: health-related
Declines in quality of diabetes care
increased progression of renal disease in very high risk population. It is likely that renal decline has accelerated in a small number of people who require renal replacement therapy that they would not have needed with adequate supply of semaglutide.
Others face weight gain that may have been prevented.
increased progression of renal disease in very high risk population. It is likely that renal decline has accelerated in a small number of people who require renal replacement therapy that they would not have needed with adequate supply of semaglutide.
Others face weight gain that may have been prevented.
22. Are there other impacts of medicine shortages and discontinuations that you would like to mention?
Impact: other
Seems inequitable when people who can pay for medication can have on-going access to semaglutide, including those who do not have diabetes.
Improvement opportunities
23. What is the biggest problem within the following areas that you want fixed, and why?
Opportunities: biggest problem
Equity of access based on need not ability to pay.
24. What do you think of the current TGA regulatory framework around medicine shortages and discontinuations?
Improvement: TGA regulatory framework
Entire supply chain needs to be considered, rather than fragmented approach with different agencies responsible for different aspects.
25. Do you have any suggestions about how to improve medicine shortages and discontinuations in Australia (i.e., what does good management of medicine shortages and discontinuations look like for you)?
Opportunities: suggestions
Consider support for local manufacture so we can guarantee on-going supply for Australians.
26. Do you have any further comments about medicine shortages and discontinuations in Australia?
Opportunities: further comments
Essential medicines should not be used as a source of profit but considered as a government utility and guarantee to our people. We may be able to provide secure supply for our Pacific neighbours.
Consent
27. I consent to the collection, use or disclosure of my personal information as set out in the privacy notice and select the following option regarding the publication of my submission:
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Publish my response, including both my name and organisation's name
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Publish my response, without my name but including my organisation's name
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Do not publish my response