‘Critical’ drug and device shortages in women’s health

3 minute read

The PBS left an empty chair at a meeting to discuss how to safeguard women from global supply problems.

Federal ministers and the PBS failed to show at a roundtable convened today by RANZCOG to address “critical” supply issues of medicines and devices for women.

Dr Anna Clare, who co-chaired the gathering at the college’s Melbourne offices, told The Medical Republic that there had been productive conversations with the TGA, industry, pharmacy and clinicians on how to mitigate adverse impacts, but the no-shows left some issues unresolved.

She said that, since many of the supply issues were global, possible solutions focused on redirecting limited resources to areas of need.

“If we know that there’s a shortage of, say, fetal fibronectin [test kits], which are used to predict the risk of preterm birth, we could redirect that supply to rural and remote areas where it’s most needed.

“Obviously transferring a woman from a rural remote area into a tertiary centre, because she might be having a preterm birth, has significant costs and significant disruption to her life.”

According to Dr Clare, supply issues are evident across many aspects of women’s health, particularly pregnancy.

“We are determined to address the root causes of pregnancy medicine and device shortages in Australia,” said co-chair Associate Professor Amanda Henry.

“Solutions may not be simple, but we are fully committed to working together with consumers, clinicians, and all stakeholders to overcome these challenges.”

Dr Clare said sponsors were often unaware of their products’ use in pregnancy and the effects of their withdrawal, such as medications for hypertension. The group plans to make a list of these medications to help suppliers’ awareness.

Shortages are also affecting the supply of women’s contraceptive products.

“Lack of copper IUDs has impacted many women seeking non-hormonal contraception, whatever their reasoning,” said Dr Sarah Cox, women’s health doctor.

“In the termination-of-pregnancy space, some of these women cannot safely rely on their partners to use barrier contraception and so are then forced to either leave contraception to chance or use a non-preferred alternative.

“Consequently, there is potential for women to return for repeat procedures that could have been avoided with the appropriate IUD supply.”

Menopause products, particularly hormone replacement therapy products, have also been affected by shortages.

According to Dr Clare, one solution to the supply issues may be finding industry sponsors for orphaned medications.

“For instance, immediate release nifedipine doesn’t have a sponsor in Australia, so it’s not currently widely available.

“It’s only accessible through the Special Access Scheme, which takes a lot of paperwork.

“So perhaps we can find an industry sponsor today who would be prepared to sponsor immediate release nifedipine – that’d be great.”

With some products such as oral contraceptives, supply is ample but access is limited due to cost, she said.

Over the past 30 years, no new oral contraceptives have been brought onto the PBS, making newer products “significantly” more expensive despite better side effect profiles, said Dr Clare.

“I think it’d be really good to get a bit more input from the PBS to see whether some of those can be brought onto [the PBS],” she said.

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