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Adrenaline supplies; sole supply is a risky strategy “There isn’t much more of a crisis than not having adrenaline. Adrenaline is a basic frontline drug that’s used in resuscitating people from cardiac arrest. It doesn’t get much more basic than that,” explained Dr Ross Boswell from the NZ Medical Association in an interview at the time. “The delisting highlights the short-sighted approach to the security of supply of the nation’s critical medicines,” Dr Pippa MacKay said. “Reliance on single suppliers for critical care medicines is taking a serious risk with New Zealanders’ lives. The last crisis was caused by issues way beyond the control of the original supplying drug company, and there is always the risk that such a crisis will reoccur, such as it did with the flu vaccine a couple of years ago,” she said. “The lesson learned again in January was that PHARMAC’s reliance on such limited supply contracts is seriously risky and dangerous for clinicians and patients alike in emergency situations. Yet within six short months, the country is back to square one.” Dr Ross Boswell from the NZ Medical Association suggested that for critical supplies and services, “for things that we really can’t afford to be without, then maybe instead of looking for the lowest price we should be looking for a safe and secure supply. And, one way of doing that might be if instructions were issued to these government agencies that they need to maintain at least alternative suppliers for critical supplies.” Dr MacKay agrees. “New Zealand only has four million people with a tiny market in comparison with other larger countries. Why would a competitor go through the expense of registering and marketing a product that is unlikely to generate a return to compensate for the effort? If alternative supplies of critical products are to be continuously available, there has to be something in it for the suppliers,” Dr MacKay suggested. “PHARMAC was extraordinarily lucky at the time that AstraZeneca could provide supplies at such short notice. More recently, it had a golden moment to reduce future risks to supply when AstraZeneca notified the agency that supplies of its initial importation were nearly exhausted. “Instead of negotiating around further stock, PHARMAC’s response was a short notice delisting the AstraZeneca product. There was no discussion to see if AstraZeneca would be prepared to continue as an alternative supplier,” Dr MacKay said. This is despite assurances from PHARMAC in January that it was working with both supplier companies about longer term solutions to the issue. Ends…/ More information: Dr Pippa MacKay: phone 0 274 484 718 Background 19 January 2007 Supply of essential drug compromised. Hospitals have run out of ampoules of adrenaline, which may put patient safety at risk, says the NZ Medical Assn. … An alternative supply has been arranged … from an American source, where the drug is known as epinephrine, and so is labelled that way. In an emergency situation , medical staff might not immediately recognise that the ampoules provided are indeed adrenaline… and because the alternative preparation is not approved by the Ministry of Health, doctors are required … to gain informed consent from patients and to report to the Ministry the names of the patient and doctor on each occasion it is used. During an emergency doctors want to be helping patients, rather than filling out forms … said Dr Boswell. (NZMA media release 19.1.07) 20 January 2007-07-05 The crisis comes less than a year after hospitals ran out of a drug essential for heart bypass surgery and two years after the nation’s winter flu vaccination campaign was jeopardised by a manufacturing error. In all three cases, New Zealand doctors were relying on a single supplier for critical medications. … Dr Ross Boswell said Government should maintain at least two alternative sources for critical supplies and services… (The Press) 24 January 2007 PHARMAC announces it has signed contract for alternative supplies with AstraZeneca in Australia. PHARMAC’s Dr Dilky Rasiah said this would “provide certainty for NZ patients and clinicians who require adrenaline to treat severe allergic reactions and cardiac arrest.” (PHARMAC media release) 29 January 2007 Radio New Zealand reported that for the second time this month NZ has risked being likened to a third world country after supplies of two different types of drugs have come close to running out. Earlier … it was revealed stocks of the life saving drug adrenalin.. ran dangerously low … hospitals were forced to use other medication that was not registered as approved in this country. Then, last week some pharmacies ran out of calcium tablets… (Radio NZ) |
