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Monday, 20 August 2018
Page: 7695


Dr FREELANDER (Macarthur) (11:25): The Therapeutic Goods Amendment (2018 Measures No. 1) Bill 2018 is, at first sight, uncontroversial and has support from both sides, but, to me, it does not go far enough. As a medical professional, I have seen the great risks and dangers that a shortage in certain medicines poses for patients across many countries. I have worked and seen in South-East Asia and in other parts of Asia the difficulties that medication shortages can cause communities.

I'm very concerned that, in Australia, we are seeing an increasing number of medications have shortages, often with very little explanation as to the reasons why. We're often quoted manufacturing difficulties, supply chain difficulties or import difficulties for some very common medications. These include broad-spectrum antibiotics which people would be familiar with, such as minocycline and ampicillin, which are used to treat simple respiratory infections; and fentanyl, which is pain relief medication used for severe pain. It also includes some vaccines. In particular, in the recent influenza season, we've had shortages of the particularly high-dose influenza vaccine. More recently, we've been faced with shortages and lack of supply of EpiPens used to treat acute life-threatening anaphylaxis. To me, this is an issue that is not going to go away.

This bill will go a little way towards encouraging pharmaceutical companies to maintain supplies of certain medications. Maintaining supplies of many different medications is something that we will find increasingly difficult in the modern world, with the disappearance of manufacturing in Australia and the lack of reserve supplies kept in Australia for many common medications. Sadly, the manufacturing base in Australia continues to shrink. With this shrink will come an increase in the likelihood of medication shortages. Whilst this legislation is about being prepared for such instances, and, hopefully, about ensuring we're able to have a timely response to prevent such instances arising in the first place, I do have my doubts that there is sufficient incentive for the remaining large pharmaceutical companies to maintain supplies of off-patent medications.

From my medical career as a paediatrician, I can certainly attest to the impact a lack of proper medication has upon my patients, both in hospital and in ambulatory-care practice, and their families. Time and time again, I've witnessed the rapid increase in quality of life for the patient and their families when a child's been given a medical treatment that they require and that previously has not been available. Take epilepsy, for example. It's a common and mostly permanent condition affecting around three per cent of the population. This is a condition which, without appropriate treatment and medication, can control the life of a child and their family. About 70 per cent of all epilepsy sufferers have their condition treated with medication and remain well because of it. It's vitally important that sufferers of epilepsy take their medication regularly and on schedule. Failure to do so can cause seizures, which can sometimes be life threatening. It's therefore critical that supply of these medications is closely monitored.

Asthma is another common condition which impacts upon daily life of many members of our community and, indeed, a significant number of the members of this House. I recently had the pleasure of relaunching the Parliamentary Friends of Asthma group, alongside the member for Barker. Those present at the launch had the opportunity to hear from guest speakers and representatives from Asthma Australia, who were able to effectively convey the need for medications to be taken seriously and to make sure we maintain adequate supplies of these medications. During the recent thunderstorm asthma epidemic in Victoria, many pharmacies actually ran out of medications for asthma—again, illustrating the fragile nature of our supply chain for these vital medications.

I have already mentioned the shortage of EpiPens. My experience is quite a personal one, as some members of my family do have anaphylaxis and require their EpiPens to be kept with them at all times. To go to a pharmacy and be told, 'There are no EpiPens available, and we don't know when we're going to get them,' is shocking.

Complacency in our ability to provide medications is widespread, even amongst medical practitioners and pharmacists. We need to be very careful in this space. We are already seeing regular shortages of a number of medications, and my fear is that this will increase as there is very little incentive for manufacturing companies to manufacture in Australia and for importing companies to import significant quantities of off-patent medications—often very important medications—unless we have a better system of making sure we maintain supplies. EpiPens are one example; broad spectrum antibiotics are another. Even some of the other countries around the world, such as the United States, have recently had shortages of injectable hospital medications—particularly antibiotics, which have reached a critical situation. Australia is only a very small proportion of the pharmaceutical market, compared to the United States.

We are increasingly seeing vaccines becoming available for many previously fatal illnesses, such as meningococcal disease and haemophilus influenzae type B, which can cause meningitis and epiglottitis in children. My fear is that, unless we have better supply chain practices, some manufacturing in Australia and reserve supplies of these medications, we will be in serious trouble. We need to make sure that these medications are available in sufficient quantities to meet with demand.

Recently we've had shortages of the medication Metformin XR, which is the most commonly used medication for type 2 diabetes. The fact that we could have a shortage of such a widely-used, relatively cheap and well-known medication is a sign, to me, that the system is impaired. Whilst this medication will go a little way to improving the situation, it is by no means sufficient. I encourage the government to look further with the regulation of the pharmaceutical industry in making sure that Australia maintains supplies of these vital medications—particularly things such as vaccines, broad spectrum antibiotics, anti-epileptics and medications for diabetes—so that we can look forward to a future when these drugs will be readily available to all.