The Editorial Executive Committee welcomes letters, which should be less than 250 words. Before a decision to publish is made, letters which refer to a published article may be sent to the author for a response. Any letter may be sent to an expert for comment. When letters are published, they are usually accompanied in the same issue by their responses or comments. The Committee screens out discourteous, inaccurate or libellous statements. The letters are sub-edited before publication. Authors are required to declare any conflicts of interest. The Committee's decision on publication is final.

Letter to the Editor

Editor, – Thank you for Elizabeth de Somer's clear article explaining the complexities involved in the supply chain of medicines (Aust Prescr 2011;34:105-7).

From a prescriber's perspective, we are well informed when a medicine is discontinued, but temporary lack of supply is rarely advertised. Too often, we find out when a patient returns with an unfilled script. Similarly when supply returns to normal, prescribers are often the last to know.

It would be helpful to have access to a list of unavailable items, including at least the more common drugs. With the almost universal use of electronic prescribing, a simple alert of a supply problem could easily be incorporated into prescribing software.

Could Medicines Australia perhaps facilitate this process with the relevant software developers?

Andrew Montanari
General practitioner
Newcastle

Author's comments

Elizabeth de Somer, author of the article, comments:

Medicines Australia is the peak body representing manufacturers of prescription medicines that are involved in the research and development of new medicines (www.medicinesaustralia.com.au).

Unfortunately, Medicines Australia would not be able to facilitate building an alert system into prescribing or dispensing software. The manufacturer is also unable to control or monitor the stock levels held by individual pharmacies.

When a product is listed on the Pharmaceutical Benefits Scheme, supply is a condition of listing. Any advance knowledge of expected supply interruptions or shortages to PBS listed items will therefore be communicated to the Pharmaceutical Benefits Division of the Department of Health and Ageing, and the Therapeutic Goods Administration. Strategies for managing supply will be agreed, and these include sponsors alerting healthcare professionals to the issue and providing advice on any agreed management approach.

Prescribers may not be made aware of short-term supply chain difficulties occurring at the pharmacy. It is also likely that the manufacturer would be unaware of these types of stock outages. With 5000 community pharmacies across Australia, local supply shortages can occur in individual pharmacies unrelated to any action by the manufacturer, and may be caused by wholesaler and pharmacy ordering, stock decisions or unexpected spikes in local demand.

The Australian Government is progressing the development of electronic health records management with the aim of maximising electronic data linkages.1

The Pharmacy Guild of Australia is the national peak body for community pharmacy and liaises with governments and software providers to develop pharmacy tools that meet the needs of the community.2

The NPS recently conducted a review that identified the most important features of prescribing software that impact patient safety.3 This was supported by the Medical Software Industry Association.4

The impact of short-term stock outages related to individual pharmacy supplies may be a significant problem for prescribers to track and may require some consideration by these groups.