South Africa faces medicine shortage

According to reports, South Africa is facing a medication shortage, as certain locally and internationally produced medicines are out of stock at the suppliers.
 
Aaron Motsoaledi, the Minister of Health, convened a meeting with relevant industry players last week in a bid to determine why the suppliers are out of stock, and how long it will take the manufacturers to fill all of the orders for the various medicines.
 
According to Dr Ali Hamdulay, from Metropolitan’s health division, pharmacies and hospitals within the private sector still have stock of at least some of the medicines.
 
He added: “However, the drugs in question are Penicillin (injectable) - for which many alternatives are available, Atropine (which is used as an emergency intravenous drug in some patients with specific heart conditions); and Digoxin (therapeutic alternatives exist). Currently we have a list of around 110 products (NAPPI codes) that are out-of-stock on the market, however most of the products have generic or therapeutic alternatives with a similar mode of action.”
 
The effect on the public
 
Hamdulay explained: “In general, there are substitutes available for medicines which patients can use until the shortage is corrected. While injectable penicillin is commonly used, there are other less used alternatives, which are important for management of patients with heart conditions. The circulating stock levels will need to be assessed to determine whether it is sufficient to cover the stock-out period. This can be mitigated by a collaborative effort between all facilities that keep drug stocks.”
 
While there are generics that people can take in some instances, Hamdulay pointed out that some of these may not be as effective as the originals.
 
“[In the event of a shortage,] there are therapeutic substitutes which can be considered for use. They may not be affective in all instances, hence the dependency on [the] availability of prescribed treatment is a huge concern and the dangers of a stock-out become apparent.”
 
According to Hamdulay, the importance of having the correct medications available to treat patients cannot be overemphasised.
 
He stated: “Patients have a right to expect the correct treatment for their condition, when they need it. The responsibility for this stretches across the supply chain and may indicate a need for co-ordination of drug availability and stock-outs at an industry level. At a patient level, it may mean increased monitoring and health visits over that period, to maintain vigilance in the event that an individual requires care.”
 
Dr Elsabé Conradie, general manager of stakeholder relations at the Council for Medical Schemes (CMS), noted: “If no medicines are available, it might affect the medical scheme industry. If a particular medicine is not available, but a generic or alternative can be provided, the schemes will have to pay in full, without any co-payment. This will have a negative effect on the claims medical schemes will then have to pay.”
 
Hamdulay highlighted that Metropolitan Health is in contact with the various pharmaceutical companies, and are therefore directly informed when certain medications are out of stock.
 
“We have processes around the follow up on the stock situation. Where there are no generic alternatives available, affected patients are identified and the treating doctor is proactively engaged by our clinical specialists to find a suitable alternative treatment for the patient. Pharmacy circulars are also distributed to all pharmacies around South Africa to inform the process,” stated Hamdulay.