Expert insights from Pharmacy Alliance Managing Director, Simon Reynolds & community pharmacist, Amanda Seeto.

Positioned at the frontline of the COVID-19 pandemic, community pharmacists have demonstrated their unwavering commitment to the ongoing provision of essential medications, support and health advice for those in need.

COVID Comms Cast spoke with Pharmacy Alliance Managing Director, Simon Reynolds, Melbourne, about the challenges of providing ongoing patient access to essential medicines while tackling issues of industry supply.

We also spoke with community pharmacist, Amanda Seeto, Brisbane, about the impact of COVID-19 on PBS prescriptions and the supply of flu vaccines, and pharmacists’ call to extend the one-month supply of prescription medications beyond the current pandemic.

Within the first two weeks of March alone, in response to COVID-19, demand for medicines increased markedly, with pharmacies and wholesalers reporting numerous product lines being out of stock. In the week ending March 14, 2020, 16.4 million items were scanned through Australian pharmacies – a 37 per cent increase on the same week in 2019.

According to Mr Reynolds, pharmacies have had to change the way in which they operate, to help slow the spread of corona virus, while continuing to provide patients with access to essential medicines, and tackle industry supply issues.

“Firstly, pharmacies were panic buying to meet customer demands. Secondly, there are long lead times to get medications into Australia via sea freight. Thirdly, we have very little manufacturing capability on shore.

“Then to overlay and compound these issues, larger, more sophisticated corporates were stockpiling more than six months’ worth of medications in their own warehouses, and the pharmaceutical wholesalers had little or no way to prevent this,” said Mr Reynolds.

Pharmacy Alliance has equipped its members, particularly smaller independent community pharmacies, with the resources to keep their patients informed of the various restrictions and shortages, while helping to ensure their ongoing access to critical products.

Beyond the challenges of industry supply, the COVID-19 pandemic has propelled a sudden shift in the way in which Australian pharmacists deliver healthcare, with digital platforms and services provision gaining much attention. Pharmacy, and the industry as a whole, has witnessed swift operational adaptation to fulfill eHealth and telehealth requirements, as an additional measure to better serve their respective communities.

“The way in which we receive prescriptions has changed, because GPs have been conducting telehealth consults and sending pharmacists digital images of prescriptions to be filled,” Ms Seeto said.

“These digital image prescriptions have proven really valuable throughout the pandemic, as they have allowed our patients to order their medications in a click and collect format, or to request delivery, minimising their risk of exposure to COVID-19.”

With these new digital measures in place, Services Australia has reported a 20 per cent increase in PBS/RPBS scripts processed last month, compared to the same period last year. In particular, there has been a heightened demand for respiratory medicines.

Despite the rapid implementation and evident consumer demand for these digital services throughout the pandemic, questions have been raised regarding the ongoing availability of these options, post- COVID-19.

According to Ms Seeto, given people experience medical emergencies every day, charging pharmacists with the responsibility of providing one months’ emergency supply of prescription medication, subsidised by the PBS, is warranted beyond this current pandemic.

“Pandemics, and other emergencies, such as the Australian bushfires witnessed earlier this year, are not the only situations in which patients are unable to visit their doctor to renew a medication.

“I’d like to see these current arrangements remain a permanent feature of our health system, to enable pharmacists to continue to support their patients,” said Ms Seeto.

Over the course of the pandemic, pharmacists have also voiced their concerns regarding access to sufficient flu vaccine supply.  

“We’ve seen a significant, and earlier demand for flu shots this year. Even people who are eligible for a free, annual flu shot [such as the immunocompromised], are coming into pharmacy, and are willing to pay for the vaccine to ensure their protection against the virus,” Ms Seeto said.

Demands for an annual flu shot reportedly peaked early (in April) this year in response to COVID-19, relative to previous years, lending credence to the concerns of pharmacists and GPs regarding dwindling flu vaccine supplies.

Pharmaceutical companies have appeased pharmacists concerns this week by confirming their distribution of additional supply of flu vaccines nation-wide to GP and pharmacy clinics, pre- winter.

As a champion of pharmacist-administered, in-pharmacy annual flu vaccinations, Ms Seeto recommends “all Australians, regardless of COVID-19, should have an annual flu shot.”

Despite the current global health crisis and their highly challenging work environment, pharmacies have nonetheless, remained a reassuring constant for their local communities.

According to Ms Seeto, more than ever, patients have been seeking professional pharmacist advice, particularly over the phone.

“Patients seem really comforted by the fact that we have, and continue to remain, open for business,” said Ms Seeto.

According to Mr Reynolds, pharmacies have been collaborating to create patient-focused solutions, and displaying real empathy for their respective communities, to help contain, and manage the spread and implications of COVID-19.

“The camaraderie within the industry has extended to Pharmacy Alliance members sharing new or best practices, implemented within their own pharmacies, with their industry counterparts, to minimise the spread of COVID-19,” Mr Reynolds said.

With Australia now journeying out of COVID-19, Mr Reynolds reflects on how pharmacy should best exit.

“While nobody anticipated the impact of COVID-19 on the industry, we hit the ground running, and developed the necessary strategies to manage the pandemic with our members, partners, and suppliers alike.

“This pandemic has made us re-evaluate how we operate and serve our communities. Temporary regulatory changes of ‘continued dispensing’ (available until June 30, 2020) have increased the number of days a medication can be supplied without a prescription, to heighten patients access to medications. Ultimately, this has enabled pharmacists to play a more pivotal role in helping their communities stay well,” said Mr Reynolds.

“Going forward, not only will the pharmacy industry be better prepared, but suppliers would have taken additional steps to ensure they can better manage the supply chain, in the event of a second wave.

“It is however, important to bear in mind, that Australia will continue to be susceptible to global supply chain risks, due to our limited manufacturing capabilities on shore,” Mr Reynolds said.

“It will be difficult to overcome the supply issues faced in Australia, unless there is both significant change and investment into manufacturing in Australia.”

As Australia’s lockdown begins to lift, pharmacists are urging Australians to remain vigilant with their personal hygiene and social distancing measures.

“It’s really important to practice the basics – wash your hands, cover your mouth and nose when you cough or sneeze, and stay at home if you’re unwell,” said Ms Seeto.

If we all adhere to this simple protocol, we will not only reduce the risk of a second wave of COVID-19, but will also be able to establish new community norms in managing future outbreaks of infectious diseases.”

Simon Reynolds is a Melbourne-based pharmacist, Co-Founder and Managing Director of the independent pharmacy industry group, Pharmacy Alliance.

Amanda Seeto is a Brisbane-based community and practice support pharmacist who has also served as a professional practice pharmacist for the Pharmacy Guild of Australia’s Queensland Branch.