There are supply issues with some medicines. Photo / Getty Images
The global impact on the supply chain because of the pandemic has led to shortages of essential medicines in New Zealand, forcing pharmacies to ration them, as staff struggle with burnout.
About 24 medications, used to remedy illnesses such as inflammatory bowel disease, pain (analgesics), cardiac blood pressure, hormone replacement, smoking cessation and even certain antibiotics used by children, are running low.
Pharmac director of operations Lisa Williams said Covid-19 was having a global impact on manufacturing plants, workforce disruptions, logistics and supply chains.
"Our contracts require companies to hold around three months' supply of their medicines in New Zealand and they place the onus on suppliers to source alternatives," Williams said.
"Where suppliers go below or think there is the potential that they will go below the minimum level of stock, they are required to contact us with their management plan for the continuity of supply."
In most cases, alternative medicines have been sourced, she said.
Pharmac, a Government agency that decides which medicines and related products are funded, pays for nearly 1000 medicines, she said.
Otago University professor and the president of the Pharmaceutical Society Rhiannon Braund said although alternatives for most medications running low were there, using another medicine was not always easy.
Prescription medicines were difficult to change because they not only require a new visit to the doctor, but also re-adjusting the doses and managing any possible side effects and reactions it may have on the patient, said Braund, who is also a member of Pharmac's pharmacology and therapeutics advisory committee.
New Zealand's independent pharmacists' association vice president Sarah Mooney said for the most part Pharmac decided how frequently pharmacies could dispense something, whether a repeat prescription or giving it all at once.
Usually, "if we give a restricted supply due to shortages this is dictated to us by Pharmac".
Since the first lockdown, pharmacists have been told to restrict paracetemol.
Chemists used to give it out up to the maximum quantity allowed on the script unless the doctor specified otherwise.
"During the first lockdown, there were supply issues so we were told to give out no more than 100 per dispensing and no more than 300 per prescription - 100 with 2 repeats - unless the patient is on it regularly.
"This is actually a lot of paracetamol and I don't believe restricting it to this quantity is actually a bad thing as it is New Zealand's most common poison; however as with most things, it is not our call. We just do what Pharmac or the doctor tell us to do," Mooney said.
Which medicine is short changes all the time, she said.
"It would really help if the public would 'shop normally' for their medicines.
"During the first lockdown we ran low on a lot of regular medicines and Pharmac made us start dispensing it all monthly, but the only reason we were starting to run low was because people were stockpiling," Mooney said.
Recently pharmacies have been running low on blood pressure Quinapril and Locoid Lipocream, a common steroid cream for skin problems and they ran out of cefaclor suspension, a children's antibiotic.
"It certainly consumes a lot of extra time trying to keep on top of what's available and arrange new prescriptions from doctors for alternative medicines when what they want isn't available," she said.
Shortages in workforce
Upper Hutt Queen St pharmacy owner Brooke McKay said workload had increased in a huge way especially by having to do vaccinations and rapid antigen testing (RAT) and they "definitely" needed some extra helping hands.
But the process for the pharmacists to return back to work if they had taken some time off was an expensive and long process.
She said most pharmacists had been working 12 hours a day, seven days a week. She even had to return early from maternity leave and many were changing holiday plans.
"Most pharmacists are doing well over 40 hours a week with owner pharmacists doing up to 60 hours a week and that's ongoing since the first lockdown.
"Most of us cancelled holiday breaks." she said.
To mitigate the shortages of pharmacists in the country there should be an easier process for the recent retirees and locums to come on board.
Even qualified and experienced retired pharmacists have to pay about $1000 to re-register and do some form of training to be able to start working if they have been out of a job for more than three years.
"We have stepped up and we have never shut our doors to our customers and we should be proud of our work. We will continue to serve our community throughout the pandemic," McKay said.
Mooney said: "Pharmacists workloads have been increasing for a long time, but the pandemic has been the nail in the coffin for many of us and anecdotally there are a lot of pharmacists burned out from the pressure.
"We are anxious about picking up Covid-19 and taking it back to our families.
"We are worn out from the extra workload - RATs and vaccine certificates just started seemingly out of the blue - at the busiest time of year and there wasn't time to organise extra staff so the existing staff just sucked up the extra work," she said.
Pharmacy council chief executive Michael Pead said the fee for an annual practising certificate (APC) is about $920 and has to be renewed every year in March in time for the practising year that runs from April 1 to March 31.
"Council has arranged short-dated practising certificates to help former practising pharmacists - less than three years out of practice - return, to help workforce pressures. These processes are in place if and when required," he said.
"We do not charge for short-dated certificates, in 'emergency' situations. Council applied this approach when in lockdowns and will likely do so under traffic light red and or as necessary in response to workforce pressures.
"The period of the short dating will depend on the practitioners and the length of employment required - in the case of lockdowns, three months has been typical."
Braund said the Covid-19 pandemic was not considered an emergency, unlike the aftermath of the Christchurch earthquake.