A nationwide shortage of the vital HIV prevention drug, pre-exposure prophylaxis (PrEP), has sparked concern among Australian healthcare professionals and the LGBT+ community.
The Australian Therapeutic Goods Administration (TGA) announced recently that multiple brands of tenofovir/emtricitabine combination tablets are either in limited supply or unavailable, with some shortages expected to last until March 2025.
The TGA cited manufacturing reasons for the shortages, stating that the sponsor is working to expedite the next shipment. However, this news comes as a blow to the LGBT+ community, which has seen significant reductions in HIV diagnoses over the past decade, partly thanks to the availability of PrEP.
Royal Australian College of General Practitioners (RACGP) President Dr Nicole Higgins has urged GPs to discuss options and supply with their patients.
“We need to make sure that everyone who needs PrEP has access to it and has adequate supply,” Dr Higgins said to newsGP.
“We also need to be able to counsel our patients on other ways to take PrEP and on other HIV prevention methods.”
The TGA website lists bottles of tenofovir-containing medication with supply impact dates that last until 11 October 2024 and 3 March 2025 while blister pack versions of the tablets have a supply impact date that lasts until 8 November 2024.
The shortage was announced on the same day the Kirby Institute revealed a 33% reduction in overall HIV diagnoses in Australia over the last decade.
Among Australian-born gay and bisexual men, diagnoses reduced by 64%, with the institute attributing much of this success to the introduction of treatments such as PrEP.
Professor Andrew Grulich from the Kirby Institute emphasised the importance of PrEP in HIV prevention.
“We have the strategies and technologies to eliminate HIV transmission in Australia,” he said.
“But we need to make sure PrEP and other prevention strategies are reaching the populations that most need them, including gay and bisexual men who were born overseas.”
Dr Higgins has called on the Federal Government to investigate the shortage further, describing it as part of a worrying trend.
“Medication shortages, such as PrEP, are at best an inconvenience, but at worst can be life-threatening,” she said.
“This is part of a global supply shortage, and Australia is a small market in the scheme of things. But if this continues, the Australian Government needs to make a choice about ensuring that we have adequate stockpiles of essential medications on soil, or the capacity to be able to manufacture essential drugs.”
ACON’s HIV and sexual health director Matthew Vaughan said while the situation is concerning, he’s confident the situation will be resolved in the coming months.
“If you are currently taking PrEP, please do not leave restocking your medication to the last minute,” he said.
“Given the current situation, you may need to visit more than one pharmacy to find a supply. There may be limitations on how many bottles of PrEP you are able to obtain from the pharmacy.
“Please plan ahead to ensure you don’t run out.”
He advised anyone unable to obtain PrEP through pharmacies to access it online, with information available at the PrEP Access Now website here.
The TGA launched a medicine shortage investigation in February 2024, receiving 221 submissions. The outcomes of these discussions will be provided to the Australian Government for consideration. In the meantime, Dr Higgins has advised GPs and patients to work together to guarantee access to the medication.
“The medication shortages are not just an annoyance for GPs and patients, in some cases they can have significant impacts on cost and travel,” she said.
“It’s creating extra red tape and time for GPs and their patients to locate where medications are with pharmacies.”
Last Updated on Sep 10, 2024
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