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RAT out of hell: how has Covid-19 disrupted Australia’s pharmacy sector?

​Since making the leap from animal to human in late 2019, Covid-19 has created unprecedented challenges for governments, businesses and individuals. Now, as we settle into 2022 and more Australians are receiving their vaccine boosters, many of us are returning to something approaching normal.

For Australia’s pharmacists, however, the pandemic is not yet over – and “normal” still looks a long way away. Covid-19 has had profound impacts across our society and economy. However, the pressure it has applied to the pharmacy sector, as well as pharmacists themselves, is unique. In the first days of the pandemic, confusion and anxiety led to widespread panic buying across Australia, including paracetamol, cold medications and prescription medicines. The implementation of lockdowns caused pharmacies to experience big drops in foot traffic. When the vaccines became available, pharmacies were one of the main ports of call for Australians looking to get a jab or have a chat with an expert. As states and territories opened borders and lifted lockdowns, and the scarcity of Covid-19 tests became a major issue, it was Australia’s 35,000 pharmacists who were once again expected to step up to the plate. On top of their many other responsibilities, overworked pharmacists were expected to become experts in de-escalation when dealing with concerned or aggressive customers ranting about the vaccine or demanding to know when the next batch of Rapid Antigen Tests (RATs) would arrive.

Governments have now jettisoned the Covid-zero strategy in favour of living with the virus. This change in approach led to massive increases in demand for both Polymerase Chain Reaction (PCR) and RATs. Unfortunately, supply failed to keep up with demand. According to Associate Professor Chris Freeman, National President of the Pharmaceutical Society of Australia, huge demand for RATs has placed significant financial burdens on many pharmacies. “In recent weeks … distributors have had to go to extreme lengths to get RATs into the country, resulting in a substantial increase in freight and delivery costs.”

The Federal Government’s new scheme to provide concession card holders with access to RATs, which was intended to ease financial pressure on pharmacists, appears to have exacerbated the problems instead. According to A/Prof Freeman, the program’s “premature launch” means that patients “are still presenting to pharmacies under the impression that stock [of RATs] is guaranteed.” Meanwhile, reporting elsewhere suggests that that $10 rebate doesn’t fully cover pharmacists’ wholesale costs – and that rebates won’t be provided for weeks.

Disruptions are not confined to Rapid Antigen Tests. The pandemic has worsened existing shortages of medicines while also disrupting pharmacy supply chains due to factors such as logistics and warehouse staff contracting the virus. This has led, in the words of A/Prof Freeman, to the “creation of bespoke, short-term delivery solutions” which have made it hard to precisely estimate delivery dates. Furthermore, disruptions have been unequally distributed across Australia, with rural and regional communities being particularly impacted.

The Pharmaceutical Society has called for a “broad range” of solutions to these current disruptions, including appropriate therapeutic substitution and the ability to adjust dosage form and strength to deliver the prescribed treatment dose. Fundamentally, however, says A/Prof Freeman, pharmacists are being expected to do so much more than before the pandemic – such as quickly and accurately communicating supply outages – without receiving the support they needed to best meet the huge increase in workload.

From the difficulties of maintaining adequate stock levels, to the rapid implementation of electronic prescribing, Covid-enforced staff shortages, dealing with irate or scared customers, Australian pharmacists have faced countless challenges. That they have remained resilient while administering five million Covid-19 vaccinations – and counting – is to their immense credit.​

Already among our most highly-trusted occupations, pharmacists are now more tightly connected to their communities than ever. Pharmacists and industry bodies should use this once-in-a-generation demonstration of their importance to forcefully advocate for more transparent communication from government, better support when it comes to managing supply chains, and better support for individual pharmacists, many of whom are burnt out and all of whom have been hugely overworked.

There will be no return to “normal” for Australia’s pharmacy sector. But there is an opportunity to leverage the goodwill the sector has created to prepare for the next pandemic.