Healthcare workers tell GPs to rein in HIV medication prescriptions amid coronavirus crisis

Christopher Knaus
Photograph: Bradley Kanaris/Getty Images

Healthcare workers fear Covid-19 could cause a run on critical stocks of HIV medication and have instructed GPs to stop prescribing large volumes to prevent stockpiling.

The pandemic has caused temporary shortages of a range of common medicines and supplies – most notably Ventolin, children’s paracetamol, masks and hand sanitiser – as frightened Australians stockpile from pharmacies, despite clear advice from the government that there is no national medicine shortage.

Particular fears have now been expressed for the potentially dangerous effects of stockpiling on access to HIV medication.

Special regulations governing the distribution of HIV medication – known as regulation 49 prescriptions – allow individuals to quickly get access to large volumes of the drug by filling all of their repeats at once.

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Despite no prospect of a national shortage of HIV medication, stockpiling in this way could cause localised and temporary shortages and supply chain delays.

The Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine told the Guardian a run on medication of this kind could have serious consequences for those living with HIV.

The society is now urging GPs not to issue regulation 49 prescriptions, thereby limiting the volumes that can be dispensed at any one point.

It issued advice on Friday directly to doctors advising them that “a large amount of regulation 49 (also known as regulation 24) prescriptions continuing to be written may increase the potential for shortages or supply chain disruptions to occur”.

“This is particularly relevant if patients are accessing the medications in pharmacies that do not keep large amounts of HIV or viral hepatitis medications in stock, or if they are on older HIV regimens, which may be more susceptible to supply chain delays or shortages,” the advice said.

A GP and the society’s president, Assoc ProfMark Bloch, said his patients had expressed concerns about other medication shortages and were “naturally concerned”. Bloch said keeping one month’s supply at home was recommended.

“There is more than adequate supply of HIV medications in Australia but if patients start trying to stock up it may cause delays in access to certain medications in some areas,” he said.

The society has set up a national taskforce with the leading researchers, epidemiologists and frontline health workers to prepare for how Covid-19 will impact those living with HIV, viral hepatitis and other blood-borne viruses.

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The taskforce expects “critical challenges to the health system supporting people living with blood-borne viruses, across treatment, care, support and prevention”.

It will closely consider the potential for a run on HIV medication .

“We need to encourage GPs to reassure their patients that there are currently no HIV medication shortages, and no need to stockpile,” Bloch said. “Outside of exceptional circumstances, we also need to encourage GPs to avoid writing regulation 49 prescriptions, which allow patients to have all repeats dispensed at once.”

In an effort to stop stockpiling of other non-prescription medical items, the government last week instituted limits on children’s paracetamol and Ventolin. Customers were restricted to buying a single unit of Ventolin or children’s paracetamol at a time, and pharmacists were instructed to place children’s paracetamol formulations behind the counter.

Many pharmacists reported copping abuse and threats from aggressive customers trying to buy large amounts.

The Pharmaceutical Society of Australia national president, Prof Chris Freeman, has assured Australians that national supplies were adequate to deal with the increased demand.

“Demand for medicines has increased considerably in response to the Covid-19 pandemic which has the potential for numerous product lines to be out of stock, and some pharmacists are being pressured and abused to provide unsafe quantities of medicine,” he said.