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New modelling demonstrates that current and anticipated supply of critical medicines for ventilating patients is sufficient to support both a return to elective surgery and a rise in COVID-19 cases.
The modelling was undertaken as part of a coordinated effort to manage medicines supply during the COVID-19 pandemic by the Therapeutic Goods Administration (TGA) within the Department of Health, the pharmaceutical industry and medicines wholesaler groups, health professional bodies and state and territory health departments.
The modelling, combined with information from sponsors about current stock and future deliveries, indicates that anticipated supply of sedatives, neuromuscular blocking agents and analgesic medicines from June to October is sufficient for usual surgical activity in addition to 200 intensive care unit (ICU) beds per month to be occupied with ventilated COVID-19 patients - or ICU management of approximately 1750 COVID-19 patients over this time.
A total of 50 patients with COVID-19 in Australia have been admitted to ICU and received ventilation.[1]
Since the emergence of COVID-19 in Australia, the TGA has been working with the members of the Medicine Shortages Working Party to monitor supply of critical medicines used in the intensive care setting, and to identify and respond to medicine supply issues as they arise.
Some hospitals and health professional groups have raised concerns that supply of intensive care medicines in Australia may not be sufficient to support a rise in COVID-19 cases requiring intensive care as elective surgery recommences. These concerns arose in March and April when many hospitals' orders for critical medicines were only being partially filled. As purchasing increased to prepare to operate additional ventilated ICU beds, medicine sponsors reported supplying significantly increased quantities of critical ICU medicines, but actively limited orders and held some reserve stocks to allow for equitable allocation and emergency supply.
The current modelling does not take into account stock already held by hospitals, which would support a further increase in ICU capacity given that medicines stock levels will be increased due to the cessation of elective surgery, lower than expected COVID-19 case numbers, and increase in supply in March and April.
The estimates derived from the modelling will be used by the Department of Health to work with industry and health professional groups to monitor and manage medicines supply during the pandemic for ICU management of COVID-19 patients and for elective surgery.
The model was developed with advice from a working group including representatives of state and territory health departments, anaesthetists, intensivists and the TGA, chaired by Professor Michael Dooley, Director of Pharmacy at the Alfred Hospital in Melbourne.
The Medicines Shortages Working Party is chaired by the Australian Government Department of Health and includes:
- Australian Commission on Safety and Quality in Health Care
- Australian Medical Association
- Chemist Warehouse
- Consumer Healthcare Products Australia
- DHL
- Generic and Biosimilar Medicines Association
- Medicines Australia
- National Pharmaceutical Services Association
- Pharmaceutical Society of Australia
- Pharmacy Guild of Australia
- Society of Hospital Pharmacists Australia
- TGA Licensed Compounders
Additional information about the modelling, including graphs portraying projected national demand for key ICU medicines, is available in the documents below.