Three leaders of Australia's pharmaceutical wholesale sector sat down for an extended discussion with BioPharmaDispatch. In part one, they talk about their companies' experience during the recent bushfire crisis and the increasing recognition of the pharmaceutical supply chain as a critical component of the country's health infrastructure.
The National Pharmaceutical Services Association (NPSA) represents the full-line PBS wholesalers who also qualify for payments under the program's Community Service Obligation.
Sigma CEO Mark Hooper is the NPSA chair and he was joined in the discussion by the CEOs of API and Symbion, Richard Vincent and Brett Barons.
Mr Hooper said the federal government has recognised the distribution of prescription medicines as part of Australia's "critical health infrastructure" but it is "invisible" to most people.
"People walk into their pharmacy and assume the products they need will be there. It is in times like fires, or like the floods we have had in the past as well, that we as companies go over and above to ensure the PBS infrastructure delivers for patients.
"All of our companies stepped up to provide additional support to rural communities impacted by these tragic events to make sure patients are still getting their medicines. I do think to a degree it has focussed attention on the support required to maintain this infrastructure on an ongoing basis."
API's Richard Vincent said they were challenged during the bushfires by a crisis that "was changing on a daily basis".
He said, "At API, we had a crisis room staffed by our logistics people, as well as our salespeople who support pharmacies on a daily basis. They were making assessments and arrangements based on things like road closures, finding alternative routes, and that means engaging with our transport providers. They were telling us places they could not go so we had to think outside the box about getting into certain areas. In some cases, and the other companies would have been in the same situation, our people were going hundreds of kilometres outside our normal routes, even hiring or chartering boats.
"We were also coordinating with the RAAF so they could make medicine drops via helicopter and ensure medicines get to where they needed to be. The simple reality is that we were able to manage this complexity because we have been doing it for so many years. The bushfires were the most recent challenge but we have regularly dealt with natural disasters, such as cyclones and floods in Queensland."
He continued, "We also assembled some essential kits for impacted families. We started that back in November because there were people already being displaced from their homes. Our staff asked the question - what can we do to help? We distributed them through our retail chains because they would know the families. We made it so they could keep coming back to get more of the items."
Symbion's Brett Barons said the companies are constantly monitoring for potential disruptions in the consistent delivery of PBS medicines, pointing to the recent threat of ex-tropical cyclone Esther.
"We take this responsibility very seriously. The product needs to get to the pharmacy. It is not overstating it to say lives are at risk if deliveries do not get through. During the bushfires, areas were being cut-off so we did things like hiring a refrigerated container in Newcastle so the product did not have to go back to Sydney. That way, we could keep it in Newcastle and that meant pharmacies received their deliveries three hours earlier.
"We also worked to ensure the CFA firefighters had the equipment they could use to keep drinks cool. It is a small but significant thing."
He added, "I think we would all say our commitment to the delivery of medicines is a cultural feature of our sector. As a company, we are in our 175th year and this culture underpins our commitment to patients. It is an expectation we all impose on our organisations. We do not ever want to let down patients or pharmacies. We have to pay tribute to pharmacy because we all know the challenges they faced during the bushfires - they were still coordinating their pharmacies even when their own homes burnt down. We all feel compelled to support that."
The companies have also supported the federal government's response to coronavirus by supplying kits for the flights chartered to evacuate Australians from impacted parts of China.
Mr Hooper said the NPSA has been talking a more proactive approach over the past twelve months aimed at raising awareness of the critical health infrastructure wholesalers maintain to support the delivery of medicines.
"In the past, I think not reminding people of this was to our disadvantage - we are the invisible arm of the National Medicines Policy and that can be forgotten because we do a good job. At the end of the day, our actions during the bushfires and any other national emergency is 'what we do'," he said, adding it is a commitment "born out of a sense of responsibility to make sure patients get their medicines".
Asked about recognition of this commitment in the Community Pharmacy Agreement, he added, "There has been a decrease in funding over the past two Community Pharmacy Agreements (CPA). At the end of the day, when it comes to the Seventh CPA, without wanting to delve into specifics we are looking for recognition of the critical nature of what we do and an adequate level of remuneration to make sure we continue to reinvest in the network that is part of this country's critical health infrastructure. That has always been our basic ask at the end of the day."
In the second part of the extended interview, the three leaders of Australia's pharmaceutical wholesale sector talk about their sector, its ambitions and hopes for the current negotiation with the federal government.