A shortage of generic drugs is causing "anxiety and panic" among patients dependent on basic heart disease or asthma drugs in regional areas, according to pharmacists.
Simon Reynolds, owner of the chain of regional pharmacies Alliance Pharmacy, said small rural chemists suffered the most of all, with small communities left with few options.
"Customer comes in, might be every month, might be for their chronic blood medication or diabetes medications, something they almost take for granted, like a litre of milk," he said.
"All of a sudden they come in and your local pharmacist said I can't get that for you. I don't know when it's going to be available. You can imagine the anxiety and the panic it causes the customer. That flows onto the pharmacy staff and the pharmacists.
"We have had patients where we literally have not been able to get medication for a chronic problem that they've got, and we've had to then work with GPs and the health professionals to be able to get them on another type of medication. It's a big cost to the healthcare system, the work involved, not to mention the stress involved as well."
Mr Reynolds said a number of heart medications, Ventolin, and even puffers for asthma are in short supply, among other very cheap drugs.
The problem is worse in rural areas, which are often not serviced by big chains that have the cashflow, warehousing capacity and market influence to be able to get rapid delivery, he said. Rural people often do not have dozens of chemists to choose from, like city residents.
"You always feel, I guess being in the country you do feel sometimes that you're the poor cousin and you do feel like that maybe the city does get preference," he said.
"But the preference is probably more to some of the more sophisticated groups that can get ahead of the supply chain and actually have the ability to stockpile some medicines, whereas the smaller independent pharmacies seem to order on a monthly basis and they do not generally order up large quantities at a time."
Former President of the Pharmacy Guild of Australia Kos Sclavos said if an entire region ran out, that could force pharmacists to take drastic measures.
"The more regional and remote you go the more likely that is going to be an issue, because it's not like you're in the CBD of Brisbane or Sydney where there's another wholesaler you can order the supply from," he said.
"And if that's that day that you're packing Mr Smith's medicines for a week, or if that's the day that somebody presents and they want their normal chronic therapy medicine, the pharmacist is left with no other choice but to switch someone to another generic. That does cause medicine misadventure."
Patients have to be weaned off some types of blood pressure medicines, in order to change to others he said - not an easy task if there's none left.
Professor Chris Levi, Director of the John Hunter Health Innovation Precinct, said there was a range of solutions to a problem caused by Australia's place at the end of the global pharmaceutical supply chain.
Because negotiation by the Pharmaceutical Benefits Scheme has driven prices down to ultra-cheap prices, generic drugs tend to not be very profitable for offshore drug producers, he said.
"The key question that we have got to be asking is should we be more self sufficient in the local manufacturing of simple drugs that we need every day, rather than needing to import them," he said.
"Australia is becoming a less attractive destination for generic medicine companies because our pricing is really pretty tight."
He said that could take the form of a government-owned pharmaceutical company, like the old Commonwealth Serum Laboratories, or simply incentives for the private sector.
Mr Sclavos said government could also create incentives for local pharmacists to stockpile drugs in case of a shortage.
Alliance Pharmacy owns Ditton's Pharmacy in Inverell.
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