Local pharmacy’s played an important role after the Tasmanian’s bushfires in 2013. Credit: Wayne Rigg, Country Fire Authority.
This article first appeared in the Spring 2016 edition of Fire Australia magazine. By Kaitlyn Porter, Bushfire and Natural Hazards CRC and Queensland University of Technology PhD student.
Pharmacies are critical to the health of their local communities. During a disaster they play a further important role, often at their own considerable cost.
Emergency services stress the need to have medication in emergency kits. It might sound like common sense, but having the medication you need on hand can save you money, and free up vital emergency response for those in critical need. With one-third of the population suffering from at least one chronic disease, maintaining medical supply is vital during an emergency. In order to reduce the pressure on doctors and the healthcare system during disasters, disaster management planning needs to involve community pharmacists.
During a disaster many displaced individuals will present to the nearest available pharmacy requesting a re-supply of their chronic disease medications as well as basic necessities. Often this will be without prescriptions, or even personal identification and money. In times of emergencies, pharmacies are able to give an emergency supply of medications when the following criteria have been met:
A patient’s continuation of the medication is essential
The pharmacist deems an emergency situation exists for this patient (patient is unable to obtain a prescription in a timely manner)
The quantity sold does not exceed three days’ supply.
If these three criteria are met, an emergency supply of a patient’s medication may be issued in the absence of a prescription. However, this is not covered by Australia’s Pharmaceutical Benefits Scheme (PBS) and is at the patient’s own expense. This means that a pensioner could pay up to $36 for a medication that would normally cost them $6.20 on the PBS.
With the effects of a disaster often lasting longer than three days, sometimes stretching for weeks, legislation requires affected individuals to return to the pharmacy every three days to receive continuing supplies of their medications, further compounding the psychosocial trauma brought on by the disaster. The alternative to this is obtaining a doctor’s prescription, but this can put medical resources under strain. Whilst chronic disease management is important, during emergencies, hospitals and medical centres have to prioritise their available resources to treat any influx of acutely injured disaster victims requiring immediate medical assistance.
In previous Australian disasters, community pharmacies have played an important role in supporting their local communities by staying open late to ensure people have access to primary healthcare, and supplying affected individuals’ with basic essentials and medications free of charge (at the pharmacy owner’s expense). Pharmacies are unable to obtain remuneration from the Australian government natural disaster relief and recovery fund, as they are not recognised as providing an essential service during the disaster. This places pharmacies in a difficult position – how do they continue to meet the public’s health care needs when it places a significant financial burden on the pharmacy’s business? In some instances, the financial impost is so great that pharmacy owners have been forced to close their doors during disasters until the reestablishment of the community health services.
Both federal and state governments have a role to play here, and need to review the emergency supply rules for disaster situations, taking into consideration the added stress to affected individuals and pharmacy staff. They should also accept responsibility for the financial remuneration of community pharmacy owners whose businesses are also impacted by the disaster but who choose to still supply their community with basic necessities free of charge.