Failure to manufacture pain medicines leaves a confronting picture

A coalition of seven organisations is demanding government action to tackle the worsening pain medication shortages, calling for a ‘Made in Australia’ solution.

Every day, around 400 Australians die from terminal illnesses, yet more than 60% do not receive specialist palliative care at any stage. Despite this alarming gap, critical pain relief medicines remain in short supply, leaving many to suffer in their final days.

Palliative Care Australia (PCA) has welcomed the Federal Government’s $20 million investment to expand local manufacturing of IV fluids through a partnership with Baxter Healthcare in Western Sydney. However, PCA said the government must go further.

“Ongoing shortages of IV fluids have been a huge concern for clinicians since 2023, but over the same time frame, even longer in some cases, we have seen heartbreaking shortages of pain relief medications for people of all ages at the end of life,” said Camilla Rowland, CEO of PCA.

“In the same way that government and industry are now investing in local production to solve the IV fluids shortage, we need to do the same for pain relief medications so that people can die with peace and dignity, and so families aren’t left with the trauma of seeing loved ones in pain and distress.”

“Palliative care isn’t just about dying well – it’s about living well in the time we have left,” said Ged Kearney, Assistant Minister for Health and Aged Care, as she reflected on her personal connection to palliative care at Parliament House in November last year. “Both my mother and my nephew taught me that.”

Beyond supply issues, cost remains a significant barrier. Many alternative medicines are not subsidised through the Pharmaceutical Benefits Scheme (PBS). One striking example is hydromorphone SR, which costs $182 for 32mg. The overseas alternative, which is not PBS-listed, is a staggering $4,209 for 100 tablets – 23 times more expensive.

Yet, Australia is uniquely positioned to solve this crisis. Tasmania is the world’s largest producer of poppy-derived alkaloids, the raw material essential for manufacturing pain relief medications like morphine, thebaine, and codeine. According to the Tasmanian Department of Natural Resources and Environment, Tasmania’s 450 poppy growers supply nearly half of the global demand for these ingredients.

“This is a significant competitive advantage for Australia as global supply chains falter and business models are challenged,” Rowland said.

“Our experience during COVID also demonstrates that we have the skills and capacity to manufacture vaccines locally – at that time, we were able to have some independence from supply shortages and global transport challenges and look after our own. A future made in Australia must include medicines. Using Australian-grown poppies to make pain relief medications for Australians just makes sense.”

PCA, along with six other healthcare organisations*, has presented an 11-point plan to the Federal Health Minister, Mark Butler MP, to resolve the ongoing shortage of pain relief medicines.

“As part of making these medicines in Australia, we are also advocating for a national stockpile to be established and for pharmaceutical companies to give more notice of impending shortages,” Rowland stated.

She further added, “We want to be partners in solving an issue that has gone on for too long. The wider community is also calling for action, with close to 35,000 signatures on our Better access to palliative care petition.

“We remain hopeful that those who want to make up the 48th Parliament of Australia will respond and work with us to fix this so that quality of life at the end of life can be delivered to every Australian.”

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*Palliative Care Australia, Australia New Zealand Society of Palliative Medicine, Advanced Pharmacy Australia, Pharmaceutical Society of Australia, Palliative Care Nurses Australia, Pain Australia, and Aged and Community Care Providers Association.