NT clinicians facing higher costs and shortage of lifesaving rheumatic heart disease drug
The escalating shortage of a lifesaving rheumatic heart disease medicine is causing ‘deep concern’ among Territory health services, despite NT Health stating access to treatment is not impacted.
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Northern Territory health clinicians are “deeply concerned” by the escalating shortage of a crucial drug and its alternatives which are used to treat rheumatic heart disease.
Benzathine benzylpenicillin, commonly known as Bicillin, is a specialist antibiotic which is used to treat bacterial infections including acute rheumatic fever and syphilis.
It is also used to prevent serious conditions which can follow these infections such as rheumatic heart disease.
There has been a global shortage of the antibiotic since 2023 due to manufacturing and supply issues.
In June, the Therapeutic Goods Administration reissued approval to import alternative overseas-registered versions of the drug.
However Aboriginal Medical Services Alliance Northern Territory (AMSANT) said in July, it was announced with “no warning” that the supply of Extencilline from a French supplier was depleted.
Chief executive of AMSANT, Dr John Paterson, said this left Territorian lives at risk.
“This is a looming public health crisis,” Dr Paterson said.
“The NT has some of the highest rates of rheumatic heart disease in the world.
“Thousands of people, particularly in rural and remote communities, rely on uninterrupted access to Bicillin for monthly injections to prevent recurrent acute rheumatic fever and other life-threatening complications.
“Without it, lives are at risk.”
NT Health: Access to treatment remains uninterrupted
Rheumatic fever, rheumatic heart disease and syphilis are conditions which disproportionately affect Aboriginal and Torres Strait Islander people.
In the NT, the rate of rheumatic fever diagnoses among First Nations people is the highest in Australia.
As of December 2023, despite having the smallest population, the NT had the most people living with acute rheumatic fever and/or rheumatic heart disease (4,357).
It also had the highest number of new reported cases of acute rheumatic fever.
That year, the NT reported 284 news cases, double the second highest which was Queensland sitting at 142 cases.
In the new NT Health Surveillance Report in July, the latest advice was that all pregnant women would now be tested five times for the disease during their pregnancy, as should anyone over 15 years old.
According to NT Health, Benzathine Benzylpenicillin is one of 350 medicines currently in short supply.
However, the shortage is expected to be resolved by September.
An NT Health spokesman said the shortage has had no impact on access to treatment.
“Supplies have been carefully managed to ensure people who need this medicine continue to receive it,” he said.
“NT Health develops guidance for clinicians to advise of suitable conservation strategies and appropriate alternatives for medicine shortages that impact the whole of the Territory.
“NT Health has an agreed process to share this information to ACCHOs for distribution within their networks.
“Access to treatment remains uninterrupted.
“In times of limited supply, medicines are reserved for patients without other treatment options, while equally safe and effective alternatives are provided to others where appropriate.”
‘There is real concern in NT health clinics that supply will not be able to meet demand’
But alternatives are again in short supply and can be more expensive for health services.
There is a limited supply of one alternative, Brancaster, but as it is not listed on the Pharmaceutical Benefits Scheme, health services have to purchase it privately costing around $66 per vial according to AMSANT.
Another substitute Benzatacil is still awaiting emergency approval to be used in Australia.
Dr Paterson said AMSANT is calling for fast-track approvals from government to ensure affordable access to the needed treatments and help in reimbursing health services who are forced to buy more expensive medicines.
“These privately billed medicines not only place a financial burden on already stretched services — but there is real concern about whether supply will be sufficient to meet demand across the Northern Territory,” Dr Paterson said.
“We simply cannot afford to be left without the medicines we need to prevent heart disease and premature death in our communities.”
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Originally published as NT clinicians facing higher costs and shortage of lifesaving rheumatic heart disease drug
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