Life-saving medicines frequently in short supply and doctors are worried

New ABC analysis has revealed the important medicines that have repeatedly been in shortage, highlighting supply chain weaknesses that could get worse.

If you've never heard of Bicillin L-A, count yourself lucky.

It's a long-lasting penicillin and a life-saver for many Australians with syphilis or rheumatic heart disease.

Trouble is, there's a global shortage and Australia's emergency supplies ran out in September.

And, as it turns out, this isn't the first time this important medicine has been in short supply.

Medicine shortages are reported on the Therapeutic Goods Administration's (TGA) website.

For this story, we tracked shortages going back to 2015, including some that were expected to continue into next year.

Bicillin L-A 1.2 million units went into shortage in April 2025, and isn't expected to be back to normal until March next year.

It's been labelled a critical shortage, which means there could be a risk of life-threatening or serious impacts.

It also means there's not enough supply or no other suitable replacement on the Australian market.

But we found multiple shortages of this drug, and most of them were critical.

The current shortage is the longest recorded for this drug, and the company says it's due to manufacturing issues.

And this is far from the only drug in critical shortage.

Another is Creon, which is used to help people digest food, including patients with cystic fibrosis.

Two different doses of this drug have been in shortage for more than a year, due to an unexpected increase in demand.

One dose, Creon 25,000, has been in shortage multiple times in recent years.

We found a low impact shortage in 2015, followed by four medium impact shortages.

Like Bicillin, the current shortage is the longest and most severe.

These are only two of the 40 medications recently in critical shortage.

Our analysis revealed more than half of them have had at least one recorded shortage before.

And 13 medications, or about a third, have been in critical shortage multiple times.

We've put them together here, ordered by the number of previous shortages and the length of the current one.

It's important to note that some of the medicines relate to a specific dose or formulation, and there are ways the health sector manages shortages, which we'll come back to.

(If you're concerned your medication is in shortage, you can check the TGA website).

Most of the shortages continued beyond October 2026, when the data was last collected.

Bicillin and Creon are among the medicines that have the most shortages recorded, with six each.

The other drugs at the top of our list include a nuclear medicine used to assess how blood moves through the heart (Radpharm PYP), and an injection that reduces high blood pressure in late pregnancy (among other uses).

The list also includes the only vaccine available for Q fever — a bacterial disease that can result in serious illness. Australia is due to run out of the vaccine this week.

While many of us are lucky enough to never have heard of these drugs, some on the list are ones you'd commonly get from your pharmacy.

They include the EllaOne morning after contraceptive pill, which is known as the gold standard, and Lyclear scabies cream.

Some medicines haven't had as many shortages, but that's because they've spent several years in one continuous shortage.

Again, the reasons given by the suppliers are either increased demand or manufacturing issues.

And it's not just the repeated critical shortages causing headaches for medical staff and patients.

More than 420 shortages were recorded between late September and early October, with critical ones making up the smallest share.

Royal Australasian College of Physicians spokesperson and internal and addiction medicine professor John Saunders said repeated medicine shortages — including medium-impact ones — caused "great frustration" among doctors.

While there were often alternatives available, he said sometimes they weren't as good, or were simply not available at all.

"It's not something that I can say, 'Oh there, there, don't worry about it, it'll be alright' — far from it," he said.

"Switching medications when this isn't part of a plan … is a very difficult thing for [patients] to experience."

University of Adelaide pharmacy lecturer and pharmacist Jack Janetzki said the medicines on our "critical" list spanned a wide range of essential uses, such as treating life-threatening and severe fungal and viral infections.

He said while authorities could manage these shortages — by drawing on local stockpiles and dispensing approved unregistered medicines, for example — repeated critical shortages needed close attention.

"A shortage is obviously challenging enough for health professionals and consumers to navigate when it happens as a once-off, but repeated shortages can indicate that a medicine or its supply chain remains vulnerable to disruption over time," he said.

Peter Coomber, a University of Queensland pharmaceutical supply chain researcher, agreed that repeated shortages of important medicines were a "big problem".

"The medicine is ultimately necessary for care, potentially life-saving situations, and we don't have a suitable substitute for that in a sufficient quantity," he said.

He said Australia's medicine supply chain was "lacking resilience and vulnerable to disruption".

Australia imports 90 per cent of medicines, but makes up only about 2 per cent of the global pharmaceutical market.

"We're an unattractive market based purely on market size," Mr Coomber said.

He said overseas frustration over Pharmaceutical Benefits Scheme (PBS) pricing and Australia's distance from the rest of the world added to the difficulty.

The reasons behind recent critical shortages were mainly manufacturing problems, followed by raw material supply issues, an increase in global demand, commercial viability and transport.

And while TGA data indicated the number of new and repeated shortages over the years was relatively stable, Mr Coomber said he believed they were affecting more people.

Recent shortages included EpiPens, ADHD medications, IV fluids, blockbuster GLP-1 drugs like Ozempic and opioid pain relief.

Dr Janetzki said the various ways to deal with shortages appeared to be generally working well, but that researchers did not fully understand the costs of shortages on individual patients.

These included time costs, like having to call or visit multiple pharmacies, financial costs around paying extra for a more expensive brand or seeing your doctor, and potentially even health costs.

Mr Coomber said all Australian jurisdictions should commit to a national List of Essential Medicines, which could help streamline efforts and coordination during a shortage.

The World Health Organization (WHO) has one, as do many countries around the world including China and India, as well as the European Union.

The TGA said it maintained a regulatory Medicines Watch List — a list of active pharmaceutical ingredients where any shortage would automatically be classified as having a "critical" impact — but said states and territories might also maintain their own lists.

The TGA also reported some long-lasting shortages on its website, but it said it was "not comprehensive".

Mr Coomber also said Australia should help develop manufacturing capability with regional allies.

A recent Senate inquiry into proposals to strengthen mandatory reporting for medicine shortages and discontinuations — among other amendments — also noted some submissions said Australia needed to build "sovereign capacity".

The TGA said it acknowledged that repeated or long-running shortages of specific medicines were very impactful and concerning.

"However, the occurrence of a previous shortage does not necessarily determine the nature or impact of a future shortage," it said in a statement.

It said every shortage was "unique and dynamic" but it approached them in a consistent way, by working with the company to resolve it and with state and territory health departments.

It said there were a number of government initiatives aimed at supporting local manufacturing and reducing supply disruptions, and it was actively investigating and developing reforms.

"However, it is important to understand that pharmaceutical companies are private businesses, and the government cannot compel a pharmaceutical company to register, manufacture, market or continue supply of a medicine in Australia."

The medications outlined in the analysis are represented by a variety of pharmaceutical companies, including research-based and generic drug makers.

Medicines Australia CEO Liz de Somer, who represents some of the research-based pharmaceutical companies, says shortages can occur due to "unforeseen supply chain disruption" and "underinvestment by the government in the PBS".

Generic and Biosimilar Medicines Association CEO Nikki Lorenz, who also represents some of the companies experiencing shortages, says while Australia have been "very successful" in reducing the cost of generic medicines, supply resilience is "not free".

But Mr Coomber said Australia's supply chain resilience needed to be improved.

"With increasing global geopolitical instability, as well as reportedly increasing natural and environmental disasters, the frequency of shortages may increase."