Centralised approach key in tackling intravenous paracetamol shortages

A statewide critical shortage of intravenous (IV) paracetamol has started to ease following efforts by an HSV-led clinical advisory group to manage and conserve supplies of the vital medicine.

The advisory group, formed with HSV, health service clinicians, Safer Care Victoria and the Department of Health coordinated the response, which involved issuing recommendations on conserving usage and available alternates, sourcing stock from overseas-registered suppliers and managing the distribution of IV paracetamol stock across the state. 

Problems with IV paracetamol supplies were first identified in February 2024 when the state’s main registered supplier advised it would have to reduce supplies to around 30 per cent of forecast requirements due to rising global demand.

HSV then carried out a stock assessment which found Victoria only had two weeks’ worth of supply remaining.

HSV Head of Supply Chain Surety Paul Callahan said that as part of the response, HSV managed a centralised distribution system to allocate supplies to Victorian health services based on usage and needs assessments. After consultation with the advisory group, clinical guidelines issued by the Department of Health restricted use of IV paracetamol to critical medical cases.

“The coordinated response clearly demonstrated the effectiveness of centralised supply chain management in crisis situations,” Paul says.

Western Health Acting Deputy Director of Pharmacy Daniel Grabek said the centralised approach saved his department valuable time and resources because they didn’t have to source new supplies.

“We have a high usage of IV paracetamol across our network and we were worried we wouldn’t have enough stock,” he says.

“When we knew that HSV was controlling the allocation and we had visibility of the supplies coming through, it gave us confidence. It also meant we could provide our clinical staff with clear communication about usage and stock levels.”

Paul said HSV engaged with overseas-registered suppliers and worked with the Therapeutic Goods Administration to expedite the application review process so that additional supplies could be brought into Australia.

“We were able to successfully reduce the administration burden involved in sourcing IV paracetamol overseas.”

Essential for post-operative pain management and fever control in hospitals, around 1700 vials of IV paracetamol are used by Victorian health services each day in emergency departments and intensive care units.

As a result of the conservation guidelines, IV paracetamol usage reduced by 70 per cent between February and June 2024.

For more information on supply chain surety initiatives or to raise any risks, please contact the Supply Chain Surety team on supplychainsurety@healthsharevic.org.au.