How a real-time OTC codeine monitoring system would look

codeine tablets, glass of water

ASMI’s Deon Schoombie takes a look at how the prototype real-time monitoring system for OTC codeine would work

During the last few weeks there has been substantial discussion about the potential for a real-time monitoring system to reduce the risk of consumers ‘pharmacy shopping’ for over-the-counter codeine-containing analgesics.

I have been asked how this system will work and how it will address issues of misuse and addiction to Schedule 3 (S3) codeine-containing analgesics.

The prototype real-time monitoring system developed by The Pharmacy Guild of Australia, Pharmaceutical Society of Australia, Australian Self Medication Industry and consumer groups will provide pharmacists with support to help them decide whether or not to provide a consumer with the requested medicine.

It will also provide objective data to guide evidence-based policy reforms.

This monitoring system would be separate to Project STOP, but would provide a similar function in standardising the pharmacist’s interaction with patients and in recording the patient’s recent purchase history. It would also provide a simple means for referral of patients to pain specialists if chronic use is identified.

There is no corresponding system in place for monitoring prescription analgesics.

The real-time monitoring system will record sales of codeine-containing analgesics to individual consumers, allowing pharmacists to identify those consumers potentially at risk of codeine misuse and helping pharmacists to determine the suitability of supplying the product to the consumer.

The system identifies who initiates the purchase i.e. whether the consumer requests the product, whether the pharmacist recommends it in response to the consumer’s symptoms, or a GP, pain specialist or another health professional recommended it.

The pharmacist will only supply the product if the consumer consents to recording of the purchase. If the consumer does not provide this consent, the pharmacist may suggest an alternate OTC product or refer them to a doctor, if more appropriate.

The consumer’s purchase history will guide the pharmacist’s decision on how best to manage them. Identification of repeat purchasers enables those people to be counselled on potential addiction risks and enables referral to a medical practitioner.

Once this system is implemented, policymakers will have access to up-to-date data to guide their policy decisions.

ASMI calls on the Federal Government to base policy decisions upon evidence.

We urge the Delegate to defer making a decision on the scheduling of OTC codeine-containing analgesics for 12 months to allow sufficient time for the prototype real-time monitoring system to be implemented and for it to collect current, objective data on which a final scheduling decision should be based.


Deon Schoombie is the Chief Executive Officer of the Australian Self Medication Industry.

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1 Comment

  1. Jarrod McMaugh

    Any real-time system must be capable of integrating with ant S4/S8 RTM

    ideally, it would be a single programme. It would capture items supplied based on barcode scan. it would integrate seamlessly with existing dispensing and prescribing programmes. It will be able to parse information to the PCEHR (or integrate, preferably).

    If patient use data is not readily available quickly and completely, the purpose for such a system to exist will have been thwarted.

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