AMA castigates “peddling of alternative codeine models”

But the Guild has hit back saying it’s time to put common sense and patients before “tired old turf wars”

The Australian Medical Association fully supports the TGA’s decision to upschedule codeine, President Dr Michael Gannon reiterated on Thursday.

“There is compelling evidence to support the decision to make codeine prescription only,” said Dr Gannon, adding that all parties need to work together to move forward on the issue.

“The decision has been made – what we need to see now is cooperative implementation,” he said.

“We are extremely concerned at recent reports of some groups endeavouring to influence or coerce State governments to change, delay, or dilute the impact of the TGA decision.”

Dr Gannon is referring to the Pharmacy Guild of Australia’s announcement last month that it is working on a model that would see certain limited circumstances in which patients could continue accessing codeine-containing medicines directly through community pharmacies without a prescription.

It had also stated that pharmacy representatives have been active in meeting State and Federal Ministers and politicians, as well as stakeholders, to inform them of its proposal.

The Guild has hit back at Dr Gannon’s statement, saying it is a “disappointing misrepresentation of the Guild’s approach” and calling on the AMA to introduce real-time monitoring before next February.

“Community pharmacy voluntarily put a real-time system – MedsASSIST – in place last year for over-the-counter codeine pain relief medicine. What is the AMA doing?” said the Guild.

Guild National President George Tambassis said: “The Guild is not seeking to reverse the upscheduling decision.

“However upscheduling alone will not address issues of addiction and could actually exacerbate them, particularly given the lack of any mandatory national real-time monitoring system of doctors and the likelihood that some patients will be prescribed higher-strength codeine-containing products.

“Neither the Guild nor community pharmacies are acting irresponsibly. It’s time for the AMA to put common sense and patients before tired old turf wars,” said Mr Tambassis.

However Dr Gannon was firm: “The AMA urges all stakeholders to not deviate from the TGA decision, which was made with open and transparent consultation.

“At this stage, we do not want to see the peddling of alternative models, dressed up as ‘patient concern’, which undermine the TGA position.”

Dr Gannon argues that the codeine decision is an independent decision that was made in the “best interest” of Australians.

“We call on all those who work in the wider health community – including pharmacy – to quickly implement the changes that are necessary,” Dr Gannon said.

PSA National President Dr Shane Jackson said the pharmacy member organisation remains “fully committed” to supporting pharmacists to manage the planned February 2018 change in the scheduling of codeine.

However he says they “don’t believe it will fix the problems of pain in the community as it’s a blunt approach to address the over-use of opioids in Australia”.

“The lack of a uniform mandatory real-time recording system has stifled pharmacists’ ability to identify patients who have been abusing, or misusing codeine,” Dr Jackson told AJP.

“That’s why a national real-time recording system is fundamental to future availability of codeine-containing analgesics – and PSA has publicly supported this move.

“Community pharmacists have the skills, knowledge and expertise to expertly advise patients on the effective and safe use of OTC analgesics for the treatment of acute, short-term pain.”

He says the PSA believes:

  • Mandatory real-time recording of opioids including codeine is fundamental to addressing the issues of opioid misuse in Australia; and
  • There is a need to provide support for pharmacists, consumers and general practitioners with the planned changes to prescription-only.

“PSA position has always been we support consumers continuing to have appropriate access to codeine containing OTC products with the advice of a pharmacist.”

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