Codeine upscheduled

Codeine-containing OTC preparations will be upscheduled due to concerns about its abuse

Codeine upscheduling decision fails consumers, says the Guild, this morning following the announcement.

The decision to upschedule medicines containing codeine to be available only with a prescription will simply add to overall healthcare costs and do little to address the misuse of these products by some patients, it says.

Guild president George Tambassis says the reported decision to upschedule the medicines is short-sighted and ultimately will only add pressure to the already financially stressed health system while also increasing the burden on already overworked GPs.

“What this decision means is that patients will have to go to their GP and get a prescription for these products every time they need them,” Tambassis says.

“It will limit access to these medicines for people with genuine medical needs.

“The decision has purportedly been made to help stamp out abuse of these medicines by some people but in reality this measure will only encourage vulnerable patients to doctor shop and try to find ways around the system.

“To show how community pharmacies could help cut the misuse of codeine-containing medicines and avoid any need to upschedule them, the Pharmacy Guild developed and introduced a real time recording system called MedsASSIST.

“This clinical decision support tool enables pharmacists to refuse sales to people they believe could be misusing, or be in danger of misusing, these products.

“More than 4 million transactions have been recorded since March when the system was introduced across Australia.

“Of these transactions, pharmacists have denied sales to some 70,000 patient because of identified risk factors.

“Nearly 50% of patients denied a sale were referred to their doctor for more treatment.”

However, despite the success of this program, the decision reportedly has been made to reschedule from 2018.

“Making these medicines Schedule 4 will simply create a barrier to the majority of consumers who use these products safely,” says Tambassis.

“This decision will not address issues of misuse and abuse but rather will increase Government expenditure on the MBS and PBS with consumers forced to visit a GP to have a prescription written.

“Shifting it to prescription only without a mandated real time recording system or any screening program will simply bury the problem even deeper in the overwhelmed system and cost shift it to an already bursting MBS,” Tambassis says.

The Guild says onus will now be on the Federal Government to:

  • ensure that the 98%-plus of Australians who use these medicines safely will continue to have timely and affordable access to pain management medication, considering they will have to access a prescription from a GP; and
  • address issues of addiction to codeine containing medicines, particularly given the even larger societal problem of addiction to prescription-only medicines, the lack of any real time monitoring system, and the likelihood that patients who go to a doctor are likely to seek greater strength pain relief that is subsidised under the PBS. 

“As custodians of Australia’s medicines schedule, pharmacists will comply with the decision and ensure they are available to advise and counsel patients, many of whom will be disappointed and annoyed that their safe access to these medicines has been denied,” says Tambassis.

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