Doctors erupt over Nats codeine announcement

AMA President Dr Michael Gannon.

The AMA has accused the Pharmacy Guild of “actively undermining” the TGA over the codeine upschedule

Following yesterday’s announcement by NSW Deputy Premier John Barilaro that the NSW Nationals supported a reversal or compromise of the upscheduling decision, doctors have attacked the Pharmacy Guild in an official statement, and on social media.

“AMA President, Dr Michael Gannon, today condemned the Pharmacy Guild of Australia for its irresponsible and unprincipled lobbying of State and Territory Governments to undermine the ruling by the independent Therapeutic Goods Administration (TGA) to make codeine a prescription-only medicine from 1 February 2018,” the Australian Medical Assocation said in a statement yesterday. 

“The Guild, which represents pharmacy owners, announced today that it had won the support of the NSW Nationals to sneakily use State legislation to allow pharmacies to avoid compliance with the TGA decision and put patients’ health at risk.”

The AMA says that it has previously warned that “some groups would put self-interest ahead of patients’ best interests by using highly-paid lobbyists to influence or coerce State Governments to change, delay, or dilute the impact of the TGA decision – an outcome borne out by today’s Guild announcement with the NSW Nationals”.

Dr Gannon said that “it is essential for public safety that the TGA makes evidence-based decisions about medicines, free from political interference and sectional interests”.

He cited recent AIHW data which showed that 75% of recent painkiller or opioid users had misused an OTC codeine product in the previous 12 months.

“We will be urging the Pharmacy Guild and others groups who seek to undermine the TGA to reconsider their actions and put the health of Australians first,” Dr Gannon said.

High-profile doctors also took to Twitter to express their displeasure over Mr Barilaro’s statement and lambast the Pharmacy Guild.

But the Pharmacy Guild told the AMA that it needs to “get real” on the subject of codeine.

It said that the AMA has “deliberately distorted” the Guild’s position on the upscheduling.

“The Guild is not seeking and has never sought to overturn or disregard the TGA decision announced in December 2016. This is simply an overblown claim from the AMA, which does them no credit,” it said in a statement.

“The fact is the TGA decision to upschedule medicines containing codeine from 1 February on its own does little to address the issues of addiction and harm arising from medicines containing codeine.”

The Guild said that the upscheduling will increase cost and inconvenience for patients who currently use OTC low-dose codeine appropriately, particularly in rural areas like Harden, where Mr Barilaro made his announcement yesterday.

Harden has recently been without a GP for up to five days at a time.

“What are patients with migraine, toothache or period pain meant to do in Harden when there is no doctor within a hundred kilometres for a week at a time? The AMA has no answer,” says the Guild.

It again criticised the doctor groups for failing to address areas of concern such as real time monitoring and doctor shopping, issues it has recently highlighted several times.

Several industry stakeholders have recently pointed out these issues, including the PSA’s Peter Carroll.

“We applaud NSW Deputy Premier John Barilaro for his support of the Guild’s common sense proposal to allow pharmacists to continue to supply these medicines where appropriate, subject to strict protocols, and with mandatory real time recording,” says the Guild.

“It is time for the AMA to get real on codeine. Accept that doctor shopping is rife; and acknowledge that patients using codeine medicines safely and appropriately should continue to be able to do so with safeguards and real time recording in place.”

You may be interested in:

Nats call to reverse or compromise codeine decision

Why upscheduling codeine won’t solve any problem

The pill epidemic

Docs missing the point on codeine harms


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1 Comment

  1. John Smith

    Just to be clear on this issue. The PGA has made it crystal clear that they only work for the interest of its members in different occasions and forums, and hence the PGA decisions, reports, and press releases only represents its members ( the owners ) and maybe some pharmacists who happen to be members too.

    So in regards to people who have migraine and get it all the time, which is better, to get codeine or go and seek prophylactic agents and rely on panadol, hydration, nurofen, or paracetamol/ibuprofen combo, or even old remedy aspirin, which if someone is on a prophylactic measure, shouldn’t be getting them too often.

    regarding toothache, which is better leave the patients relying on pain killers or by upscheduling, they will go to the dentist and solve the roots of the problem.

    Doctor and pharmacy shopping is a problem anyway, so let’s not mix the two problems together. monitoring Rx is a must either and criteria for prescribing and selling it is a must too. That is irrelevant to the upscheduling, it should have happened ages ago.

    The notion of common sense in pharmacy does not resonate with me at all as a pharmacist, because since when we rely on common sense in dealing with medicines? evidence to support is the way to go. That is why we have schedules, dispensing policies and procedures. We never ran before on common sense. For example, the regulations in NSW to keep the DDs repeats on premises. What if the customer is moving interstate, isn’t it common sense to give it back? regulations and rules are there for a reason, and we need to respect for the safety of patients.
    It is an opinion, some might agree and some might not… that is just life and have a good day everyone

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