New advice on combinations


PBS issues new claiming advice on opioid combinations as listing changes take effect

From yesterday (1 June 2020) Pharmaceutical Benefits Scheme (PBS) listings have changed for opioid products. 

The PBS has advised pharmacists of specific amendments to the PBS items for paracetamol 500 mg + codeine 30mg combination tablets that it says will “affect the way outstanding repeats for this product can now be claimed from 1 June”.

“In response to concerns regarding the high number of deaths and hospitalisations due to prescription opioids, the Pharmaceutical Benefits Advisory Committee (PBAC) recommended changes to PBS opioid listings to assist with the appropriate use of opioid medicines for the treatment of pain,” the PBS release said.

“The changes include amendments to existing restriction requirements and arrangements for increased quantities and repeats”.

Specifically:

  • Paracetamol 500mg + codeine 30mg tablets will continue to be available under PBS item code (1215Y) for the treatment of pain, with new arrangements in addition to new item codes.
  • The previous PBS item code (8785J) for paracetamol 500mg + codeine 30mg tablet products will no longer exist on the PBS or within pharmacy dispensing software.  

For prescriptions written for paracetamol 500mg + codeine 30mg tablets prior to 1 June and claimed on or after 1 June, pharmacists will need to claim under item code 1215Y.

“This will assist in allowing a smooth transition to the new listing arrangements for opioids,” the PBS says.

It advises that pharmacists will need to acknowledge the mismatch warning code presented (W 162/W 163) and keep sufficient information relating to the claimed prescription.

“Pharmacists are also encouraged to advise patients of the changes that have been made to relevant opioid PBS listings and encourage them to seek further information from their prescriber at their next visit”.

In a recent release covering the changes, the TGA said: “To be eligible for treatment with opioids, patients will need to be unresponsive or intolerant, or have achieved inadequate relief of their acute pain, to maximum tolerated doses of non-opioid treatments.

Patients who require long-term treatment of chronic pain with opioids will still be able to access larger pack sizes and prescribers will be able to prescribe repeats where they meet the new restrictions requirements”.

“For chronic pain, increased quantities and/or repeats may be authorised by Services Australia where the patient meets the restriction requirements,” the agency said.

“Increased quantities to extend treatment up to one month may be requested via telephone/electronic authority request, and up to three months’ supply (up to one-month quantity and up to two repeats) may be requested via an electronic/written authority request”.

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2 Comments

  1. Karalyn Huxhagen
    02/06/2020

    What an absolute mess!!!!!!!!!!!!! yesterday we had people in with their regular Rxs reprinted by GPs trolling down their previous Rxs and hitting print. There were no streamlined codes etc.

    so I rang Practice managers and explain they need to write Rxs from anew and follow new guidelines. WHAT new guidelines? Really why is phcy left to carry this can time after time again!!

    Then I start asking whether they have run the PBS updates and software updates for 1st June. Practice manager shows me her update screen from Best Practice software that says updates are pending . So if the prescribing software companies are not keeping up with these changes what hope does a medical practice have.

    By the end of day (6pm) software updates for Best Practice were still pending and we had GPs pulling their hair out trying to write controlled drug Rxs manually.

    Some accountability in practice software land would be really really helpful.

    • Bradley Thomas
      04/06/2020

      Totes agree. I rang one practice regarding a faxed prescription for tramal 100mg SR 20, on an SN Card to boot. Apparently best practice updates are run at the end of the month. So I said do you expect every pharmacy presented with one of your opioid scripts to charge patients non PBS prices? The tramal 50mg 20 caps with 2 repeats is now non PBS even if it was written prior to June 1. Why not have the changes affect scripts written from June 1 onwards?
      Not long ago controlled release opioids went from quantities of 20 to 28, probably in an effort to make it easier for patients in chronic pain to drag their pain riddled backsides down to the Drs every 14 instead of 10 days.
      And now this! Make your minds up. I know I’ll be claiming clinical intervention of Toxicity for the extra workload imposed on me because every patient ever prescribed an opioid before June 1 was according to this decision, at risk of opioid toxicity, is the message that is being sent.
      Hey while we’re at it let’s make Panadeine Forte, Prodeine and Panamax Co Schedule 8 and go completely Nanny State!!
      Do the health economists not get a say in these decisions and say what about all the extra billing costs to Medicare due to the extra work being asked of prescribers in both the short and long term?

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