No ‘snowflake in hell’s chance’ of approval were codeine invented today

MedsASSIST is “inadequate” and codeine would not be approved were it invented today, the AMA president has said

But the Pharmacy Guild says that the decision-making tool deserves to be made mandatory across all States and Territories.

AMA national president Dr Michael Gannon told 2GB’s Ben Fordham that “the low-dose codeine that’s contained in preparations with anti-inflammatories or with paracetamol is no more effective than the drugs given alone”.

“There are very, very good, large, well-validated studies which show that it’s not that effective,” he said.

“I can tell you for nothing, Ben, if codeine was invented tomorrow, it would not have a snowflake in hell’s chance of being licensed on the PBS. It’s that poor a drug.”

Mr Fordham did not seem entirely convinced, pointing out that “anyone who’s used these drugs, including Tony Abbott, who we just spoke to before, and I certainly know it, there’s a big difference between using Nurofen Plus and using Nurofen”.

He asked whether a safeguard similar to Project Stop would have been a more appropriate proposal than upscheduling the drug.

Dr Gannon said that “the Pharmacy Guild has spoken a lot about their proposed real-time monitoring systems, but they are currently inadequate and there’s no move to make their reach any better”.

He said that doctors were changing their prescribing habits, and that a positive outcome of the upschedule could include patients talking with their GP about alternative treatments for headache and other pain, such as relaxation techniques or physiotherapy.

“When you go to your doctor, they should talk to you about more effective or safer alternatives.”

A spokesperson for the Pharmacy Guild said that “the main thing that is ‘currently inadequate’ is the AMA’s plan to address doctor shopping for codeine products beyond 1 Febraury 2018”.

“When it comes to real time recording, the AMA unfortunately is all lip service and no action.

“MedsASSIST was developed and introduced nationally by the Guild in March 2016. Since then it has been adopted by more than 70% of pharmacies, recording over 9 million transactions.

“More than 160,000 sales have been declined on safety grounds, with referral back to doctors or addiction pathways. There has also been a significant drop in the volume of over-the-counter codeine sales.

“The Guild maintains MedsASSIST has worked very well, and deserves to be mandated nationally so that it is adopted by all pharmacies.

“Unfortunately, when these medicines become prescription only from February, there will be no safeguard and no real time recording to prevent doctor shopping, and action taken by doctor groups so far has been thoroughly inadequate.”

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