Anger over the increased price of low-dose codeine is growing – and pharmacists are in the firing line

Pharmacy Guild NSW Branch president David Heffernan has hit back at claims that pharmacists are hiking up the price of low-dose codeine now that the preparations are Prescription Only, but not PBS subsidised.

He spoke with 2GB’s Ben Fordham and pleaded with the general public not to blame pharmacists for the increased retail price of the medicines, pointing out that the markup has not taken place at the pharmacy level.

Mr Fordham then launched a blistering attack on Health Minister Greg Hunt over the codeine issue, challenging him to come on the program and explain what he planned to do about it.

“I understand that you are now going ballistic as a result of the conversation that we just had on air with David Heffernan,” Mr Fordham said.

“Go ballistic at yourself and the Therapeutic Goods Administration because we warned you, Mr Hunt, this was a brain dead decision.

“Now we know that the cost of codeine medicines has gone through the roof since your changes.”

Mr Fordham said the program had been tipped off by a pharmacist who identified herself as Linda, who emailed 2GB to explain that the wholesale price had increased.

This echoed the experience of a pharmacist who told the AJP on February 2 of his shock when he went to order Nurofen Plus with new Prescription Only packaging, and found the price had gone up from $6.91 to $17.95.

He said at the time that it was important for pharmacists to explain that “it’s not necessarily because pharmacies are hiking it up, but because we’re being charged this ridiculous amount”.

Mr Fordham read out a series of price hikes experienced by listeners who called in to complain about the new cost of low-dose codeine; these included “Helen” who was now paying $40 for Mersyndol (up from $11), and “Donna” who was “in the same boat” but had managed to find Mersyndol at $26 by calling around several pharmacies.

“The cost of medication containing codeine has now doubled, tripled, in some cases gone up four times the price,” Mr Fordham said.

The Health Minister has now made a request for the Australian Competition and Consumer Commission to investigate the pricing increase.

And PainAustralia CEO Carol Bennett has suggested that pharmacists could be responsible for the increase in price to consumers.

“We are extremely dismayed to hear of alleged increases in the price of codeine-containing products and we join Minister for Health Greg Hunt in his condemnation of this practice,” she said in a statement.

“At a time when codeine is less available, industry and pharmacists are reportedly putting the price up. If true, this is unacceptable from government supported health providers.”

Ms Bennett told the AJP today that “the feedback we’ve had is that people are paying significantly more in some instances – I don’t know how widespread that is, or what the source is, but we would certainly agree with Greg Hunt that if that is the case, vulnerable people are being disadvantaged and of course we want to see that investigated.

“People with chronic pain already face enormous pressures,” she said. “They are often unable to work full time, have numerous expenses due to medical appointments and treatments, and are not in a position to absorb any additional costs.”

Mersyndol manufacturer Sanofi today issued a statement denying it had increased the price for prescription-only medicines which contain codeine.

Sanofi’s General Manager Consumer Healthcare for Australia and New Zealand, Stephen Walker, said that Sanofi had worked closely with wholesalers, pharmacies and healthcare professionals in the months leading up to the upschedule.

“Over recent months Sanofi has not increased the price of any of its medications which contain codeine,” he said.

“We strongly believe in equitable access to medicines for all Australians and will continue to offer a range of treatments for the management of mild-moderate to severe pain.”

 

Don’t blame the messenger

The Guild’s David Heffernan told the AJP today that “it’s a simple fact, as I said on the radio yesterday, that if you sold Nurofen Plus for the same price you were before February 1, you’d be selling it for half the price you’re buying for”.

He confirmed that he and Guild members have experienced significant negative feedback from patients.

“A similar thing happened when they took Panaol Osteo off the PBS,” he said. “So pharmacists are not pushing up the price.

“We put in our [the Guild’s] submission [to the TGA] that this might cause an increase in the price of these things.

“You just can’t blame pharmacists for this. There aren’t as many choices now for generics, and many pharmacists have no choice but to get in Nurofen Plus only.”

Mr Heffernan also pointed out that low-dose codeine was not indicated for the management of chronic pain.

“Pharmacists are frustrated because something that was controlled in the community has now become an expense for people. And we still want the real time monitoring for all drugs subject to abuse to go ahead.

“We’ll be advocating for that, because that is the only way to identify these people and help them.

“Counsel your patients, talk to them about their options – because there are other options out there, they may be inferior, but they’re there – and see if they need an appointment with their doctor to look at other options.

“The main message to the public is ‘please don’t take it out on the pharmacist’. Pharmacists are taking the heat.”