Pharmacy compared to North Korea

north korea flag

Australia’s pharmacy sector has been compared to North Korea in an article which attacks both the sale of OTC codeine-containing preparations and regulations governing pharmacy.

The article, Why can Aussies still buy this controversial drug in shops? by Michael Heath, begins by questioning the availability of OTC codeine and uses MedsASSIST as an example of the power of the Pharmacy Guild.

“Futile attempts to regulate the sale of codeine despite addiction risks, and the lack of debate on the issue in the run-up to next month’s election, illustrates the strength of the pharmacy lobby,” the article says.

“It’s also an example of a wider impasse on structural reforms that’s put a brake on Australia’s productivity.”

The article then promotes “bolstering competition” in industries including pharmacy as a way to drive economic growth.

It quotes economist Saul Eslake stating that pharmacies are “totemic”.

“If you could do them then you could do almost anything else and that would help revive productivity that’s crucial to increasing national wealth,” Eslake told Heath.

“It’s the archetypal example of an industry that has been able to use its extraordinary political clout to insulate itself from reform.”

The article says regulators are up against strong opposition from community and industry groups when it comes to attempts to further regulate codeine.

It then quotes Eslake as saying, “The chances of either side of politics tackling the industry is equivalent to Kim Jong Un unilaterally renouncing North Korea’s nuclear weapons.”

Pharmacy Guild Victorian president Anthony Tassone said that the article appears to call for deregulation for deregulation’s sake, without actually providing evidence of added benefit.

“If you spoke to GPs and asked what it’s like working for a corporately owned medical centre, a number may very well say they would prefer a doctor or medical practitioner to own that centre,” he told the AJP.

“Two wrongs don’t make a right. Just because a corporation can own a medical centre doesn’t mean we should duplicate that flaw in approach in the pharmacy industry, which continues to provide a trusted, accessible and valued service to the Australian community.”

He says that internationally, corporate ownership and the lack of pharmacy location rules have resulted in reduced access and reduced choice for the consumer.

“In fact, some European countries are trying to repair the damage done from previous deregulation and there are moves to reregulate, after realising the faults and flaws of opening up their pharmacy industries.”

MedsASSIST is a genuine bid to help people who misuse codeine while not disadvantaging genuine users, he told the AJP.

“The TGA conducted its own review of the use of codeine and concluded itself that there is evidence of benefit for the treatment of short-term acute pain,” he says.

“So that’s the recommended use of OTC products containing codeine, and MedsASSIST helps pharmacists, as a clinical decision-making tool, to recommend these products within their indicated use. For pain that is persisting longer or chronic pain, pharmacists can then refer to a doctor or appropriate professional for further treatment.

“Moving codeine to prescription only is only going to put additional pressure on an already stretched general practice system, and only shifts concerns around potential misuse or abuse there.”

He says North Korea is not an apt comparison for the pharmacy sector.

“Pharmacists continue to be one of the most trusted professionals in Australia, and provide a valued health service that people are satisfied with. People are entitled to their opinion, but I don’t imagine many share it!

“I don’t see any comparison with a repressive dictator as this individual chooses to draw.”

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1 Comment

  1. Ron Batagol

    Forget the nonense about North vietnam!
    Medassist is great for monitoring “codeine pharmaacy shoppers” But, let’s face it, it’s been well established that you need to give 30mg plus for effective pain relief (see recent Australian Prescriber articles and various other reviews).
    Also, remember that up to 20% of the population metabolise Codeine in variable ways, from slow to ultra-fast, with all the resultant variability in efficacy and in some cases, toxicity.
    I don’t have any easy answers but if the low-strength formulations aren’t effective (but may be toxic to some people) and their ready availability is encouraging dependence or abuse,at the rnd of the day, maybe Codeine products will end up as script only-which, of course, does nothing to help people seeking effective relief from pain without a script!

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