Real-time monitoring, not Rx, for codeine: Guild

tablets and glass of water

The Pharmacy Guild of Australia is calling for the implementation of a national mandatory real-time monitoring system in community pharmacy to address the issue of abuse and dependency related to over-the-counter medicines containing codeine.

The Guild has provided a submission to the TGA’s Advisory Committee on Medicine Scheduling in response to a proposal to move OTC codeine medicines to prescription only.

The Guild says it opposes this proposal and instead recommends a real-time monitoring system in combination with a variety of complementary measures that include changes to packaging and labelling, improved education for health professionals, and consumer awareness campaigns.

“A real-time monitoring system in community pharmacy would be a more effective and economical way to assist in identifying consumers at risk of codeine abuse and dependency without compromising access for the majority of consumers who are using these products safely and effectively,” says Guild National President George Tambassis.

“Moving these products to Prescription Only is unlikely to address the issues of dependency and abuse and would result in significant extra costs to both consumers and the health system.

“It would be a shifting of the problem to an already stretched general practice system.

“A real-time monitoring system would help pharmacists identify consumers who are may be misusing or abusing codeine-based products be referred to appropriate treatment and support programs.”

A 2014 Macquarie University report estimated if current Pharmacist Only analgesics were moved to Prescription Only, the costs to Medicare alone in additional doctors’ visits would equate to $170 million a year.

Consumers would face additional out of pocket costs of $70 million a year.

“In a time where Governments are trying to contain health care costs, it would make no sense to unnecessarily restrict consumer access to these products when there are more effective and far more equitable options available,” Tambassis says.

“Project STOP, currently used to monitor pseudoephedrine sales in real time, has been successful in addressing diversion and misuse. There is no reason why a similar system for codeine products would not be equally effective.”

A consumer survey conducted by the Guild in April indicated 95% of the 506 respondents were willing to have their personal details recorded when purchasing OTC codeine products so they could continue to be purchased without a prescription.

The ACMS will consider this proposal at its July meeting.

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