Tasmanians to track low-dose codeine


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Tasmania is leading the way as it sets up real time monitoring of formerly-OTC codeine, pharmacy stakeholders say

The island state has announced that it plans to implement Drugs and Poisons Information System Online Remote Access (DORA) for a number of Prescription Only drugs of concern, in addition to the Schedule 8 drugs it already tracks.

PSA president Dr Shane Jackson told the AJP that Tasmania has been “well ahead” on real time monitoring for some years.

“Essentially what they’ve done now is what they said they were going to do from the middle of last year, so it’s not just codeine, it’s other high-risk drugs: benzodiazepines, Tramadol and so on,” he says.

“Codeine will be part of that. So they’re making sure they have the information in real time, not just for S8s but other opioids and high-risk drugs, so pharmacist and doctors will have access to that and Tasmania has led the way here.

“One of the reservations some sectors had around the [low-dose codeine] upschedule was the loss of visibility. But in Tasmania we’ve got a full, complete picture which is excellent, and we welcome that.”

Pharmacy Guild Tasmanian branch president John Dowling said that DORA works “really well” in Tasmania, but hopes for a national system to be set up.

Health Minister Greg Hunt told the PSA17 conference last July that a national real-time monitoring system was to be rolled out but did not mention low-dose codeine.

“DORA works well because we’re a very small jurisdiction, and it’s a fairly manual system,” Mr Dowling says.

“It’s been offered to the larger jurisdictions but the cost of running seems too high. The one the Victorians are doing, hooked up with eRx, is more of an electronic system and we support that being rolled out throughout the country – that’s the Guild’s preferred option.

“I can’t see Tasmania switching over in a hurry, but I think eventually we’ll end up with a national system.”

The ACT also recently announced that it will use DORA to track S8s and potentially some S4 drugs.

“We support DORA covering codeine because from the Guild’s point of view, at least with MedsASSIST we had something nationwide that could monitor codeine prescriptions – whereas now, people in any other jurisdiction apart from Tasmania could be doctor shopping for codeine and you can’t pick it up,” Mr Dowling says.

“So in Tasmania, DORA should minimise the problem of people doctor shopping for codeine. But the Guild supports a national real time monitoring solution and not different things in different states.”

Dr Jackson also underlined the importance of a national solution.

“We need to make sure we have interoperability,” he says. “If there’s a different system in Tasmania and a different system in Victoria, what’s going to be the way of linking up those systems?

“They need to be interoperable. We need to make sure the states are talking to each other.”

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