The year in review: codeine

The issue of how codeine-containing preparations should be scheduled has been a big one in 2016… we take a look back over the year’s news and views

It’s been a long wait, with still no definite end in sight, to find out the fate of codeine-containing Pharmacist Only medicines after the TGA deferred its decision on scheduling at its November 2015 meeting.

Appearing before the Senate Community Affairs Committee in February, Adjunct Professor John Skerritt, deputy secretary of the department’s Regulatory Services Group, said, “we would expect a decision to be made by about May”.

In March, the Pharmacy Guild rolled out MedsASSIST, following a successful pilot involving 138 pharmacies in the Newcastle NSW and North Queensland, conducted in February 2016.

At the time of launch, the Guild said that “MedsASSIST was developed in response to concerns over patient safety relating to these medicines and as an effective alternative to making them prescription-only.”

By July, the most recent advice from the Health Department was that a decision was expected by the middle of this year… but at the time, the Department told the AJP that no decision was imminent.


A decision soon?

In September, stakeholders told us that MedsASSIST was working, and had gone a long way to help reduce codeine shopping.

At the ASMI conference in October, Health Minister Sussan Ley suggested that stakeholders could expect a decision as to the scheduling fate of codeine by the end of the year. With only three weeks to go, time is running out… and that’s made at least one of our readers suspicious.

Reader Toby predicts the TGA will announce a decision to upschedule “as close as possible to Christmas Eve”.

“This will have the intentional effect, of the media (let alone the pharmacy bodies) not even noticing the decision until the New Year.”

It’s no wonder that the profession is split as to what it predicts the TGA to do. Last month we ran a poll asking what pharmacists expect to happen, and found that 35% of readers expect the medicines to be upscheduled, 36% expect the status quo to be retained, and 28% are expecting the TGA to defer its decision again.

In the meantime, most stakeholders continue to assert their opposition to upscheduling codeine… such as ASMI, which said last month that “any suggestion to make all codeine products prescription-only disregards the expertise of pharmacists and their important role in the frontline of primary care”.

And MedsASSIST had clocked up more than 4 million transactions as of November 21… of which 2% were deny/non-supply.

Guild data showed 86% of consumers who had made five or more purchases were recommended to take follow-up action to help them seek further help in managing pain and addiction.

“There is strong evidence that MedsASSIST is having an effect as intended and reducing inappropriate OTC codeine use for people who might be at risk of codeine dependency, while maintaining access for legitimate use,” the Pharmacy Guild said.

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