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Codeine impact will be felt “acutely” in rural Australia

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state and territory Health Ministers write to Greg Hunt urging him to manage codeine upscheduling

All states except South Australia have written to Health Minister Greg Hunt relaying unnamed stakeholder concerns about the “unintended consequences” of requiring a script, says the Australian.

This follows Nationals leader John Barilaro throwing his support behind the Guild proposal “prescription – except when” concept,

“We’ve made an announcement where the Nationals are calling on the Federal Government to reverse their decision in relation to the way customers can access codeine products over the counter,” he said.

“A reverse would be great, or a compromise position, which I know the Pharmacy Guild have been looking to.”

NSW Health Minister Brad Hazzard is one of the signatories on the letter to Mr Hunt, which relays concerns that the impact of upscheduling “will be felt particularly acutely in rural and regional areas where access to GOPs is ­already low”.

The letter stops short of asking for changes or even a review of the TGA decision, instead asking Mr Hunt to work with stakeholders to address their concerns.

Pharmacy Guild president George Tambassis said that State and Territory Health Ministers are justifiably concerned that  upscheduling will clog up doctors’ practices and emergency departments, leaving patients with temporary acute pain such as headache, toothache and menstrual pain without timely access to treatment.

“The State and Territory Health Ministers have rightly pointed out in their letter to the Federal Minister that this will be particularly problematic in rural and regional areas where GP access is often spasmodic and non-existent after hours,” Mr Tambassis said. 

The AMA’s Northern Territory President, Dr Rob Parker has echoed these concerns telling the NT News on 8 August:

“The problem is if you get a toothache at 6pm you are restricting people who actually need it and can’t access a doctor. That’s been my concern all along.”

While the Guild and the Pharmaceutical Society of Australia are not seeking to overturn the TGA decision to up-schedule these medicines to prescription-only, we are asking governments to support a common sense exception whereby pharmacists could supply these medicines for the temporary treatment of acute (not chronic) pain under a strict protocol with extra training and a mandatory requirement for electronic real time monitoring to identify non-legitimate misuse.

“In MedsASSIST, community pharmacies around Australia have already put such a system in place, very significantly reducing the number of codeine purchases and providing support to at-risk patients, including referring them to GPs and pain and addiction management services. 

The AMA has previously embraced such an approach stating in its May 2015 submission to the TGA:  

“There are also alternatives to up-scheduling that could be considered, for example, introducing pharmacy requirements to record codeine dispensing in the same way as for pseudoephedrine.”

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