Opioids: PBS changes after June 2020

Dr Chow Chow

Dr Chow Chow

Key Points:

  1. On 1 June 2020, changes were made to the listings of opioids and formulations listed on the PBS General Schedule

  2. Short-term therapy with opioids for acute severe pain has new Restricted Benefit listings – 10 tablets/capsules, No repeats, No increases in maximum quantity or number of units

  3. Full pack sizes of opioids for acute severe pain have been amended – MUST only be considered for severe pain associated with malignancy or chronic severe disabling pain

  4. Opioid listings for chronic severe pain are now Authority Required (Streamlined) with strict clinical criteria

  5. Different item codes for Codeine use in cough suppression

  6. The new and amended PBS listings complement ongoing TGA regulatory measures to support the safe and appropriate use of opioids

Why were the changes made?

Every day in Australia, an average of 3 people die, 150 people are hospitalised and 14 people present to emergency departments because of harm from opioids.

The aim is to support appropriate prescribing and use of opioids, and to prompt ongoing assessment of harms and benefits by prescribers and other healthcare professionals working with people requiring severe pain management.

These changes will lead to fewer patients being prescribed more opioids than required for acute severe pain, resulting in fewer remaining unused tablets and prescription opioids circulating in the community.

What is the role of Pain Specialist in this circumstances?

For listings of opioids that have ‘authorities for increased maximum quantities and/or repeats’, these authorities must only be considered in certain circumstances. These include when opioid use by a patient to help manage severe pain exceeds or is expected to exceed 12 months. The patient must also be referred to a pain specialist or alternative prescriber for clinical review. The full name of the medical practitioner consulted and date of the consultation must be provided for every authority application.

Accredited pain specialist underwent high quality training under the Faculty of Pain Medicine, where the specialist have great understanding of the pharmacokinetics and pharmacodynamics of different opioids and their interactions with the patients. Cautious balanced use of minimal effective dose for opioid-responsive pain needs to be thoroughly assessed for its effectiveness and potential harm minimisation.

Unsure if you are a candidate for opioid review? Contact us to find out more.

References:

  1. Pharmaceutical Benefits Scheme. PBS Schedule: Summary of changes June 2020. (accessed 10 Feb 2021)

  2. NPS MEDICINEWISE. Opioids: New and amended PBS listings. 18 June 2020 (accessed 10 Feb 2021)

  3. PAIN AUSTRALIA. Opioid Reforms. (accessed 10 Feb 2021)

Credit: Photo by Maria Ionova on Unsplash

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