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News & Trends - Pharmaceuticals

How imposed PBS restrictions on opioids shifted market dynamics

Health Industry Hub | April 12, 2024 |

Pharma News: Among people with chronic pain, opioid dependence and misuse is estimated to be 10% and 24%, respectively. A recent study conducted by UNSW Sydney sheds light on the impact of tightened Pharmaceutical Benefit Scheme (PBS) restrictions on opioid supply in Australia.

Initiated in June 2020, these measures aimed to curb the prescription and consumption of opioids across the nation. The changes included limitations on repeat prescriptions, introduction of half pack sizes, and heightened authorisation requirements for certain opioids, among other adjustments, in alignment with the Therapeutic Goods Administration’s (TGA) regulations.

The PBS restrictions were met with mixed responses from the community. For many people, it led to an extra burden of needing return to their doctors to get additional prescriptions, or being driven to the private market to get pain relief.

Co-senior author Dr Benjamin Daniels, a Senior Research Fellow from UNSW’s Medicines Intelligence Research Program led the first independent assessment following the PBS alterations. He noted, “Opioid use subsidised through the PBS declined as a result of all these changes, and that likely represents a true decline in opioid use.”

The analysis, spanning two years before and one year after the policy change, revealed an overall 4% reduction in opioids dispensed through the PBS. The number of repeat prescriptions fell from 7.4% of all opioid dispensing pre-June 2020, to 1.3% after the PBS changes, largely driven by codeine/paracetamol combinations and tramadol.

Dr Daniels elaborated, “On face value, this doesn’t sound like a big change, but it equates to around 9,000 20-tablet packets of 30mg combined codeine-paracetamol formulations, or 4,000 fewer 20-capsule packets of 50mg tramadol dispensed annually.”

However, the study also uncovered a surge in the use of one opioid despite the overall decline. Seqirus’ Palexia SR (tapentadol), the newest addition to PBS-listed opioids, exhibited an upward trend, contrasting with the diminishing consumption of other opioids.

Dr Daniels explained, “The use of most opioids has been declining over the past five or so years, but tapentadol has been going in the other direction during that time.”

The team suspect that COVID-19 may help explain this jump, given the temporary ban on elective surgeries decreased opioid sales between March and May in 2020, but more research is needed explain the shift.

“While our study gives us a high-level look at what happened following the changes, we don’t see how individuals are impacted. Balancing harms and benefits can be very challenging for medicines like opioids. There are a lot of people who benefit from these medicines, and they carry with them high risks of misuse and harm,” Dr Daniels emphasised.

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