Analysis of the proposed codeine up scheduling: Part III

In Parts I & II of these posts we looked at the proposed codeine up scheduling that the Therapeutic Goods Administration is currently reviewing. We examined the independent review commissioned by the Pharmacy Guild and produced by Cadence Economics. Now for some final words on this discussion.

Final decision on the proposed codeine up scheduling delayed

On Thursday, 19 November 2015 the Therapeutic Goods Administration announced it would defer a final decision on the proposed codeine up scheduling due to the huge number of responses received. The possibility that Schedule 2 and Schedule 3 codeine containing cold and flu and analgesic medicines could be up scheduled to Schedule 4 drew wide opposition.

The proposed codeine up scheduling could change the way consumers get certain medicines.

The proposed codeine up scheduling could change the way consumers get certain medicines.

127 submissions have been received in response to the TGA’s proposed codeine up scheduling. 113 of these are opposed to the proposal. In order for the TGA to fully consider all of the submissions they recently announced that a final decision will not be made until at least June 2016 and would not take effect until 2017.

As discussed in the previous MediSecure articles on this matter, the Pharmacy Guild of Australia engaged Cadence Economics to do an economic analysis of the proposal. The report highlighted that the proposed codeine up scheduling could cost $316 million a year. The report, in line with the Guild’s response, recommends the federal government should carefully consider the net costs of the proposed codeine up scheduling, particularly when other lower cost alternatives exist.

Proposed alternatives to re-scheduling codeine containing medicines

The Pharmacy Guild, the Pharmaceutical Society of Australia and the Australian Self Medication Industry have already made it clear that they support these alternate initiatives, particularly an OTC register for codeine-containing drugs.

The Pharmacy Guild has a prototype of a real-time monitoring and clinical decision support tool developed by its GuildLink division. This

system would assist pharmacists to record patient details when they buy OTC medicines and to review other recent purchases, which are recorded in real time. George Tambassis, the Guild national president has said the Guild would move quickly to implement this real time recording system for codeine sales.

The Guild also supports increased consumer education and alternatives such as mandatory warnings as a way to reduce the number of fatalities and cases of dependencies that are a result of codeine containing medicines.

The final comments from the Guild on this the proposed codeine up scheduling were published on their website:

“…[It] will do little or nothing to address any issues of addiction while disadvantaging the overwhelming majority of Australians who use these medicines responsibly…Whichever way you look at it, this proposed up-scheduling does not provide value-for-money either for patients or for the Australian taxpayer.”


MediSecure is certainly in favour of the rollout of a real time monitoring system, particularly because we have seen the successful development of our own version of prescription monitoring that is designed for prescribers. This is a valuable system that can assist with the monitoring of medicines that are Schedule 4 and above, because it gives prescribers the ability to see where a patient has obtained other prescriptions for medicines with potentially addictive consequences. A system that would assist pharmacists in the monitoring of OTC medicines would also have potentially life-saving implications.

Be sure to keep following our blog and social media for more updates on this important issue.

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