Pharmacy Daily | Opioid use has dropped

A UNSW Sydney big health data study out today showed that tightened PBS restrictions has reduced all prescription opioid use in Australia.

Published in the Medical Journal of Australia, this is the first independent study released on prescription opioid use following the PBS changes after its own evaluation published last year.

"Opioid use subsidised through the PBS declined as a result of all these changes, and that likely represents a true decline in opioid use," said study co-senior author Dr Benjamin Daniels, a Senior Research Fellow and Cancer Institute NSW Early Career Fellow from UNSW's Medicines Intelligence Research Program.

"Our study indicated that some people chose to access opioids using unsubsidised private prescriptions, meaning they weren't bound by the new PBS rules, but this wasn't extensive."

The UNSW researchers examined the changes in opioid supply in the two years before and one year after the policy change, using a standard metric, oral morphine equivalent milligrams (OMEs), that accounts for opioid strength.

Different opioid medicines contain different potency levels for example, the opioid codeine has lower OMEs compared to stronger PBS opioids like oxycodone or fentanyl.

"We found an overall 4% decline in OMEs dispensed through the PBS in the year after the policy changes," said Dr Daniels.

"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."

Instant release formulations were the main contributors to this decrease, stated UNSW.

The one exception was the newest opioid medicine, tapentadol which has increased.

Tapentadol was listed on the PBS in 2014 and it's common for the use of newer medicines to increase until the market has matured, the researchers explained. JG