Fiscal impacts of codeine changes

The Pharmacy Guild of Australia engaged Cadence Economics to undertake an analysis of the fiscal impacts (and related issues) of all medicines containing codeine to require a prescription.

Currently, low dosage codeine medicines are available without a prescription. Medicines containing codeine are mainly for pain relief (eg codeine with paracetamol or ibuprofen) or cold and flu preparations (codeine with pseudoephedrine or phenylephrine, and paracetamol).

Figures from healthcare data firm IMS Health show that in 2014, there were approximately 16.4 million packs of analgesics containing codeine dispensed, and 5.2 million packs of codeine-containing cold and flu medications.

We estimated that if OTC codeine rescheduling went through, 53 per cent of patients would elect to visit a GP to get a script for a codeine-based analgesic. This could cost the federal government up to $316 million a year.

The figures do not take into account patients seeking a script for the 5.2 million codeine-based cold and flu symptom relief medications - the conservative assumption is that most will instead purchase an alternative remedy at the pharmacy - and nor does it take into account losses in time and productivity for patients.

Costs to the PBS are also not included as these medications would not be subsidised, although there is the potential that higher strength, PBS-subsidised alternatives such as Panadeine Forte might be prescribed more often.

We have recommended that the federal government carefully consider the net costs of the rescheduling proposal, particularly in light of obvious lower-cost alternatives such as a register of OTC codeine medicines.

Read more at the Australian Journal of Pharmacy Online Magazine.

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