In response to concerns regarding the high number of deaths and hospitalisations due to prescription opioids, the Pharmaceutical Benefits Advisory Committee (PBAC) recommended changes to opioid listings. The Department of Health has agreed to those recommendations and made changes to the limits to the standard quantity and repeats allowed for opioids. These changes support safe and appropriate use of opioids and aim to reduce harm associated with opioid dependence and fatalities. In particular smaller packs are now available for post hospital discharge and acute care situations, in order to minimise the risk of patients developing dependence (which can happen remarkably quickly).
The changes to the Pharmaceutical Benefits Scheme (PBS) pain medicine restrictions are for everyone in Australia. A waiver of these restrictions for the veteran community would undermine the integrity of the requirement that all medical practitioners have an active role in the management of prescription medicine to their patients on an ongoing basis.
Below I have provided answers to your 4 questions to assist you with understand what these changes mean for DVA clients.
1: Your doctor can continue to obtain an RPBS Authority prescription for a one month supply of opioid medicine by telephoning DVA on 1800 552 580.
If your doctor wishes to obtain repeats, they can continue to post in a prescription to DVA to obtain a one month and two repeats. This is different to when GP’s prescribe for non-Veterans as we can only prescribe one month at a time with no repeats – there is no option to prescribe for longer. It is good general medical practice to see a patient who requires opioids at least once every 3 months.
2: As part of these changes, pain management will need to be reviewed through consultation with another medical practitioner every 12 months. A reviewing doctor can be any other medical practitioner OR pain medicine specialist who will confirm the continuing need and support your doctor’s prescribed treatment. This is the main change as previously this review was only required once, after the initial 12 months of prescribing an opioid. Pat I am quite upset by the number of medicinal cannabis submissions I see in which the pain specialist has identified that the Veteran has never received any pain education, and this may present an opportunity to add this, and other non-medication options into the management plan. However please note that this review does not need to be with a pain specialist in acknowledgement of the shortage of these specialists in Australia.
3 and 4: Under these changes, no opioid medicines have been removed from the PBS and your doctor is still able to prescribe them via the RPBS under these altered arrangements.
The Department of Health has provided a Summary of PBS opioid listings for the treatment of pain as of 1 June 2020 – 2 June 2020 to assist your doctor.
Further information for your doctor can be found on the TGA website at https://www.tga.gov.au/prescription-opioids-information-health-professionals
Your doctor can call DVA on 1800 552 580 should they need further information about RPBS Authority prescription arrangements.
Below are four links providing further information on changes.