Opioid Analgesics
Page last updated: 10 July 2020
Drug utilisation sub-committee (DUSC)
February 2020
Abstract
Purpose
DUSC requested a review of the utilisation of Pharmaceutical Benefits Scheme (PBS)-listed opioid analgesics, including the combined use of pregabalin and opioid analgesics.
Data Source / methodology
Data were extracted from the Department of Human Services (DHS) Supplied Prescriptions database based on Anatomic Therapeutic Classification codes.
Key Findings
- Pregabalin had become the most supplied analgesic in the opioid and pregabalin analgesic market (see Figure 1a).
- Pregabalin and tapentadol were the only two drugs in this market currently not decreasing in utilisation. Tapentadol was increasing and pregabalin had plateaued and may have been starting to decrease (see Figures 1a and 7).
- The up-scheduling by the Therapeutic Goods Administration (TGA) of low dose codeine combination products to Schedule 4 Prescription Only on 1 February 2018 had a minor upward impact on the utilisation of PBS listed high dose codeine (i.e. 30mg) combination products (see Figures 1a and 7). The low dose codeine combination products were not PBS listed, so had to be supplied as private prescriptions. This may have provided a financial incentive to substitute low dose codeine private prescriptions with high dose PBS subsidised prescriptions.
- Prescriptions from the palliative care schedule accounted for only 0.8% of the opioid market in 2019 Q3 (see Figure 2). However prescriptions for palliative care patients accounted for at least 7.1% of the opioid market and 5.0% of the pregabalin market in the same period (see Figure 3).
- The patient drug regimen analysis showed that;
- The listing of pregabalin for neuropathic pain in March 2013 coincided with the start of an increase in both two product and more than two product drug regimens (see Figure 13).
- Currently (as at August 2019) 5 of the 10 most common two-product regimens contain pregabalin and 8 of the 10 most common three-product regimens contain pregabalin (see Figures 9 and 10).
- At the time of reporting, 79%, 17% and 4% of patients were on a one, two or more than two product drug regimens respectively (see Figure 12).
- The number of patients on two or more than two product drug regimens had started to decrease (see Figure 13).
Full Report
