New figures suggest Australia saw a decline in opioid after PBS policy changes.

Australia’s Pharmaceutical Benefit Scheme (PBS) introduced stringent restrictions on the supply of prescription opioids on 1 June 2020. These measures included limiting repeat prescriptions, introducing half-sized packaging, and requiring higher authorisation levels for prescribing certain opioids. 

The aim was clear: to curb the availability of prescription opioids in the community and reduce unnecessary prescriptions. 

The move was made in tandem with regulations set by the Therapeutic Goods Administration (TGA) as part of efforts to tackle opioid misuse.

New research from UNSW Sydney sheds light on the impact of these restrictions. 

Published in the Medical Journal of Australia, the study indicates a notable decline in PBS-subsidised opioid consumption, suggesting a broader decrease in opioid usage nationwide.

“Opioid use subsidised through the PBS declined as a result of all these changes, and that likely represents a true decline in opioid use,” says Dr Benjamin Daniels, co-senior author and Senior Research Fellow at UNSW's Medicines Intelligence Research Program.

While the study acknowledged a minor shift towards non-PBS subsidised prescriptions, this did not undermine the overall trend.

Using national PBS dispensing records and wholesale sales data, the researchers sought to create a comprehensive picture of prescription opioid use before and after the policy shift. 

By comparing opioid supply in terms of oral morphine equivalent milligrams (OMEs), they uncovered a 4 per cent reduction in PBS-dispensed opioids in the year following the changes.

This decrease primarily stemmed from instant release formulations, suggesting the new PBS guidelines were effective in reducing repeat prescriptions.

Despite the overall downward trend, the study noted an exception in the usage of tapentadol, a newer opioid, which had been on a rise before the PBS changes took effect. 

This anomaly, alongside a 9 per cent increase in sales of instant-release formulations not covered by the PBS, suggests areas requiring further scrutiny and possibly, additional interventions.

Australia is a nation of significant opioid consumption, ranking ninth per capita globally. 

With drug-induced deaths primarily attributed to opioids, and dependency and misuse issues prevalent among chronic pain sufferers, the PBS restrictions represent a critical step towards mitigating these challenges. 

However, the new regulations have sparked debate, highlighting the complexities of balancing opioid accessibility for genuine needs against the risks of misuse and dependency. 

Dr Daniels says it is a delicate balance, with the study providing an overarching perspective on the policy's impacts, yet acknowledging the individual experiences it does not capture.