Feature Article

Opioid prescribing: what do the 2020 PBS changes mean for GPs?

HESTER H.K. WILSON, FERGAL ARMSTRONG, IAN G. THONG

Figures

© RFBSIP/STOCK.ADOBE.COM models used for illustrative purposes only
© RFBSIP/STOCK.ADOBE.COM models used for illustrative purposes only

Abstract

On 1 June 2020, TGA and consequent PBS changes to reduce prescription opioid-related harm came into effect. They include changed PBS categories and clinical criteria, and smaller pack sizes for opioids. Further changes were announced on 1 October 2020. The implications for GPs prescribing opioids and managing patients with severe pain are illustrated by case studies.
Note
The original version of this article was published in the September 2020 issue of Medicine Today. The version available here has been updated to incorporate subsequent TGA and PBS changes that were announced on 1 October 2020.

Key Points

  • On 1 June 2020, TGA regulatory and PBS changes that affect opioid prescribing came into effect.
  • The changes include smaller pack sizes to limit unused medications for severe acute pain and re-defined indications for immediate- and modified-release formulations and higher potency opioids.
  • The changes aim to minimise harms associated with prescribed opioids in line with current evidence and best practice.
  • Evidence supports managing chronic noncancer pain with multimodal strategies, with function an important measure of efficacy.
  • On 1 October 2020, further changes were announced to clarify the June changes, including allowing the annual secondary review of opioid use for palliative care patients to be conducted by palliative care nurse practitioners.