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. The implications for GPs prescribing opioids and managing patients with severe pain are illustrated by case studies.
Important update: further opioid prescribing changes
On 1 October 2020, further PBS changes that impact on opioid prescribing were announced. These included clarification of the requirements for secondary review of opioid use, particularly for palliative care patients, and for recording of the second prescriber review. The article has been updated to include these changes. The updated article is available here.
- 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.
- The use of opioids in the management of cancer pain and palliation and end-of-life care is unaffected by the TGA and PBS changes.