A Health Cost Increase ?

Just when the government was hoping that the health budget might be contained a new fight has broken out between doctors and pharmacists about over the counter pain relief medication.  Coedine is effective in relieving intense pain, but it is also addictive.  Pressure is building to make two of the most popular products containing Coedine - Nurofen Plus and Panadeine Extra - restricted by requiring a doctors script for supply.

The need to get that script for what is at present an  over the counter item will certainly result in a surge of doctor visits and their consequent increase in Medicare costs. The move is opposed by pharmacists who are on the front line in advising customers on pain relief and who believe that script restrictions are unnecessary.

This proposal turns the spotlight on the wider subject of doctor's scripts for all forms of medication. Generally, each script allows for five repeats and consequently any patient permanently taking a particular medication needs to see their doctor at least twice a year to get new scripts to ensure uninterrupted supply.    Doctor visits could be reduced if the life of each script were extended to provide a full year supply.

Doctors would oppose this on the grounds that when script renewal requires a visit the patient is examined to determine if the medication is doing it's job and whether any change is necessary. Good health requires the patient to be constantly monitored and the present script repeat numbers ensures that the correct doctor/patient consultations occur.

The crux of the problem is the addictive nature of products containing Coedine.   Each tablet has an enhanced street value and apart from patients becoming addicted, there is a widespread trade amongst drug users.   If they are subjected to script supply we may see a sharp increase in "doctor shopping " - where individuals using a false name visit numerous doctors seeking a script for an imagined ailment, with the intention of making profit from the sale of their script.

Another option would be to legislate to decrease the pack size available over the counter, and to place restrictions on the amount available in a single purchase.  This would place pharmacists in the role of "gatekeeper " and at best it would slow the trade in Coedine, but it would also inconvenience those with genuine severe pain problems.  It must be remembered that Coedine is a genuine source of relief for those suffering intense pain and a total ban on sales is impractical.

It seems that there is no clear solution to this dilemma.   Newton's law comes into effect.  "To every action, there is an equal and opposite reaction "!       To make products containing Coedine a pharmaceutical that requires a doctors script for supply will immediately sharply increase the number of doctor visits and blow out the costs of Medicare.

To reduce pack sizes and place restrictions on quantity availability will put pharmacists under pressure and prevent those with genuine needs from getting adequate pain relief, and neither will have much effect on the availability of illicit drugs from the underworld.

Thar raises the question of whether the wisest decision might be to take no action at all !