Quality use of publicly subsidised tapentadol in Australia: a population-based analysis

Ximena Camacho; Andrea L Schaffer; Jonathan Brett; Nicole Pratt; Nicholas A Buckley; David Henry; Sallie-Anne Pearson

doi:10.1111/imj.16335

Quality use of publicly subsidised tapentadol in Australia: a population-based analysis

Intern Med J. 2024 Feb 1. doi: 10.1111/imj.16335. Online ahead of print.

Authors

Ximena Camacho^{1

2}, Andrea L Schaffer^{1

2

3}, Jonathan Brett^{1

2

4}, Nicole Pratt^{2

5}, Nicholas A Buckley^{2

6}, David Henry^{2

7}, Sallie-Anne Pearson^{1

2}

Affiliations

¹ School of Population Health, Faculty of Medicine and Health, UNSW Sydney, Sydney, New South Wales, Australia.
² NHMRC Centre of Research Excellence in Medicines Intelligence, Sydney, New South Wales, Australia.
³ The Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
⁴ Clinical Pharmacology and Toxicology, St Vincent's Hospital, Sydney, New South Wales, Australia.
⁵ Quality Use of Medicines and Pharmacy Research Centre, Clinical and Health Sciences, University of South Australia, Adelaide, South Australia, Australia.
⁶ Biomedical Informatics and Digital Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.
⁷ Institute for Evidence Based Healthcare, Bond University, Gold Coast, Queensland, Australia.

PMID: 38299430
DOI: 10.1111/imj.16335

Abstract

Background: Sustained-release (SR) tapentadol was listed on Australia's Pharmaceutical Benefits Scheme (PBS) in 2014 for chronic severe pain requiring long-term opioid treatment. Dispensings have increased since listing despite declining trends in other PBS-listed opioids. Preferential prescribing of SR opioids may increase the risk of dependence and accidental overdose, particularly when used to treat acute pain.

Aims: To explore the quality use of publicly subsidised tapentadol in Australia.

Methods: We examined annual initiation rates and patterns of use of tapentadol (SR) in the dispensing records of a 10% random sample of PBS-eligible Australians (2014-2021). We used national tapentadol sales data to assess the proportion of sales attributable to the PBS.

Results: Tapentadol initiation increased from 2014, peaking at 7.5/1000 adult population in 2019 before declining to 5.3/1000 in 2021. We identified 63 766 new users between 2014 and 2020, of whom 92.8% discontinued in the first year following initiation, 58.0% had only a single dispensing and 34.3% had no other opioids dispensed in the 3 months before or after initiation. 27.8% of new users were dispensed tapentadol on the same day as potentially interacting medicines. There was a sustained drop in the proportion of sales attributable to the PBS from June 2020 onwards, from an average of 69.1%, to 63.9% of pack sales.

Conclusions: Patterns of use suggest tapentadol (SR) is generally used for short duration. Although most tapentadol sold in Australia is subsidised, there is evidence of a shift towards private sales.

Keywords: Australia; drug utilisation; opioids; pharmacoepidemiology; tapentadol.

Abstract

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