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Smoking cessation - Bupropion (Zyban)
Smoking cessation - Bupropion (Zyban)
Date Created: 19/02/2001 Last Modified: 19/02/2001 Last Checked: 16/01/2003
Authority script requirements, smoking cessation and bupropion.
There have been a huge number of authority requests for bupropion (Zyban). For the Queensland centre alone (which covers N. NSW also) it has been in the region of 2000 per day, possibly a lot more. Estimates indicate that the cost of this drug is probably creating the greatest ever acute drain on PBS financial resources. Such an event may not pass without comment.
Current psychological / counselling services cannot cope with that demand. Such services are a required adjunct to bupropion treatment in order for a legitimate benefit to be paid: the wording for a legitimate authority approval is "part of a comprehensive treatment program..........". Follow up visits to a GP may not be viewed as a comprehensive treatment program.
The Medical Board of Queensland annual report (issue No 13 Dec 2000 pages 11-12) contained an article from an HIC official reminding doctors that there are penalties for not complying with authority script requirements. This concluded as follows:-- "prescribing of an item contrary to its listing is in breach of the National Health Act and may result in action being taken by the commission".
It appears a firmer line is being taken about something that some doctors may feel infringes their clinical freedom to treat patients as they feel is best. In the past doctors seem to have been allowed to interpret the authority guidelines as they felt was appropriate with little or no discussion or audit. Does this signal a change of policy? If any readers have any information or views please contact me using the Cohtact Me button in the menu.
I suspect some doctors are not fully aware of how often they treat patients in a way that may be, strictly speaking, not quite in complete accordance with authority requirements. This is a difficult and serious clinical issue that may now place some patients at great disadvantage if regulations are tightened. The position may now be that only those who can pay themselves will have the full range of choices their own doctor deems appropriate for their particular circumstances.
Cost approx 500 million per year in Australian $.
Or (based on approx 20,000 GPs) = an extra $25, 000 per GP per year!
All text ©Dr Ken Gillman MRC Psych - PsychoTropical Research®
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