There is mounting evidence that while medication can play an important role in pain treatment, the best practice approach for pain management is multidisciplinary. However, this approach currently remains unaffordable and inaccessible for most Australians, leading to an over-reliance on medication to manage pain in an average of 70 per cent of GP consultations.
While they are not the only way to manage chronic pain, it is important to remember that medications can also play a role within a multidisciplinary approach, which is why access to appropriate and safe medicines is an important part of pain treatment.
This week, Painaustralia provided input to the Inquiry into approval processes for new drugs and novel medical technologies in Australia, highlighting the need for consumer access to new and innovative pharmacological options to manage chronic pain.
We know that people living with pain are often unable to access proper assessment and care, and can fall between the gaps of our healthcare, mental health and disability systems. The Medicare Benefits Scheme does not support a best-practice treatment model. Through this, medications have played an increasing role in the management of pain.
The over-reliance on opioids is an unfortunate consequence of a system that is not working. At least 80 per cent of people who live with chronic pain are not receiving treatment that could improve their health and quality of life.
Until we can address these larger systematic problems, it is important to recognise the role of medications and the necessary reliance on pharmaceutical options to manage pain. Sometimes it is the only available option for people to receive pain relief and remain functional.
Many people living with chronic pain opt to self-medicate, so it is vital that they have access to new and emerging medications and technologies that are informed by evidence.
There is also the issue of cost, as people living with chronic pain bear about 22 per cent or $2.7b of the out-of-pocket costs associated with chronic pain.
In Australia, a new drug or treatment option cannot be subsidised for access without the recommendation of the Pharmaceutical Benefits Advisory Committee (PBAC). The PBAC is required to review medicines for listing on the Pharmaceutical Benefits Scheme (PBS) with consideration of both cost and effectiveness.
There is an opportunity here to improve mechanisms for consumer input to PBAC processes. These are currently limited and the very people whose quality of life is going to be impacted by the decisions of the committee are not involved in the decision-making process.
Painaustralia’s recommendation to the Senate Inquiry is to improve patient and broader consumer involvement into PBAC processes, looking to the values developed by the Health Technology Assessment International (HTAi) special interest group for patient and citizen participation as a useful starting point.
While the management of chronic pain is complex and there is not one solution that will work for everyone, we cannot ignore the role that medications currently play in the management of pain for many people living with pain.
Until we can provide affordable access to best practice multidisciplinary care, we must ensure that the regulatory processes for new and innovative pharmacological pathways consider the value that these medications provide to improve the lives of millions of people living with pain conditions.