Senator Rachel Siewert says the discriminatory arrangements for the Opiate Dependence Treatment Program (ODTP) are "grossly unfair" and "need to change".
The Greens Senator spoke with BioPharmaDispatch as pressure builds on health minister Greg Hunt to reform the program under which the federal government removes pharmacy remuneration and explicitly denies patients the protection of PBS co-payments and the safety-net.
Patients can access their PBS-listed treatment through a community pharmacy but are required to pay an uncapped and unregulated dispensing fee. Some patients face charges in excess of $200 per month.
The Federal Court has found people living with opiate dependence are considered to have a disability.
There are also serious doubts over the enforceability of the current ODTP arrangements given they are not covered by a legislative instrument. As a result, the parliament has been denied the opportunity to scrutinise and potentially disallow the arrangements.
Senator Siewert questioned Department of Health officials on the program at Senate Estimates last October. They responded by quickly drafting and distributing to stakeholders for consultation a legislative instrument.
Implementation of the legislative instrument was scheduled for 1 February 2021 but has been delayed.
The anomaly of the ODTP is made all the more stark by health minister Greg Hunt's previous statements on the importance of fighting opiate addiction.
In October 2019, Minister Hunt announced funding for naloxone nasal spray. The antidote medicine used to treat a narcotic overdose in an emergency situation was added to the PBS under normal co-payment and safety-net arrangements but is also available at no cost to patients.
In announcing the listing, Minister Hunt said, "Every day in Australia three people die from drug-induced deaths involving opioid use, and nearly 150 hospitalisations and 14 emergency department admissions involve opioid harm.
"Over 110,000 Australians are currently struggling with opioid dependence with increasing deaths from overdose, 1119 deaths in 2016.
"Prescription opioids are now responsible for more deaths and hospitalisations in Australia than illegal opioids such as heroin."
In the 2019-20 Budget, the government also funded a 'take home' program under which naloxone was provided to patients for free.
"The Take Home Naloxone pilot aims to improve access and uptake of naloxone, by providing it for free and without a prescription, from a wide variety of locations including community and hospital-based pharmacies, alcohol and other drug treatment centres, needle and syringe programs, custodial release programs, first responders (police) and GP clinic access," said Minister Hunt.
The government will fund pharmacy remuneration and patient costs for access to the PBS-listed antidote to overdose. Yet it will not do the same for those on PBS-listed treatment to end their dependence on opiates.
