GPs encouraged to prepare for opioid dependence changes

RACGP President Dr Nicole Higgins has encouraged GPs to prepare for incoming changes that will see opioid treatment medicines such as methadone and buprenorphine become available via the PBS.
 
From 1 July, eligible patients – Australian residents with a Medicare card who meet the criteria for opioid dependence – will only need to pay the PBS co-payment of $30 (or $7.30 with a concession card) for up to 28 days’ supply of a number of different medications.
 
The payments will also contribute towards patients’ PBS Safety Net threshold, and Dr Higgins said the Government’s decision to heed RACGP calls and make the treatments more affordable is ‘great news’.
 
However, she also said clinicians should help patients smoothly transition into the new regime.
 
‘GPs play a vital role in supporting and prescribing opioid dependence treatment [ODT] for their patients, and I’m sure many will be breathing a sigh of relief with the changes coming into effect on 1 July,’ she said.
 
‘I encourage all GPs to take steps such as talking to local pharmacies, preparing the move to PBS scripts, ensuring your patients have scripts to tide them over during the transition period and even just advising your patients that this change is a positive thing that will save them valuable dollars.’
 
Dr Hester Wilson, Chair of RACGP Specific Interests Alcohol and Other Drugs, backed the President’s comments, and said cost has been a key factor preventing more people from getting the help they need.
 
‘This is a game changer for alcohol and other drug treatment in Australia,’ she said.
 
‘People dependent on opioid drugs such as heroin or oxycodone and whose health is at risk every day, will … no longer have to pay a private pharmacy dispensing fee of between $5–15 a day, but rather just $7.30 or $30 per month.
 
‘Every life matters, and people in communities across Australia with opioid dependence need help to get their lives on track. If we can remove roadblocks, including cost, that stop them from getting treatment it will save lives.’
 
However, the change has not been supported everyone in the sector. Some pharmacists and private opioid treatment services have warned that they will be forced to close as a result of the shift, with some patients potentially left behind as a result.
 
The Department of Health and Aged Care has since refuted this claim, with an open letter published in the Australian Journal of Pharmacy seeking to address ‘incorrect reporting around changes to the Opioid Dependence Treatment program’.
 
‘These changes will improve access to and affordability of ODT by supporting the delivery of pharmacy services for people in treatment programs for opioid dependence – around 80% of whom are estimated to be on income support,’ the letter states.
 
‘The department has been working in cooperation with states and territories since last year to ensure patients are supported to manage this transition safely and that no patient is without the medicine that they need.
 
‘All existing clinics will continue to be able to treat and provide clinical services to patients. The Australian Government will continue to pay pharmaceutical companies directly for ODT medicines supplied to private clinics, non-PBS approved pharmacies and other sites such as GP clinics up to 30 November 2023.’
 
For Dr Paul Grinzi, a GP with 20 years of addiction medicine experience and the author of a recent journal article outlining how GPs can help patients experiencing alcohol and other drug-related issues, the changes ‘couldn’t come at a more important time’.
 
‘This is an historic move,’ he said. ‘It brings this lifesaving treatment for people of all ages into the mainstream and seeks to change the inequity of patients having to pay significant fees for treatment.
 
‘We should not be stigmatising people with opioid dependence and demanding that they go without the PBS safety net – that mindset is outdated and will get us nowhere.
 
‘People who have a problematic relationship with alcohol and other drugs, including opioids, need help and compassion. Judging them or making the cost of treatment beyond their reach doesn’t achieve anything and, in my view, diminishes us as a nation.’
 
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buprenorphine methadone opioid dependence Opioids PBS