Victoria needs to address OST fees

COVERING pharmacists’ dispensing fees for opioid substitution therapy (OST) could be key to removing barriers to accessing treatment for patients in Victoria, State MP, Dr Tim Read, believes.

Speaking in the Victorian Legislative Assembly earlier this week, the Greens MP, noted that while some OST medications have been listed on the Pharmaceutical Benefits Scheme (PBS), the dispensing fees have not been covered, leaving patients with outof-pocket expenses.

“They [dispensing fees] are typically $30–$35 a week, and that fee, I am told by pharmacists, has not increased in 30 years,” he said.

“When you consider the interaction that they have with the patient, the consumables and the time spent, that is not a lot for them to ask.

“But patients often do not have the money and do not pay.

“It sets up a tension between the pharmacist and the patient, and patients too often fall off the wagon.

“I had one patient die almost certainly as a consequence of not being able to pay for her methadone.

“I think we have a system that puts up significant barriers to people receiving the best treatment to stop their heroin or other opioid use, and methadone, naloxone and buprenorphine are regarded as the best treatments for heroin addiction.

“There are more than 50,000 people using this kind of treatment in Australia, and every state other than Victoria provides some form of subsidy or access.

“So I think this is a real challenge for the Victorian Government and one that I recommend the government accept.

“I think that with these dispensing costs, when compared to the costs of, say, the hospital admission of the patient that I mentioned—who fell off the wagon, used heroin and got a heart valve infection and spent months in hospital—a $30-to-$35-a-week dispensing fee pales into insignificance.”

Read also flagged concerns over the shortage of doctors prescribing OST in Victoria, noting it was a role that nurse prescribers could fill in the future.