Changes to the OTP in 2023
What’s happening?
On May 10, the Commonwealth Government announced additional funding for the Opioid Dependence Treatment Program (ODTP) of $377 million over 4 years. This follows years of advocacy, particularly by drug user advocates and organisations, and significant input from the affected community.
The increased funding means that people receiving these medications (methadone and buprenorphine tablets, film or injections) will be able to get them on the PBS like all other prescribed medications in Australia. It is a win for the human rights of people on the ODTP.
This change will make it easier and less expensive for people in Australia to access ODTP medications.
How much will I pay?
From July 1, you will pay what is known as a monthly co-payment. For concession card holders, this will be $7.30 every 28 days (even if you are dosed/pick up more regularly) and $30 every 28 days for Medicare card holders.
If you are on two different strengths for buprenorphine (e.g. 2mg and 8mg films), you will be required to pay two co-payments.
There may be a few services that choose to supply ODTP medicines outside this new arrangement from 1 July and they could charge more. We expect this to only happen in rare cases.
Will my treatment change?
Your treatment should not change because of the PBS reform, but you may need to see your doctor more frequently. This is because of the new rules under the PBS.
Will I still be able to get my ODTP medication if my pharmacy or clinic won’t offer it on the PBS?
Your ODTP medicines will not be discontinued. In NSW, Local Health Districts and the Ministry of Health are working to make sure that no one is left behind. If you have concerns please ring the Opioid Treatment Line (OTL) on 1-800-642-428 or NUAA’s PeerLine on 1-800-644-413 for free, confidential peer support and advice.
If you’ve been told your treatment will stop on July 1, please call us immediately.
ODTP services are working hard to continue your treatment, but these changes mean services have to change how they work and there may be delays.
What if I get my medications at a community pharmacy?
In most cases, your treatment will be cheaper after July 1. Community pharmacies will be paid by the Commonwealth to provide you with your ODTP medicine.
What if I am a client at a public clinic?
If you receive your dose at a public clinic, you will continue to receive your treatment for free after 1 July 2023. You will not be required to pay a monthly co-payment. If your prescriber works in a public clinic but you receive your dose at a community pharmacy, you will still have to pay but will receive the new lower rate.
What if I get my medications at a private clinic or non-PBS pharmacy?
The Commonwealth Government has provided a transition period for these services, so you should not see a change in your treatment after 1 July 2023. However, this will end on 30 November 2023. For free, confidential peer support call PeerLine at 1800 644 413 – they are there to help.
While these services are still operating, they will be still able to charge their current fees (including after 1 July 2023).
Will ODTP be part of the Section 100 co-payment program?
No, ODTP will not be part of the Section 100 co-payment program in NSW.
If your pharmacy or clinic won’t offer ODTP medication on the PBS, the Opioid Treatment Line can help find you a new dosing point where you can receive the PBS rate.
What are my rights when negotiating my treatment during this time?
It is your right to receive medical care that suits your needs. If you are being asked to change your treatment in a way that you do not like, talk to your doctor about why that does not work for you. Services will do their best to help you and to find the best available option.
We understand that these changes may cause you disruption or raise questions or issues. For free, confidential peer support, call PeerLine at 1800 644 413 – they are there to help.
NUAA strongly supports these changes.
Bringing these medicines under the PBS is long overdue and will make a significant difference to the lives of the 25,000+ people on the ODTP in NSW.
We applaud the many drug user activists who fought for many years to make the ODTP fairer and the many clients of this program who have participated in community consultations. We would like to especially thank Dr. Annie Madden AO who, with Harm Reduction Australia, was instrumental in creating this change.