28 March 2013

Some Australian stats on opioid maintenance treatments.

A government report released recently* states that there are 46,446 people receiving opioid pharmacotheraphy treatment in Australia [this is probably about half the number of patients who have ever received such therapy]. There were 69% receiving methadone, 14% pure buprenorphine, and 17% buprenorphine-naloxone combinations.

There are 1,444 doctors licensed to prescribe maintenance opioids. There are 5,270 pharmacies across Australia, one third of whom 1,981 currently supervise opioid pharmacotheraphy dosing. Including hospitals, clinics, prisons, pharmacies, (and 2 doctors offices) the total number of dispensaries Australia-wide is 2,264.

*Ref: Medication-Assisted Treatment for Opioid Dependence (MATOD). 1st Canberra Roundtable Report. August 2012 Australian National Council on Drugs.

Cost of buprenorphine tablets.

My local pharmacist was unable to ascertain the price for private purchase, nor the price the PBS pays on behalf of approved recipients under the S100 system. Nor could the distributor give me the price and their staff were unwilling or unable to make further enquiries on my behalf.

Cutting through this seeming conspiracy, a senior insider informed me that 28 x 8mg buprenorphine tablets cost about A$130 (~US$130). Thus the maximum dose of 32mg would come in at $520 per month exclusive of dose supervision. This is about half the American price for the brand product I was quoted but comparable to or slight more than a US generic quote. I am not aware that the manufacturing cost of this drug is greatly different from other opioids and it seems to be the current marketing structure, substitute formulations and lack of competition which keep this 40 year old drug at a premium price. Other medications of the same generation such as diazepam and doxycycline are in the ‘bread and butter’ class, costing less than ten dollars for an average prescription. Likewise, methadone costs between 50 cents and a dollar per day on usual doses (excluding dispensing).

I hope this information is of interest to readers … and I would value any comparative feedback on its accuracy as my sources are still verbal for some of the above.

Andrew Byrne .. [presently in New York City, waiting for the spring]

Since writing this I have been informed that the PBS listed prices are indeed available on-line.