Opioid Maintenance Therapy (OMT) is an effective treatment for opioid addiction. In Australia the main forms of OMT are methadone and buprenorphine. OMT provides a regular, consistent and long-acting opioid dose that allows people the opportunity to regain control of their lives. A long-term OMT program enables individuals to improve their physical and mental health, resume employment and/or education and strengthen their relationships with family, friends and the wider community. It also greatly reduces people’s risk of fatal overdose, which kills more Australians each year than car accidents.

Better access to OMT will help address growing rates of prescription opioid misuse and overdose. Under the present system, it is cheaper and easier to procure prescription opioids than OMT. Ensuring OMT is affordable is an important strategy to help stem prescription opioid as well as heroin addiction. This paper focuses on one major impediment to enabling more Australians to access medication-assisted treatment: the requirement that people on OMT pay a fee for each dose they receive, rather than a flat fee per script. These daily OMT fees are described in this paper as co-payments, and they are severely compromising the public health and community benefits of an exceptional form of drug addiction treatment.

The effectiveness of OMT is dependent on people staying in treatment and co-payments are the main reason people drop out of treatment — often resuming illicit drug use and criminal activity. Crime related to drug misuse is estimated to cost $3,161 million per year in Australia. Reform is needed to ensure better access to OMT.

Co-payment relief must be provided to patients through the Pharmaceutical Benefits Scheme (PBS) to ensure a coordinated, national approach. This will increase patient retention and uptake of OMT across Australia, resulting in better individual outcomes for illicit opioid users and reduced drug-related health and crime costs to the community.