OIA Response: Opioid substitution

Response to a request for information on opioid substitution treatment.

15 October 2019

[name and contact details redacted]

Dear [name redacted]

REQUEST FOR INFORMATION

Thank you for your request dated 23 September 2019 under the Official Information Act 1982 (OIA), related to opioid substitution treatments for 2017 to 2019.  You asked for:

  1. Subsidised units of buprenorphine with naloxone, and methadone in the community for each relevant period.
  2. Special Authority approvals for initial and renewal applications for Suboxone (SA1203).
  3. Opioid Substitution Treatment Service Fee.
  4. Number of patients dispensed in the community for each relevant period.
  5. Total scripts.

The data below has been provided in response to your request. Data is for the financial years ending 30 June, for each year requested, and is from pharmaceutical prescription claims data.

Methadone is also used as an analgesic so the data will include this indication as well as for opioid substitution. PHARMAC does not have data split by indication for methadone in this respect. 

In respect of questions 1 and 4, methadone hydrochloride, Methatabs, Tab 5mg was not listed on the Pharmaceutical Schedule in 2017 or 2018.

In respect of question 3, whilst we do not have data specifically for opioid substitution treatment fees, the data we have provided is also inclusive of other dispensing fees.

In respect of question 5, we cannot provide data on Suboxone doses as requested, because PHARMAC does not hold a complete data set.

On the basis stated above, those parts of your request are refused under section 18(g) of the OIA, as the information is not held by PHARMAC, and we have no reason to believe it is held by another agency.

You have the right, by way of complaint under section 28(3) of the OIA to an Ombudsman, to seek an investigation and review of our decision.

PHARMAC approaches its assessments of requests for information under the OIA on the basis that, once released, the information becomes publicly available.  We trust that this information answers your queries.

We are making our information more freely available, so we will now publish selected OIA responses (excluding personal details) on our website.  Please get in touch with us if you have any questions about this.

Yours sincerely

Alison Hill
Director, Engagement and Implementation

Question 1: Subsidised units of buprenorphine with naloxone, and methadone in the community for each relevant period

Chemical

Brand

Formulation

2016/17

2017/18

2018/19

Buprenorphine with naloxone

Suboxone

Tab sublingual 2 mg with naloxone 0.5 mg

351,949

407,601

460,122

Buprenorphine with naloxone

Suboxone

Tab sublingual 8 mg with naloxone 2 mg

368,192

434,995

472,980

Methadone hydrochloride

Biodone

Oral liq 2 mg per ml

1,580,570

1,643,982

1,571,257

Methadone hydrochloride

Biodone Extra Forte

Oral liq 10 mg per ml

3,717,715

3,462,808

3,341,356

Methadone hydrochloride

Biodone Forte

Oral liq 5 mg per ml

21,096,238

20,618,935

20,164,484

Methadone hydrochloride

Methatabs

Tab 5 mg

n/a

n/a

893

Methadone hydrochloride

Methatabs

Tab 5 mg - bottle pack

2,204,227

2,218,984

2,091,988

Notes: Methadone hydrochloride, Methatabs, Tab 5mg was not listed on the Pharmaceutical Schedule in 2017 or 2018.

Question 2: Special Authority approvals for initial and renewal applications for Suboxone (SA1203)

 Chemical

2016/17

2017/18

2018/19

Suboxone (SA1203) Initial approval Detoxification

31

14

16

Suboxone (SA1203) Initial approval Maintenance

327

321

299

Suboxone (SA1203) Renewal approval Detoxification

<10

<10

10

Suboxone (SA1203) Renewal approval Maintenance

586

748

847

Suboxone (SA1203) Renewal approval Maintenance treatment where the patient has previously had an initial application for detoxification

15

20

16


Question 3: Opioid Substitution Treatment Service Fee

 Dispensing fees

2016/17

2017/18

2018/19

Total number of patients dispensed where the dispensing fee includes an opioid substitution fee

105,217

109,058

110,846

Total number of Suboxone patients for which dispensing fees were claimed (only including formulation eligible for opioid dispensing fees)

1,065

1,195

1,275

Total number of Methadone patients for which dispensing fees were claimed (only including formulation eligible for opioid dispensing fees)

5,526

5,427

5,333

Total value of dispensing fees which include an opioid substitution treatment fee

 $26,796,409

 $27,539,968

 $27,708,520

Total number of dispensings for either methadone and suboxone for formulations used for opioid substitution

2,088,684

2,114,461

2,123,976

Total number of dispensings for methadone (only including formulation eligible for opioid dispensing fees)

1,781,172

1,745,365

1,713,696

Total number of dispensings for suboxone (only including formulation eligible for opioid dispensing fees)

307,512

369,096

410,280

Notes: We do not have data specifically for opioid substitution treatment fees. However, these are included in the dispensing fees provided, which will also include other dispensing fees. The amount eligible to be claimed specifically as an opioid substitution fee is $6.89 per dispensing.

Question 4: Number of patients dispensed in the community for each relevant period

Chemical

Brand

Formulation

2016/17

2017/18

2018/19

Buprenorphine with naloxone

Suboxone

Tab sublingual 2 mg with naloxone 0.5 mg

900

1026

1077

Buprenorphine with naloxone

Suboxone

Tab sublingual 8 mg with naloxone 2 mg

865

992

1022

Methadone hydrochloride

Biodone

Oral liq 2 mg per ml

476

480

486

Methadone hydrochloride

Biodone Extra Forte

Oral liq 10 mg per ml

1597

1497

1446

Methadone hydrochloride

Biodone Forte

Oral liq 5 mg per ml

4383

4347

4247

Methadone hydrochloride

Methatabs

Tab 5 mg

n/a

n/a

16

Methadone hydrochloride

Methatabs

Tab 5 mg - bottle pack

2118

2127

2030

Notes: If a patient was dispensed more than one formulation of the same chemical in the same year then they will be counted under both formulations.

Methadone hydrochloride, Methatabs, Tab 5mg was not listed on the Pharmaceutical Schedule in 2017 or 2018.

Question 5: Total prescriptions

Chemical

Brand

2016/17

2017/18

2018/19

Buprenorphine with naloxone

Suboxone

19,691

22,275

23,610

Notes: We cannot provide data on Suboxone doses as PHARMAC does not have a complete data set.