Opioid substitution

Date sent: 15 October 2019

OIA response

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:

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