The Commonwealth Government has announced changes to the opioid treatment program (OTP) from 1 July 2023. For further information, see Pharmaceutical Benefits Scheme (PBS) | Opioid Dependence Treatment Program which includes key information and fact sheets about the changes.
OTP medicines will become part of the Section 100 Highly Specialised Drugs (HSD) Program (Community Access) arrangements. This means OTP medicines will be dispensed in the same way as other community access Section 100 HSD Program medicines.
Every OTP service provider will be required to pay wholesale suppliers for the OTP medicines up front and then be reimbursed by the Commonwealth once dispensed at a PBS-approved community pharmacy or a hospital pharmacy.
The Commonwealth has provided an extension for private OTP clinics and non-PBS pharmacies so that these changes won’t take place until 30 November 2023 in non-PBS settings.
Several other services in NSW that direct supply OTP medicines have also received this extension until 30 November 2023. These include select NGO services, Aboriginal Community Controlled Health Services, private correctional facilities and GP clinics.
OTP medicines listed under the Section 100 HSD Program can be dispensed from a:
Under the HSD Program, the patient PBS co-payment for OTP medicines will be consistent across most service settings in Australia and the medicine will be significantly more affordable for most people.
If the medicine will be reimbursed through the PBS, OTP prescribers will need to write new PBS s100 authority prescriptions.
Example handwritten PBS scripts that meet NSW requirements.
Example handwritten complex PBS scripts that meet NSW requirements.
Visit the Services Australia website for more information on the streamlined authority process. In these cases, OTP prescribers will also need a PBS prescriber number. Applications can be made through Services Australia. PBS stationery can also be ordered through Services Australia.
Prescribers involved in the transitional arrangements to 30 November 2023 (e.g. private OTP clinics, GPs that direct supply to their practice, prescribers working in select Aboriginal Community Controlled Health Services and non-governmental organisations) are not required to write a PBS prescription during the transition.
The OTP Transfer of Care Guide outlines the processes and regulatory requirements relating to a change of client prescriber or dosing point.
Please note that OTP is not included in the NSW Health Section 100 co-payment program.
NEW - A dedicated Opioid Treatment Program information page has been developed for community pharmacists, available here.
The way OTP medicines are prescribed, ordered, dispensed, supplied and remunerated will be just like other PBS medicines under the Section 100 HSD Program (Community Access).
From 1 July 2023, a new ODT Community Pharmacy Program will introduce nationally consistent payment arrangements for OTP staged supply services provided by section 90 approved community pharmacies.
Transitional arrangements for existing prescriptions during first 3 months are available from page 3 of the factsheet below:
For buprenorphine, the way OTP medicines are prescribed and remunerated will be just like other PBS medicines under the Section 100 HSD Program (Community Access).
For methadone, NSW Health will purchase and provide supply outside of PBS arrangements.
Please visit Information for people on the Opioid Treatment Program (OTP) for information for patients.
