The latest from Better Access Australia
Opiate Dependency Treatment Program News
RECOGNITION OF GOVERNMENT DISCRIMINATION AGAINST PATIENTS WELCOMED IN FEDERAL BUDGET
10 May 2023
The Albanese Government has announced funding of $377.3 million over four years, with $98.4 million ongoing to make patient access more affordable under the Pharmaceutical Benefits Scheme (PBS) Opioid Dependence Treatment program (ODTP).
An historic change to medicines access for these patients, the investment highlights the financial burden patients have endured for many years. As the system moves to end the discrimination against these patients, Better Access Australia restates its call for an Inquiry into how this was allowed to go unaddressed for so long.
“Better Access Australia welcomes the Albanese Government’s recognition of the financial discrimination perpetrated against patients accessing medicines to treat opioid addiction on the Pharmaceutical Benefits Scheme (PBS). Chair of Better Access Australia Felicity McNeill PSM said.
“Whilst no details behind the measure have been provided, the Government’s recognition that patients accessing the PBS Opioid Dependence Treatment program (ODTP) have been denied the same protections of the PBS safety net, co-pay and staged supply programs as other patients is a long overdue reform that must be embraced for the landmark change it represents.
“We thank Minister Butler for taking action to resolve an injustice his department has known about since at least 2019, but in reality has been aware of since the 1990s.
“We cannot thank enough Senators Pocock and Steele-John and former Senators Siewert and Fierravanti-Wells and the Scrutiny of Delegated Legislation Committee for their work from 2019 to today to ensure this issue was a priority of the Department of Health and Aged Care and no longer swept under the carpet. Ms McNeill acknowledged.
“In particular, we acknowledge the legislative reforms of Senators Pocock and Steele-John in 2022 placing a deadline on the Department to act and end its four-year obfuscation on this issue since a Freedom of Information request by local Canberra pharmacist, Jason Northwood was released.
“The significant investment required to place ODTP patients on an equal footing with patients managing diabetes, cancer, heart disease, and mental health highlights to the community just how much these patients have financially suffered each and every year.
“The significant investment highlights why multiple coronial inquiries found that these likely unlawful fees contributed to the deaths of too many people in our community. Too many people’s mums, dads, daughters, sons, work colleagues and partners lost to an insidious disease because the PBS didn’t give them the equal access it delivers to every other patient under law.
“We look forward to receiving the details of what this means for the PBS co-pay and dispensing fees on these drugs because as we know from the Government’s implementation of its Newborn Screening Program – the devil is always in the detail.
“In the meantime, Better Access Australia stands firm in its efforts to ensure that not only is this unlawful discrimination finally corrected from 1 July 2023, but that restitution is made and an apology issued to those who suffered financially, emotionally and physically before 1 July.
“Consequently, we have written to the Senate Community Affairs Reference Committee asking that an inquiry into the administration of the ODTP be undertaken to ensure that this level of discrimination never occurs again in any program. Too many people have suffered, too many lives have been lost. We must do better.
“But today as we also focus on next steps, we stop to recognise the courage and long-standing work of groups such as Harm Reduction Australia, and individuals such as Annie Madden AO, and Leah McLeod who have shared their stories time and time again to try and make a difference for others.
“The long overdue reform of the PBS Opioid Dependence Treatment Program is theirs, this change for others is because of them, the fact no other group will likely have to endure such levels of stigma, discrimination, and financial disadvantage to access their healthcare, is because of their work and courage. Ms McNeill concluded.
Please see media release in full here.
Opiate Dependency Treatment Program News
A BUDGET WITH SOME GOOD FOUNDATIONS BUT IT DOESN’T DELIVER FOR ALL AUSTRALIANS
25 October 2022
In their first budget, the Albanese Government has delivered on their election commitments to provide a national expanded and world class newborn bloodspot screening program for Australian babies and make medicines more affordable for some Australians.
Better Access Australia has been advocating for these reforms since 2021 but there are gaps in the announcements tonight.
World Class Newborn Screening in Australia about to be a reality
“Better Access Australia welcomes the Albanese Government’s investment of $39 million to deliver a world-class new newborn bloodspot screening program in Australia commencing in 2022-23.
“This is a huge day for the families that have courageously told their stories and fought so hard to ensure no other families have to endure the diagnostic odyssey of rare disease for babies born in Australia. Because without diagnosis there is no treatment.
Cheaper medicines for many Australians welcomed but not everyone protected from Australia’s record inflationary pressures
“Tonight’s budget funds the reduction in the cost of PBS medicines for families and individuals earning over $78,000 a year by over 30% from $42.50 to $30.
“But in a cost-of-living budget, concessional patients have been forgotten, with their co-payments scheduled to go up by around 50 cents a script from 1 January. These are the same families and pensioners earning less than $78,000 a year and struggling to meet their rent, mortgage, power bills, food bills, and education expenses.
“Government is getting a windfall from these indexation arrangements, and that needs to stop.
“A freeze on indexation for two years would protect concessional patients and pensioners not just general patients – because every percent increase hurts, and every additional cent is hard to find.
There’s still time to fix this with the legislation coming before the Senate tomorrow.
Discrimination against some of the most vulnerable patients in the health system continues
“There is still no protection from medicine costs for patients accessing the Opiate Dependency Treatment (ODT) Program in this budget.
“The current general co-pay legislation currently before the Parliament will ironically exacerbate the discrimination against these patients who are paying over $200 a month in out-of-pocket dispensing fess to access their PBS medicines. The only patients on the PBS to be discriminated against in this way.
“In June 2021 the Senate Standing Committee on the Scrutiny of Delegated Legislation found that the ODT Program would likely be found unlawful by the courts if challenged - but still not action by Government to fix this discrimination and injustice.
“One in ten patients accessing the ODT Program identifies as a First Nations person. Despite the Government’s announcement of more than $133.5 million to prioritise First Nations peoples’ health outcomes, with a total investment of $4.6 billion over 4 years, there continues to be no support for patients accessing the ODT Program.
“Once again tomorrow’s Bill before the Senate is the opportunity for the Parliament to act to protect the rights of some of the most vulnerable in our community
Changes to the NDIS
“Better Access Australia welcomes the Government’s ongoing commitment to the National Disability Insurance Scheme (NDIS) as part of Australia’s critical social infrastructure now and for future generations.
“BAA also welcomes the recently announced Review to rebuild community trust in the NDIS and ensure its sustainability into the future. The anticipated high growth in the NDIS in future years underscores the importance of making sure every dollar is well spent to support people with disability.”
Please see media release in full here.
Better Access Australia welcomes bipartisan first steps in medicine affordability, but more is needed to make it a generational and equitable reform
1 May 2022
Both major parties are committing to reduce the PBS co-payment for individuals and families earning over $67K per year from 1 January 2023.
“Better Access Australia welcomes the recognition by the major parties that we need to bring the day-to-day affordability of medicines back within reach of working Australians. Felicity McNeill chair, Better Access Australia said.
“Yesterday the Prime Minister committed to reducing the general co-payment for medicines on the Pharmaceutical Benefits Scheme (PBS) by $10 to $32.50, and today Mr Albanese has announced the general co-payment will be reduced by $12.50 to $30.00 if Labor is elected to Government.
“These are incredibly important first steps in making day to day healthcare and medicines more affordable for the community.
“Reducing the general co-payment is an important first step, but with inflation at 5.1% both these commitments will be chewed up within two years like the 2019 safety net measure.
“It’s why we need a second, third, fourth and fifth step if we are to achieve the systematic reform that makes medicines affordable again over the next decade. Ms McNeill said
“In welcoming these announcements Better Access Australia maintains its call for:
a permanent mid-tier co-payment of $20 for individuals and families earning under the Family Tax Benefit A income thresholds,
automated safety nets to make sure high medicine users get the full protection of the system like they do on the MBS,
a freeze on indexation for five years on both co-pays and safety nets to stop inflation devaluing the commitments made over the past 24 hours, and
ensuring the PBS co-pays and safety net apply to all PBS listed medicines and end the discrimination against specific diseases on the PBS.
“In combination with the policies announced by the Coalition and Labor, BAA is asking for reform that will ensure the principle of affordable access to medicines under the PBS can transcend economic volatility.”
Please see media release in full here.
Election 2022: Six Health and Disability Services Scheme Reforms
27 April 2022
Better Access Australia has written to all parties and independent candidates seeking commitments to six reforms and actions of our health and disability services schemes.
As a not for profit focused on system level reform, we are focused on the gaps in access and gaps in affordability of our system and delivering reforms that help patients, consumers, government and industry.
1. #MindtheGap in Newborn Screening
with a nationally funded newborn screening program for 80 rare diseases
2. #MindtheGap in keeping healthcare affordable for patients
with a mid-tier PBS co-pay of $20 and freeze indexation increases for five years
3. #MindtheGap in time to health technology access
with a #100day from TGA registration to subsidised system access KPI
4. #MindtheGap in the affordability of private healthcare
with a review that addresses consumer needs and out of pocket costs
5. #MindtheGap in government mandated discrimination
by ensuring all PBS medicines are protected by co-pays and safety net
6. #MindtheGap in access between health, NDIS and employment support
by improving assessment processes and equality of access
Read the quick link (the two-pager) to our six asks, and if you want more detail on why these reforms are needed and how they can delivered click here.
We will publish a ready reckoner of the responses and commitments of all parties and individuals in response to our requests to keep our work transparent and the community informed.
Newborn screening is already a federal election commitment from the Labor party, and PBS Co-payment reforms have been committed to by the Coalition, with Labor announcing there will be policy reforms in this area too.
Read our letter to Mr Adam Bandt and Senator Steele-John of the Australia Greens here.
Read our letter to the Independents here.
Read our letter to The Hon Mark Butler, Shadow Minister for Health and Aging here.
FEDERAL BUDGET IGNORES THE MAJORITY OF AUSTRALIANS STRUGGLING TO AFFORD THEIR MEDICINES
March 29, 2022
The Government’s announcement of a repeat of its 2019 election PBS safety net measure shows its lack of understanding of the true cost of medicines.
Families earning no more than $70,000 a year face the ongoing choice of food on the table or medicines for themselves or their kids.
BAA welcomes reducing safety net thresholds for concessional patients, but tonight’s measures will do nothing to protect the majority of Australians from the increasing weekly unaffordability of medicines.
Waiting to fill 34 scripts for medicine cost relief is not a luxury most families can afford.
Full details in press release here.
A BUDGET THAT PRIORITISES EQUALITY AND AFFORDABILITY OF ACCESS TO OUR HEALTH SYSTEM CAN DELIVER BETTER ACCESS, AUSTRALIA
March 27, 2022
As the federal budget looms, the need for a focus on improving equality of access to health services in Australia remains critical. Individual treatment subsidies are always welcomed but the systemic shortcomings must be addressed now if we are to end the increasing tension of a system of those who have access and those who do not.
Budget 2022-23 is a chance to redefine and future-proof the system, not merely work around. Action is needed this Budget because right now:
PBS co-payments are tracking towards $50 per script outpacing the cost of living;
Australia’s babies are some of the least protected in the world for early screening and diagnosis of rare diseases;
Patients managing opioid addiction are being financially discriminated against by the government despite the protections of the law;
Average wait times for access to subsidised medicines are over 820 days and growing; and
Patients are being forced to accept huge out of pocket costs in their access to specialists for primary healthcare, none of which is covered by their private health insurance.
This week’s budget needs to:
Introduce a mid-tier co-payment for the PBS based on Family Tax Benefit A, recognising the challenges for individuals, couples and families earning less than $136,000 and freezing indexation growth for 5 years
Introduce an expanded and nationally consistent newborn bloodspot screening program following a once-off catch up review, with the new program rolled out by 1 July 2023 based on the funding model for the National Immunisation Program
End the government’s requirement for pharmacies to charge out of pocket fees for access to medicines for managing opioid addiction and bring their distribution and subsidy into line with all other PBS medicines by 1 July 2022
Establish a #100days from medicine and device registration to subsidy target in Australia to improve access to all therapeutics irrespective of indication or patient population with program administration and contracting based on this new standard
Reduce out of pocket costs for patients obliged to see specialists on an annual basis to maintain access to ongoing PBS medicines used in the primary care setting
Conduct a consumer-need analysis of private health in Australia recognising the interaction between the public and private health systems and the increasing use of private healthcare outside the hospital setting with no insurance coverage.
Full details in press release here.
INCREASING COSTS OF MEDICINES UNMANAGEABLE
BAA CALLS FOR A REDUCED PBS CO-PAY AS PART OF 2022-23 BUDGET
February 02, 2022
Better Access Australia (BAA) is calling on the federal government to #MindTheGap in the affordability of healthcare as part of its 2022-23 Budget.
“Right now, Australians are paying some of the highest co-payments for subsidised medicines in the world. Only the US, Canada and Switzerland charge patients more,” Better Access Australia Chair Felicity McNeill said.
Better Access Australia is calling for a reduction in the general PBS co-payment from $42.50 to $20 per script for some patients and freezing indexation on PBS co-pays and safety nets as Australians face the challenge of growing inflation and wage stagnation.
“With 40.4% of people aged 15-44 managing a chronic health condition, too many in the community are facing high costs to manage their health.
“Waiting to fill 36 scripts before your medicines are made affordable is not a luxury of time and luxury of cost many can afford. No individual, parent or child should be going without their medicines because they’re managing their monthly household budget and waiting for their safety net to bring the cost of their medicines down.
“Non-compliance with medicines for chronic conditions risks acute and longer-term complications. It’s not good for the health of the community or the health of our health system.
To read media release in full click here.
BETTER ACCESS AUSTRALIA’S PRE-BUDGET SUBMISSION
CALLING FOR GOVERNMENT TO #MINDTHEGAP FOR AUSTRALIAN COMMUNITY
January 31, 2022
Calling for six areas to #MindTheGap, our submission to the government asks for:
1) A national Newborn Bloodspot Screening program to match international best practice of up to 80 diseases.
2) End the government-mandated discrimination by making all medicines that treat opioid dependence, a recognised disability, subject to the PBS co-payment and safety-net provisions as afforded to every other medicine on the PBS.
3) Daily medicine access to be made affordable for families once again by reducing the general PBS co-payment from $42.50 to $20 per script.
4) End the 820-day average wait by making a 100 day policy from TGA approval to subsidised access for medicines and medical devices.
5) End the costs to patients and costs to government of unnecessary annual referrals to specialists for long-term treatment of a chronic disease.
6) Change the emphasis of Private Health Reform to better capture the consumer interest in health coverage expectations rather than an exclusive debate between government and insurers on cost of devices and annual price increases.
These proposals are a combination of targeted reforms for some of the most vulnerable in our community as well as system-wide reforms to benefit the entire population.
Better Access Australia’s 2022-2023 Pre-Budget Submission is available to read here.
CONCERNS FOR CONSEQUENCES OF BILL
INCREASING MEDICINES COSTS FOR COMMUNITY AND PATIENTS
November 24, 2021
A bill before parliament will see the price of medicines increase if it passes.
Better Access Australia supports proper parliamentary scrutiny of the National Health (PBS Enhancements) Bill. This Bill is the result of 15 months of negotiations between industry and the government and specifically excluded the community and patients from consultation on measures that will impact their hip pockets and timely access to medicines.
We support many of the measures in the Bill but the community must be given an opportunity to understand the intended and untended consequences of this Bill including Government’s intention to increase the price of many medicines by at least 50 cents and as much as $1.50.
1 in 3 scripts on the PBS is fully paid for out of a families’ budget NOT the governments. Families need the chance to assess what this Bill means for the affordability of medicines for them.
An article published in BioPharmaDispatch exploring these concerns can be read here.
*Permission to publish this article was sought and received from BioPharmaDispatch prior to uploading article.
COURT MAY FIND ACTIONS UNDER THE OPIOID DEPENDENCY TREATMENT PROGRAM TO BE UNLAWFUL
1 October 2021
The Opioid Dependence Treatment (ODT) Program is the only program on the Pharmaceutical Benefits Scheme (PBS) where patients are not protected by co-payments and the safety net and instead charged uncapped fees often in excess of $200 per month.
Minister Hunt and his Department have repeatedly asserted that the ongoing financial discrimination imposed on patients accessing PBS medicines via the ODT Program are legal and justified. They have commenced a protracted 18-month post market review (PMR) to defer taking any action on the Program.
The Senate Standing Committee on Delegated Legislation has challenged this assertion in its letter of 16 August 2021 concluding that:
“…a challenge to the validity of the current special arrangement on the basis that it should have been registered as a legislative instrument may result in a court finding the actions undertaken under the current arrangement to be unlawful.”
Some 50,000 patients rely on the PBS to help them manage their chronic disease of opioid addiction. The majority of these patients are managing addiction as a result of government-subsidised pain medications.
The Morrison Government will fund a patient’s addiction but insists they make huge out-of-pocket costs towards the medications that keep them well – something no other patient group is asked to do. Government refuses to pay the dispensing costs for the medicines and instead demand pharmacies charge uncapped fees to patients to cover the cost of the service. These charges can be in excess of $200 a month and are charges that a court is likely to find to be unlawful. Multiple coronial inquiries have found these fees prevented treatment and ultimately lead to the loss of many lives.
Minister Hunt’s correspondence to the Committee suggests the department of health has known about this legal concern since 2019.
Around 3 people lose their life each day due to the unaffordable cost of these treatments.
These lives are being lost every day as a result of this intransigency and the Minister’s delaying tactics. Just as Robodebt devastated so many vulnerable Australians, Minister Hunt’s refusal to take immediate action to end this discriminatory program is equally devastating. Enough is enough.
To read the correspondence between the Senate Standing committee and Minister Hunt please click here.
For full details of the Senate Standing Committee Delegated Legislation’s findings and Better Access Australia’s call for action, please read the attached media release here.
IT’S THE COVER UP THAT KILLS YOU –
ANOTHER AGENCY FAILS VULNERABLE PATIENTS
4 August 2021
Following Minister for Health, Greg Hunt’s advice to the Parliament that his department made a commitment to the Office of the Australian Information Commissioner (OAIC) in 2019 to register the special arrangement for PBS medicines under the Opiate Dependence Treatment (ODT) Program, the OAIC has joined the Minister and his department in perpetuating the cover-up of this discriminatory program.
A copy of the media release is available here.
A copy of the OAIC decison is here.
A copy of Better Access Australia’s request for review of the OAIC’s decison here.
SENATE COMMITTEE REJECTS MINISTER HUNT’S FOB-OFF AND DEMANDS ANSWERS ON THE LEGALITY OF PBS PROGRAM
24 June 2021
A key Senate committee has told health minister Greg Hunt to ‘try again’ on explaining the failure to lawfully implement the discriminatory arrangements for an important PBS program.
Better Access Australia wrote to the committee seeking its action in relation to the Opiate Dependency Treatment Program (ODTP) under which the government funds medicines through the PBS but removes basic PBS protections including co-payments and the safety-net.
The committee wrote to Minister Hunt on 14 April 2021. It has published the minister’s response and its own follow-up. This correspondence shows the committee has found the minister’s response insufficient and have given him until 7 July to provide a better explanation of why he and his department have ignored the Legislation Act 2003.
Better Access Australia welcomes the committee’s decision to hold the Minister for Health and his department to account for their administration of the ODTP.
A copy of the media release is available here.
GOVERNMENT USES PROCESS TO TRY AND COVER-UP ONGOING DISCRIMINATION
31 May 2021
In another example of the Morrison Government’s use of process to avoid having to take action to help the most vulnerable in the community, the Department of Health has released draft terms of reference for a protracted 18-month “medical experts” review of the Opiate Dependency Treatment (ODT) Program rather than address the ongoing illegal discrimination perpetrated against these patients by bureaucrats, pharmacists and clinicians, as approved by Minister Hunt.
A copy of the media release can be accessed here.
THE DEVIL IS ALWAYS IN THE DETAIL AND BUDGET 2021-22 IS NO DIFFERENT WITH MANY GAPS REMAINING
11 May 2021
Better Access Australia notes that the 2021-22 Budget makes some significant funding investments in health but continues to fail some of the most vulnerable in the community.
We need to #mindthegap in equality of access to our health system.
The devil is always in the detail.
A copy of the media release can be accessed here.
SENATE COMMITTEE TO ASK MINISTER FOR HEALTH ABOUT STATUS OF OPIATE DEPENDENCE TREATMENT PROGRAM
29 April 2021
Following concerns raised by Better Access Australia, the Senate Standing Committee for the Scrutiny of Delegated Legislation has advised it will write to the Minister for Health seeking advice on the technical status of Opiate Dependence Treatment (ODT) Program.
A copy of this media release can be accessed here.
A copy of the Senate Committee’ letter to Minister Hunt can be accessed here.
BETTER ACCESS AUSTRALIA CALLS FOR SENATE INTERVENTION ON OPIATE DEPENDENCE TREATMENT PROGRAM
9 March 2021
Better Access Australia has written to the Senate Standing Committee for the Scrutiny of Delegated Legislation seeking their urgent intervention to end the financial discrimination for patients accessing opiate dependence medicines on the Pharmaceutical Benefits Scheme.
“After weeks of inaction on this issue by the Minister of Health the Hon Greg Hunt MP, Better Access Australia is calling on the Parliament to urgently review the legal basis for this continuing discrimination and end the gap in access for some of the most vulnerable in our community.
“Why are these the only medicines on the PBS where a patient can be denied their co-payment and safety net protections and be charged unlimited out of pocket expenses on a daily basis at the recommendation of the government? And on what basis is this program denying these patients their legal protections under the National Health Act 1953?
“The Government and its advisory committees acknowledge that over 75% of patients accessing these medicines are facing these out-of-pocket costs, and further acknowledge those costs are a barrier to people accessing treatment for their chronic disease.
“The time has come to end the arguments about cost-shifting with the states and territories and put the patient at the centre of the system.
“The time has also come for the Government and the Parliament to stop and consider whether what they are doing is legal under the National Health Act, legal under the Legislation Act 2003 and legal under the Antidiscrimination Act.
That’s why Better Access Australia has written to Senator the Hon Concetta Fierravanti-Wells, Senator the Hon Kim Carr, Senator Raff Ciccone, Senator Perin Davey, Senator Nita Green and Senator Paul Scarr to address this circumvention of the Australian Parliament and in doing so address this discrimination and end this gap in equality of access once and for all.
Mind the gap in equality of access to the PBS. A copy of the letter can be accessed here.
A copy of the letter to the Senate Committee can be accessed here.
A copy of this media release can be accessed here.