Researchers at the National Drug and Alcohol Research Centre (NDARC), UNSW Sydney surveyed 402 people receiving OAT (including methadone and buprenorphine) in New South Wales, Victoria, and Tasmania and found that the vast majority paid some out-of- pocket costs.

Professor Michael Farrell, Director of NDARC said; “The mean monthly total out-of-pocket costs reported by OAT participants were AU$185, accounting for approximately one-eighth of their monthly income.”

Published in the International Journal of Drug Policy, the study found that among those who paid out-of- pocket costs, travel costs accounted for more than half of total costs (52 per cent), followed by dispensing fees (44 per cent).

“With the conservative assumption that the annual total out-of-pocket costs reflect the monthly costs throughout the year, it can be estimated that the mean annual total out-of-pocket costs were approximately AU$2,220,” said Professor Farrell.

The study found that total out-of-pocket costs disproportionately affects those who are newer in treatment and receiving fewer unsupervised doses. The mean monthly total out-of-pocket costs were AU$135 for public clinics, AU$161 to AU$214 for community pharmacies and AU$355 for private clinics.

“Despite higher costs at private clinics, eleven clients in our study were dispensed their medication in these settings,” said Professor Farrell.

“Individuals might select providers on the basis of opening times, convenience, availability or prior experience of service. Public clinics often give priority for higher risk clients which may result in a waiting list for services.”

“There are also reports that clients have been declined services because a provider was operating at maximum capacity. As a result, some clients may opt to access treatment in the private sector due to reduced waiting time.”

Compared to participants in NSW private clinics, those at public clinics paid one third of the total out-of-pocket costs and those at NSW, TAS, VIC pharmacies paid approximately half the costs.

“People in OAT for more than a year paid half the total out-of-pocket costs, compared with those in OAT less than a year,” said Professor Farrell.

“The burden of these costs to clients is clearly an issue that needs to be addressed to reduce barriers to entering and staying in treatment for opioid dependence. This is an important issue of equity.”

Read the full study here.