Review of methadone treatment in Australia

List of recommendations

Page last updated: October 1995

  1. That a study be undertaken to evaluate methadone maintenance treatment in smaller primary care settings compared to treatment provided in larger public and private specialist clinics with a view to identifying factors which will maximise theeffectiveness of services across practice settings.

  2. That a study be undertaken to examine the outcomes achieved through the use of community pharmacies compared to clinic-based pharmacies and the factors influencing outcomes.

  3. That a formal quality assurance (QA) process be designed which provides a basis for monitoring and evaluating the processes of methadone service delivery and the outcomes achieved in both public and private methadone clinics.

  4. That a formal accreditation process be established for methadone clinics, based on the QA protocols, with ongoing accreditation to be a requirement for approval of a clinic as a provider of methadone treatment.

  5. That a national approach to prescriber training be established, participation in which is a requirement for approval of a medical practitioner to prescribe methadone.

  6. That consideration be given to differentiating the training required of medical practitioners treating more complex cases, and that, if agreed to, suitable training courses be developed on a consistent basis nationally.

  7. That ongoing education and training be a requirement for continued approval of medical practitioners to prescribe methadone, with such training to qualify for inclusion in the vocational registration requirements for GPs.

  8. That, in conjunction with the Pharmaceutical Society of Australia and the Pharmacy Guild of Australia, a national training program be developed for dispensers of methadone, participation in which is a prerequisite for approval to dispense and administer methadone.

  9. That the involvement of general practitioners and community pharmacists in the provision of methadone services be encouraged as an appropriate method for meeting the demand for and improving access to services.

  10. That a study be undertaken into the process of dispensing and administering methadone; the factors influencing community pharmacist participation; the views of clients regarding community versus clinic-based dispensing arrangements; and the effects of differential client contributions.

  11. That State health authorities extend their activities in co-ordinating services between public and private service providers, and in providing support services to the private sector.Top of page

  12. That a maximum fee to clients for the dispensing of methadone be established across all States, to be applied to community pharmacies and clinic-based pharmacies as a condition of their approval to dispense methadone.

  13. That a decision to provide a government subsidy of the costs of dispensing methadone be based on the relative merits of a submission to this effect, having regard to its economic validity, and its capacity to attract more pharmacists to methadone programs.

  14. That Commonwealth and State governments negotiate the minimum level at which financial reporting of expenditure on public methadone programs be provided on an ongoing basis.

  15. That a national minimum data set be established for the collection of performance indicators in all States on a regular basis, and that such data collection requirements be considered as part of a streamlining of existing reporting and regulatory procedures in the States.

  16. That a regular program of clinical review be established as the basis for developing and promulgating models of best practice.

  17. That provision be made for client representation to relevant State and Commonwealth committees responsible for the development and delivery of methadone programs.

  18. That a charter of client rights be included in the quality assurance programs proposed for the accreditation process for methadone clinics.

  19. That a fast effective appeals mechanism be established in each State to deal with client complaints.

  20. That, if methadone treatment in the private sector continues to be funded under the current Medicare payments system, such services be separately identified in the Medicare Benefits Schedule, and attract a standard benefit equal to the current GP benefit levels for like services.

  21. That the Commonwealth and States consider the relevance of the criteria by which alternative payment models may be assessed as a basis for agreeing on an appropriate funding mechanism.

  22. That consideration be given to the suitability of a client management system of payment for the delivery of methadone services, its acceptability in the clinical environment, and its capacity to support and promote models of best practice.
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