{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T17:47:07Z","timestamp":1781027227421,"version":"3.54.1"},"reference-count":43,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2012,5,25]],"date-time":"2012-05-25T00:00:00Z","timestamp":1337904000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Drug and Alcohol Review"],"published-print":{"date-parts":[[2012,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p><jats:bold>Introduction and Aims.<\/jats:bold>  <jats:italic>Australian pharmacotherapy maintenance programs incur costs to patients. These dispensing fees represent a financial burden to patients and are inconsistent with Australian health\u2010care principles. No previous work has examined the current costs nor the future predicted costs if government subsidised dispensing fees.<\/jats:italic><\/jats:p><jats:p><jats:bold>Design and Methods.<\/jats:bold>  <jats:italic>A system dynamics model, which simulated the flow of patients into and out of methadone maintenance treatment, was developed. Costs were imputed from existing research data. The approach enabled simulation of possible behavioural responses to a fee subsidy (such as higher retention) and new estimates of costs were derived under such scenarios.<\/jats:italic><\/jats:p><jats:p><jats:bold>Results.<\/jats:bold>  <jats:italic>Current modelled costs (AUS$11.73m per month) were largely borne by state\/territory government (43%), with patients bearing one\u2010third (33%) of the total costs and the Commonwealth one\u2010quarter (24%). Assuming no behavioural changes associated with fee subsidies, the cost of subsidising the dispensing fees of Australian methadone patients would be $3.9m per month. If retention were improved as a result of fee subsidy, treatment numbers would increase and the model estimates an additional cost of $0.8m per month. If this was coupled with greater numbers entering treatment, the costs would increase by a further $0.4m per month. In total, full fee subsidy with modelled behavioural changes would increase per annum government expenditure by $81.8m to $175.8m.<\/jats:italic><\/jats:p><jats:p><jats:bold>Discussion and Conclusions.<\/jats:bold>  <jats:italic>If government provided dispensing fee relief for methadone maintenance patients, it would be a costly exercise. However, these additional costs are offset by the social and health gains achieved from the methadone maintenance program.<\/jats:italic>[Chalmers J, Ritter A. Subsidising patient dispensing fees: The cost of injecting equity into the opioid pharmacotherapy maintenance system. <jats:italic>Drug Alcohol Rev<\/jats:italic> 2012;31:911\u2013917]<\/jats:p>","DOI":"10.1111\/j.1465-3362.2012.00472.x","type":"journal-article","created":{"date-parts":[[2012,5,25]],"date-time":"2012-05-25T10:34:17Z","timestamp":1337942057000},"page":"911-917","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Subsidising patient dispensing fees: The cost of injecting equity into the opioid pharmacotherapy maintenance system"],"prefix":"10.1111","volume":"31","author":[{"given":"JENNY","family":"CHALMERS","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"ALISON","family":"RITTER","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2012,5,25]]},"reference":[{"key":"e_1_2_6_2_2","volume-title":"Economic benefits of drug treatment: a critical review of the evidence for policy makers","author":"Belenko S","year":"2005"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.3310\/hta11090"},{"key":"e_1_2_6_4_2","volume-title":"Modelling pharmacotherapy maintenance in Australia","author":"Chalmers J","year":"2009"},{"key":"e_1_2_6_5_2","first-page":"14","article-title":"Opioid substitution therapy: considering the costs to consumers","volume":"3","author":"Muhleisen P","year":"2005","journal-title":"Of Substance"},{"key":"e_1_2_6_6_2","volume-title":"Polygon: the many sides to the Australian opioid pharmacotherapy maintenance system","author":"Ritter A","year":"2009"},{"key":"e_1_2_6_7_2","volume-title":"National opioid pharmacotherapy statistics annual data collection: 2009 report","author":"Australian Institute of Health and Welfare","year":"2010"},{"key":"e_1_2_6_8_2","volume-title":"A national pharmacotherapy model for pharmacotherapy treatment for opioid dependence in community pharmacy","author":"Feyer A","year":"2010"},{"key":"e_1_2_6_9_2","doi-asserted-by":"publisher","DOI":"10.1080\/09595230701373891"},{"key":"e_1_2_6_10_2","doi-asserted-by":"publisher","DOI":"10.1080\/09595230500286039"},{"key":"e_1_2_6_11_2","volume-title":"Raw deal? Impact on the health of consumers relative to the cost of pharmacotherapy","author":"Rowe J","year":"2008"},{"key":"e_1_2_6_12_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.2009.02774.x"},{"key":"e_1_2_6_13_2","volume-title":"Pharmacy Guild (NSW) submission to 2008 review of pharmacy incentive scheme (methadone)","author":"Pharmacy Guild of Australia NSW Branch","year":"2008"},{"key":"e_1_2_6_14_2","volume-title":"Review of the pharmacy incentive scheme","author":"IAB Services","year":"2008"},{"key":"e_1_2_6_15_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.331.7519.762"},{"key":"e_1_2_6_16_2","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.85.11.1577"},{"key":"e_1_2_6_17_2","doi-asserted-by":"publisher","DOI":"10.1177\/002204269402400305"},{"key":"e_1_2_6_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0740-5472(03)00038-2"},{"key":"e_1_2_6_19_2","doi-asserted-by":"publisher","DOI":"10.1300\/J069v24n02_03"},{"key":"e_1_2_6_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0376-8716(99)00084-8"},{"key":"e_1_2_6_21_2","doi-asserted-by":"publisher","DOI":"10.1186\/1477-7517-4-5"},{"key":"e_1_2_6_22_2","volume-title":"Annual report 2010: the state of the drugs problem in Europe","author":"European Monitoring Centre for Drugs and Drug Addiction","year":"2010"},{"key":"e_1_2_6_23_2","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2007.119362"},{"key":"e_1_2_6_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0955-3959(03)00084-7"},{"key":"e_1_2_6_25_2","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2005.062059"},{"key":"e_1_2_6_26_2","doi-asserted-by":"publisher","DOI":"10.1002\/sdr.379"},{"key":"e_1_2_6_27_2","first-page":"A63","article-title":"Modeling the local dynamics of cardiovascular health: risk factors, context, and capacity","volume":"5","author":"Homer J","year":"2008","journal-title":"Prev Chronic Dis"},{"key":"e_1_2_6_28_2","doi-asserted-by":"publisher","DOI":"10.1186\/1478-4491-8-11"},{"key":"e_1_2_6_29_2","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2009.174490"},{"key":"e_1_2_6_30_2","volume-title":"Hygeia's constellation navigating health futures in a dynamic and democratic world","author":"Milstein B","year":"2008"},{"key":"e_1_2_6_31_2","first-page":"A52","article-title":"Charting plausible futures for diabetes prevalence in the United States: a role for system dynamics simulation modeling","volume":"4","author":"Milstein B","year":"2007","journal-title":"Prev Chronic Dis"},{"key":"e_1_2_6_32_2","volume-title":"Strategic modelling and business dynamics: a feedback systems approach","author":"Morecroft J","year":"2007"},{"key":"e_1_2_6_33_2","volume-title":"NCI tobacco control monograph 18: greater than the sum: systems thinking in tobacco control","author":"National Cancer Institute","year":"2007"},{"key":"e_1_2_6_34_2","doi-asserted-by":"publisher","DOI":"10.1080\/15427609.2011.549692"},{"key":"e_1_2_6_35_2","volume-title":"Business dynamics: systems thinking and modeling for a complex world","author":"Sterman J","year":"2000"},{"key":"e_1_2_6_36_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)60532-7"},{"key":"e_1_2_6_37_2","unstructured":"WolstenholmeE.The Potential of System Dynamics\u2014a new era for strategic planning?: The NHS Confederation Future Healthcare Network Leading Edge Series.2005."},{"key":"e_1_2_6_38_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2005.05.010"},{"key":"e_1_2_6_39_2","volume-title":"2006 national opioid pharmacotherapy statistics annual data (NOPSAD) statistical report","author":"Australian Institute of Health and Welfare (AIHW)","year":"2007"},{"key":"e_1_2_6_40_2","volume-title":"National evaluation of pharmacotherapies for opioid dependence: report of results and recommendations","author":"Mattick R","year":"2001"},{"key":"e_1_2_6_41_2","volume-title":"An economic evaluation of the prison methadone program in New South Wales. CHERE Project Report no. 22","author":"Warren E","year":"2004"},{"key":"e_1_2_6_42_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0376-8716(03)00169-8"},{"key":"e_1_2_6_43_2","volume-title":"Expenditure and prescriptions twelve months to 30 June 2007. Data and modelling section, pharmaceutical policy and analysis branch","author":"Australian Government Department of Health and Ageing"},{"key":"e_1_2_6_44_2","unstructured":"http:\/\/www.medicareaustralia.gov.au\/provider\/pbs\/highly\u2010specialised\u2010drugs\/index.jsp(accessed 14 May 2011)."}],"container-title":["Drug and Alcohol Review"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fj.1465-3362.2012.00472.x","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/j.1465-3362.2012.00472.x","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,31]],"date-time":"2023-10-31T09:38:22Z","timestamp":1698745102000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/j.1465-3362.2012.00472.x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,5,25]]},"references-count":43,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2012,11]]}},"alternative-id":["10.1111\/j.1465-3362.2012.00472.x"],"URL":"https:\/\/doi.org\/10.1111\/j.1465-3362.2012.00472.x","archive":["Portico"],"relation":{},"ISSN":["0959-5236","1465-3362"],"issn-type":[{"value":"0959-5236","type":"print"},{"value":"1465-3362","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,5,25]]},"assertion":[{"value":"2012-05-25","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}