Treatment Equity

HRA has established the Treatment Equity project to advocate for changes to the Opioid Treatment Program (OTP) to ensure a modern, accessible and person-centred program for all service users. Treatment Equity is an ongoing program of work and priority area for HRA. See below for information on the work we are doing and drop back regularly for updates…

OTP Policy Brief

On 1 December 2025, HRA launched its new Opioid Treatment Program (OTP) Policy Brief: ‘Reforming Australia’s Opioid Treatment Program – Investing in Access, Equity & Sustainability’.

Australia’s Opioid Treatment Program (OTP) is a critical, evidence-based response to opioid dependence, that provides access to life-saving pharmacotherapy medications. HRA’s new Opioid Treatment Program Policy Brief outlines some of the key challenges facing the OTP in Australia and provides a series of evidence-based recommendations for creating a more responsive, accessible and sustainable OTP into the future. 

Read our latest opinion piece on OTP reform…

To support the launch of our OTP Policy Brief on 2 December 2025, HRA published an opinion piece in Bio-Pharma Dispatch which speaks to HRA’s goals in developing the policy brief and steps out some of the most urgent reforms for the OTP in Australia in 2025. You can find the opinion piece: ‘Reforming Australia’s Opioid Dependence Treatment Program – From Red Tape to Person-Centred Care: https://pharmadispatch.com/news/reforming-australias-opioid-dependence-treatment-program-from-red-tape-to-person-centred-care

Breaking News…

There have been some recent reforms at the federal level to the Health Legislation Amendment (Removal of Requirement for a Collaborative Arrangement) Bill 2024 that have important implications for the ODT Program in Australia.

In May 2024, the legal requirement for Nurse Practitioners (NPs) and eligible midwives to be part of a ‘collaborative arrangement’ with a medical practitioner to provide certain subsidised services to patients was removed.

From 1 November 2024, NPs and eligible midwives can provide services subsidised by the MBS and prescribe certain medicines on the PBS without the need for a collaborative arrangement with a medical practitioner.

Harm Reduction Australia has been advocating for some time that NPs could be playing a much greater role in the delivery of ODT in Australia especially in regional and rural areas (but also metro and greater metro areas) where attracting and retaining GPs can be very challenging. We believe, these recent reforms remove some of the major barriers to this occurring.

HRA will continue to work with key stakeholders, through our Treatment Equity Project to make the most of this reform including how it might dovetail with last year’s PBS reforms (aka the ‘affordability reforms’) to create an even more accessible ODTP in Australia.

Deep Dive on OTP

As part of the HRA 2024 National Harm Reduction Forum in August, we ran a series of ‘deep dives’ on key areas of priority for HRA. One of these deep dives focused on the Opioid Treatment Program and aimed to bring together key voices in the OTP space to discuss the current state of opioid treatment in Australia and to identify areas of reform and how to achieve change. It was a packed online forum with great discussion and audience questions, but unfortunately, as it was a breakout session in Zoom, we were unable to record the session, we can, however, provide an outline of our speakers/panellists:

Moderator: Annie Madden, HRA Executive Director
Panellists:

  • Sarah Lord (PAMS/HRVic)
  • Adam Searby (Drug & Alcohol Nurses Association – DANA)
  • Donna Searles (Nurse Practitioner/Qld Prisons Health)
  • Charles Henderson (Burnet Institute)
  • Prof. Suzie Nielsen (Monash Addiction Research Centre)
  • Brett Valance (Nurse Practitioner, Regional Victoria)
  • Dr. Hester Wilson (GP/Addiction Medicine Specialist/RACGP)

    Rapporteur: Dr Jake Rance (HRA Board member and senior researcher at CSRH, UNSW)

    PBS Reforms

    Across 2021 – 2023, HRA strongly advocated for the Australian Government to remove the financial discrimination within the PBS against people on OTP as a matter of urgency. On 1 July 2023, ground-breaking changes came into effect which meant for the first time, OTP medications (methadone and buprenorphine) were listed on the Pharmaceutical Benefits Scheme (PBS), capping the consumer co-payment for OTP service users and ensuring that people on OTP pay the same as other Australians to access their OTP medications.

    In the lead-up to 1 July 2023, HRA produced infographics and fact sheets to assist service users and others to understand the impact of the changes. These resources are provided below along with other relevant information related to the reforms…

    PBS Reform Fact Sheets

    HRA Fact sheet – Consumers

    HRA Fact Sheet – Consumer Example

    HRA Fact Sheet – Pharmacists

    HRA Fact Sheet – Pharmacists Steps to Prepare

    Additional information

    HRA Federal Budget 2023 Media Release

    Federal and NSW Government ODT PBS reform information and fact sheets

    • Federal Government:

    Federal Government ODT reform information and fact sheets

    • NSW Government:

    Factsheet for OTP clients – S100 changes

    Private Clinic – Transfer of Care Guide

    Treatment Equity Communiques

    During an advocacy campaign to remove the discriminatory, private, daily dispensing fees that OTP service users have been forced to pay for decades, Treatment Equity produced a series of communiques aimed at keeping our stakeholders up-to-date on developments. You can read these here:

    Treatment Equity Communique #1

    Treatment Equity Communique #2

    Treatment Equity Communique #3

    Treatment Equity Communique #4

    Treatment Equity Communique #5