A raw deal? Impact on the health of consumers relative to the cost of pharmacotherapy

This sociological study is the first comprehensive qualitative report on retention rates of the Victorian opioid maintenance treatment (OMT) program. The research was based on surveys and face-to-face interviews with 60 clients currently receiving OMT, of which the majority derived their income from government support and were already considered to be financially vulnerable. This research demonstrated the negative impact of dispensing fees on retention rates, with clients experiencing financial stress as a result of having to pay the dispensing fees. The research analysed the notion of cost from several perspectives, including individuals' social functioning, their health and their ability to remain in treatment. These research findings informed recommendations regarding policy and practice change that would increase the retention rates of income-poor program recipients. In particular, the recommendation for dispensing fees to be subsidised in full and therefore respond to people in the OMT program as any other recipients of prescribed medication. This study was undertaken for the Salvation Army, Research and Advocacy Unit in response to their concerns about the cost of OMT serving as a disincentive to begin treatment and as a cause of involuntary discontinuance of treatment.