The Cost of Methadone Maintenance Programs: a Comparison between Public Hospital Clinics and Private Practitioner Programs in New South Wales*

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Abstract
The purpose of this study is to establish the financial outlays for state and federal governments in providing methadone treatment services through public clinics and private medical practitioners authorised to prescribe methadone. This study did not assess the quality of care provided by public and private methadone programs. Three public clinics and twenty two private practitioner programs were studied. The mean cost of methadone treatment per client per month in the public clinics was $113.00, with a range of $61 to $239. This range illustrates significant variations in the costs of public methadone clinics and can be partly explained by differences in staff: client ratios and the type and frequency of clinical support services, for example, counselling provided in addition to methadone dispensing. The cost to treat one client in the most expensive public methadone clinic is more than the cost to Medicare for the treatment of one client within a private practitioner methadone program ($178 per client per month). However, the mean cost of the public clinics is considerably lower than private practitioner programs because of the high cost of urinalysis by private pathology laboratories. The mean cost for clinical management is similar for the two systems. At the level of service operating within public and private programs, the mean cost of methadone treatment would be approximately the same if private practitioners used the NSW government laboratory as their urine testing facility.

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