(1) Why is ReVia (Naltrexone) listed on the Pharmaceutical Benefits Schedule only to treat those afflicted with alcohol addiction.

(2) Will ReVia (Naltrexone) be reconsidered for listing on the PBS for treatment of opioid addictions.

(3) Has his attention been drawn to a Media Release from Orphan Australia, dated 11 December 1999 titled `Naltrexone wins PBS Listing - but only for alcohol addiction' which states that surveillance figures on heroin deaths found that the only State where deaths are not increasing is WA, where the population-based naltrexone program run by Dr George O'Neil appears to be making a difference.

(4) Does he accept that ReVia (Naltrexone) is the most successful method of treating opioid addiction in Australia at present; if not, what is the most successful method of treating opioid addiction.

(1) The Pharmaceutical Benefits Advisory Committee (PBAC) considered at its July 1999 and December 1999 meetings whether ReVia (Naltrexone) should be made available:

(a) for use in the treatment of alcohol dependence within a comprehensive treatment program; and

(b) for the maintenance of formerly opioid-dependent patients who have stopped taking opioids.

Based on a large body of detailed clinical and economic data submitted by the manufacturer, the PBAC concluded that listing of Naltrexone as a pharmaceutical benefit for the treatment of alcohol dependence was justified. However, in treating opioid dependence, there was no evidence of significant efficacy based on relapse and retention rates. Coupled with major concerns about the toxicity of Naltrexone and its relatively high cost, the PBAC declined to recommend listing of the drug as a pharmaceutical benefit for this latter indication. The Government is unable to list a drug as a pharmaceutical benefit in the absence of a positive recommendation from the PBAC.

(2) Naltrexone is not expected to be reconsidered for listing as a pharmaceutical benefit unless or until the manufacturer submits further data for the PBAC's consideration.

(3) Yes.

(4) No. As is the case with many health conditions, it is not possible to develop a `one size fits all' model of treatment for opioid dependence. Different treatment options work for different users. Individual patient factors and the quality of individual treatment settings have critical impact on the effectiveness of any treatment.

Research conducted by the National Drug and Alcohol Research Centre in Sydney indicates that the most effective available treatments for heroin addiction involve drug replacement therapy supported by specialised psychotherapeutic or counselling programs. Presently, methadone maintenance is the best researched and most widely used of all currently available treatment options for opiate-dependent individuals.