HEROIN 'QUICK CURE' DRUG DENIED SUBSIDY

The Prime Minister's radical bid to have the heroin treatment drug
Naltrexone fast-tracked and subsidised on the Pharmaceutical Benefits
Scheme has been rejected on clinical grounds.

It is understood that the Pharmaceutical Benefits Advisory Committee,
the body of medical and clinical experts who guard access to the PBS,
has completed its review of international literature and research on
Naltrexone - and rejected an application by the manufacturer to place
it on the list for subsidy.

During the past two years, the drug - which is long-acting and blocks
the euphoric and other effects of opioids - has been widely promoted
as a near miracle cure for heroin users. It has been tried as a rapid
detoxification program for heroin addicts and as a long-term
maintenance program offered as an alternative to methadone.

However, it is understood that the committee concluded that, to date,
there is not enough evidence of its efficacy as an alternative
treatment for opioid-dependent people for it to qualify for a subsidy.

The drug currently can be prescribed by GPs at a cost of $250 to $300
a month. It would have cost about $20 a month with the subsidy, as
envisaged under the PBS application.

In April, at the special Premier's conference on illicit drugs, the
Prime Minister, Mr Howard, revealed the Federal Government was
considering fast-tracking Naltrexone - which is still undergoing
clinical trials - onto the PBS.

However, his announcement sparked an outcry from clinical experts,
including the Alcohol and Other Drugs Council of Australia. They
argued that while Naltrexone appeared to help some heroin addicts, it
did not work for most.

Yesterday, neither the advisory committee nor the Federal Health
Ministry would confirm nor deny the decision. The committee said
protocol required comment from the drug manufacturers first.

A spokesman for Naltrexone's manufacturer, Orphan Australia, told the
Herald that a "considered comment" may be forthcoming today.

Last night, Associate Professor Richard Mattick, Research Director of
the National Drug and Alcohol Research Centre of the University of
NSW, said Naltrexone's rejection fromthe PBS would be "perfectly justified".

"There is no evidence in the international literature that Naltrexone
is likely to bring the changes that have been suggested," Dr Mattick
said.

"The Naltrexone area is devoid of randomised control trials showing
effectiveness and there is currently no evidence to support that the
drug reduces heroin use in the vast majority of cases."

According to the most current evidence, treatment with the drug shows
a high, early drop-out rate and it has been poorly accepted by street
users of heroin.

However, it appears to be a useful alternative as part of more
comprehensive treatment plans among the more highly motivated and
psychologically healthier patients.