Disulfiram should be on the PBS

Dr Alex Wodak, from the Alcohol & Drug Service at St Vincent’s Hospital, and co-authors said that until recently, disulfiram, used to treat alcohol dependence, has been out of favour because early studies found mixed evidence for its efficacy.

“Recent reviews show that supervised administration of disulfiram is both effective and safe,” Dr Wodak said.

“Accordingly, disulfiram should be made more available and accessible through PBS listing.”

Dr Wodak said that although disulfiram is a relatively inexpensive drug (costing about $70 per month) many patients who need disulfiram cannot afford it on a continuing basis.

“We are left with a situation in which a treatment is not listed on the PBS despite being effective, relatively inexpensive, likely to save health care resources and, somewhat ironically, recommended for use in government-funded treatment guidelines,” Dr Wodak said.

“We believe that current evidence is more than sufficient to justify listing disulfiram on the PBS, but continued PBS listing of disulfiram would need to be contingent on further evidence demonstrating relative efficacy and cost-effectiveness.

“Alcohol dependence is a common, disabling and costly medical condition that affects at least four per cent of Australian adults.

“Improving treatment outcomes for patients with alcohol dependence is a very worthwhile goal — especially for critical populations such as Indigenous Australians, recidivist drink-drivers, and people with a long history of repeated alcohol-related violence.

“Increasing the affordability and use of disulfiram, by listing it on the PBS, would be an important step towards this goal.”

The Medical Journal of Australia is a publication of the Australian Medical Association.

The statements or opinions that are expressed in the MJA  reflect the views of the authors and do not represent the official policy of the AMA unless that is so stated.

CONTACT:     Dr Alex Wodak                                                0416 143 823