Hunter pharmacists fear a methadone shortage could push patients into the hospital system and put staff at risk of violence from angry customers.
Raymond Terrace pharmacist Tim Mizzi said he had run out of methadone on Thursday, while inner-city pharmacist James Reid was due to run out the same day but received an 11th-hour delivery.
The pharmacists say the shortages are linked to the federal government's decision to include methadone and other opioid replacement drugs on the Pharmaceutical Benefits Scheme from July 1.
The change has been welcomed by the Royal Australian College of General Practitioners and Australian Medical Association because it will cut costs considerably for patients.
Mr Mizzi, who has 22 patients on methadone, said the shift in how methadone was funded had created supply chain issues and wholesalers had started listing the drug as out of stock.
"All our patients now we have to refer on to hospital because we cannot treat them," he said.
"We've got 10 days where we won't receive any stock.
"Because it's happening at such a speed, no one's been able to manage the system properly.
"We haven't been able to manage our stock, the wholesalers haven't been able to manage their stock."
He said the federal government had "rushed the policy through" without adequate consultation with pharmacists.
Opioid dependency patients will pay the PBS co-payment of $30 a month, or $7.30 if they have a concession card, instead of a private pharmacy dispensing fee of at least $5 a day.
Mr Mizzi and other pharmacists who spoke to the Newcastle Herald said they would lose money because the government did not plan to reimburse pharmacists enough to cover the changes.
"Pharmacists have always been lobbying that the inclusion of opioid service delivery shouldn't be at cost to patients, but it shouldn't be at cost to us either," he said.
"When you look at the Newcastle area, which in NSW is one of the biggest areas of pharmacies delivering opioid replacement therapy, our area will be the biggest hit because access will drop.
"We'll be like every other pharmacy where we can't deliver the service any more because it's below cost."
He said the Hunter's estimated 800 methadone patients were stigmatised as being less important than others but came from "very different backgrounds".
"Some are working professionals that have been addicted to pain medications after operations," he said.
"Some are people that work in defence. Some are people who have been homeless."
Mr Reid said methadone supplies at his inner-city Newcastle store, one of the largest opioid replacement treatment suppliers in the Hunter, would have run out on Thursday but for a delivery that morning.
"A pharmacy with a large opioid treatment program like ourselves who has literally run out of methadone to the day is a very scary prospect, and the potential risk of violence towards pharmacists would be astronomical if we couldn't supply these drugs," he said.
"We had to restrict other patients' takeaways just so we could fill everyone else's doses up until today.
"If we weren't on the ball, we would have run out last week."
Mr Piggott said he had predicted a methadone shortage and had ordered extra supplies for his three pharmacies that dispense the drug.
He said he was aware of some pharmacies which planned to drop out of the methadone treatment program.
AMA vice-president Danielle McMullen said on Tuesday that Pharmacy Guild concerns about medicine shortages were a "scare campaign" which had been "widely debunked".
Mr Mizzi said his experience on the ground was that the changes were creating supply problems.
"The AMA doesn't have wholesale accounts, so I don't know how they could comment," he said.
"We're saying the supply chain won't cope, and this is a prime example of the supply chain not coping."
A NSW Health spokesperson said in a statement that the department was "aware a change in the delivery arrangements between the manufacturers of opioid treatment medications and the distributors caused a delivery delay in some locations across the state".
"This issue has now been resolved and deliveries are currently under way with a further delivery due next week."
The federal health department did not respond to a request for comment.
The pharmacists' concerns about methadone supply coincide with a broader industry campaign against the government's move from 30- to 60-day drug prescriptions for many patients.
The government says the change proposed to come into effect in September will reduce costs for patients, but the Pharmacy Guild of Australia says the shift will cut revenue and lead to job losses and business closures.
Newcastle pharmacist Anthony Piggott said 60-day scripts would cost each of his pharmacies about $180,000 a year as they would receive half as many government payments for dispensing medications.
He described assurances that the government was reinvesting savings back into pharmacies as a "lie".
"I can tell you I'm not getting one extra dollar from this reimbursement," he said.
"It's a serious, serious problem. A lot of it is the lack of detail. We're swinging in the dark at the moment.
"I'm happy to pivot and save people money, but I need a plan. This is not a shaving to my business model; this is like a sledgehammer."
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