The Sublocade withdrawal from Australia leaves patients with the highest opioid tolerances without their most effective treatment option.
US pharmaceutical company Indivior has confirmed it will stop supplying Sublocade in Australia from 31 December 2026, according to IBTimes. The decision ends access to a treatment that addiction specialists say has transformed the lives of patients recovering from opioid dependence.
Sublocade is a long-acting monthly injection containing buprenorphine. It offers an alternative to daily opioid replacement therapies like methadone. Instead of visiting a pharmacy every day, patients on Sublocade need only one injection each month. For people rebuilding their lives after addiction, that stability matters.
The Sublocade withdrawal from Australia is a commercial decision. But the commercial pressure driving it has a specific source: the Trump administration’s Most-Favored-Nation drug pricing policy.
Follow the money
On 12 May 2025, President Trump signed an executive order titled “Delivering Most-Favored-Nation Prescription Drug Pricing to American Patients,” as reported by Holland & Knight. The policy requires pharmaceutical manufacturers to offer Americans the same prices they offer other developed nations. If a drug sells cheaper overseas, the US price must come down to match.
The intent is to lower drug costs for American consumers. The unintended consequence is that pharmaceutical companies are now reconsidering whether smaller international markets are worth the trouble.
Sublocade is currently listed on the Australian Pharmaceutical Benefits Scheme at A$395.84 per monthly dose. In the United States, the wholesale cost exceeds US$2,000 (approximately A$2,900). The price ratio is roughly seven to one.
According to senior treatment clinicians in Queensland, Melbourne and Sydney, the Australian Sublocade market is worth approximately A$10-15 million annually. The US market is estimated to be about 100 times larger. For Indivior, the mathematics are straightforward. Why maintain a small market that undermines your pricing position in a much larger one?
A vulnerable cohort
On a single day in 2025, 57,740 Australians were receiving pharmacotherapy treatment for opioid dependence, according to the Australian Institute of Health and Welfare. That figure has increased 24 per cent since 2011. The median age of patients is now 46 years. Seven in ten are male.
Not all of these patients are on Sublocade. But those who are represent some of the most complex cases in the treatment system.
Melbourne GP Dr Owen Harris told IBTimes that some patients respond significantly better to Sublocade than other long-acting injectable treatments. “It’s more stable, it lasts longer, people feel better on it, and it really has been life-changing for them,” he said. Some patients can safely extend the interval between injections to six weeks or longer. “It, quite honestly, has been life-saving and life-changing for many of my patients.”
What concerns senior treatment clinicians is that it will not be possible to retain or control patients with the highest opioid tolerances on other available formulations of buprenorphine. Buvidal, another long-acting buprenorphine injection, remains available through the PBS. But clinicians stress the two medicines are not identical in practice. Most Sublocade patients have already failed on Buvidal. That is often why they are on Sublocade in the first place.
The stakes
The Australian Injecting and Illicit Drug Users League has warned that the Sublocade withdrawal from Australia will destabilise an already vulnerable cohort. The consequences of inadequate treatment are predictable. Higher rates of crime. Higher rates of drug dealing. Higher rates of mental illness, physical illness, and blood-borne virus transmission. Higher rates of incarceration. Higher rates of death.
Oral methadone is one alternative. But methadone comes with its own disadvantages, particularly around safety in both the short and longer term. It is not available as a slow-release depot preparation, meaning patients must attend dosing points daily. For people trying to hold down jobs, care for families, or simply live normal lives, that daily obligation can be the difference between staying in treatment and dropping out.
The case for intervention
A federal health department spokesperson acknowledged that “any proposed discontinuation of a medicine can cause concern for patients and clinicians.” But the spokesperson noted that “these are commercial decisions made by private companies, and the Australian government cannot compel a company to continue supply.”
That may be true. But it does not mean the government is powerless.
Based on the price differential between Australian and US markets, it should be possible to achieve cost parity for Indivior for approximately A$24 million annually. That figure represents the gap between what the PBS currently pays and what the company receives in the United States.
Senior treatment clinicians are strongly of the view that a special case needs to be made for Sublocade to the relevant organs of government. The Pharmaceutical Benefits Advisory Committee (PBAC) may be one avenue. If not, clinicians are calling on the health department to redirect their concerns appropriately.
The question is not whether the government can intervene. The question is whether it will.
Recovery is the goal
For organisations focused on prevention and recovery, the Sublocade withdrawal in Australia highlights a deeper tension in drug policy. The goal of opioid pharmacotherapy is not to keep people on medication indefinitely. The goal is to stabilise patients so they can address the underlying causes of their addiction and eventually exit treatment altogether.
Sublocade has been particularly effective at supporting that transition. Patients on monthly injections have more time and energy to engage with counselling, rebuild relationships, find employment, and construct the kind of life that makes sobriety sustainable.
When that medication disappears, some patients will successfully transition to alternatives. Others will not. And for those who fall through the cracks, the consequences will be measured in relapses, overdoses, and deaths.
The Sublocade withdrawal from Australia takes effect on 31 December 2026. The Australian government has six months to act. The clock is ticking.
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