From hospitals to local pharmacies: Changes to access to HIV treatment
Change is afoot on how people can access their HIV medicines, expanding from hospitals to community settings from July 1. What will this mean for the people living with HIV and local pharmacies? Reg Domingo reports.
For years, people living with HIV have only been able to access their medicines from hospital pharmacies. No doubt for some, it hasn’t been the most convenient arrangement; for many others, it’s been a downright hassle.
But that’s all about to change on July 1 when changes come into effect allowing people to get Pharmaceutical Benefits Scheme-subsidised HIV medicines from local and online pharmacies, regardless of where they were prescribed.
“We’re really excited this initiative is actually happening,” said Craig Cooper, CEO of Positive Life NSW.
“We’ve got lots of people living with HIV wanting this to occur and we’ve got a lot of service partners ready for this to happen.”
It’s a change Positive Life has been advocating for over a decade and calls for its implementation has grown louder every year. A recent survey by the National Association of People With HIV Australia (NAPWHA) found 72 per cent of respondents would prefer to get their treatment from their chemist, with many citing “ease of access” as their main reason.
But it’s also more than just a matter convenience. This new provision will significantly impact on the way people perceive getting treatment for HIV.
Cooper says: “Being able to walk into your local chemist from around the corner of your house and get your medication directly just makes it a normal part of everyday life, rather than it being a trial of having to get to a hospital pharmacy.”
And this, in turn, will assist in getting more people on treatment, a key pillar in the campaign the reduce HIV transmissions.
“Under the NSW Ending HIV strategy, we have a target of 90 percent of people diagnosed with HIV to be on antiretrovirals,” Cooper says. “In terms of access to medications, adherence, retention and care, this helps us achieve and maintain that target over time.”
Pharmacists have welcomed the changes, embracing the opportunity to play a more active role in helping deliver health outcomes in the community.
Jenny Manning, managing partner and pharmacist at Blake’s Pharmacy in Potts Point, says her pharmacy has been fielding queries about the change over the past few weeks, and said her team were looking forward to assist people living with HIV get access to their medicines.
“The changes allow people to pick up their medication at a time that is convenient to them,” Manning says. “It will also mean that people can pick up all of their medications at the same time, rather than getting some medications from one place and the rest of them from somewhere else.”
Indeed, Manning says the response from locals has been of excitement and anticipation. “We have already had conversations with several of our existing customers and we have had nothing but positive feedback. One of our customers even expressed relief. He feels like every time he goes into the hospital pharmacy, it’s a ‘who’s who of people with HIV’, in that everyone’s there for the same thing essentially. If you are coming in to a community setting, you could be coming in for anything really, whether it be for something small like cold and flu medications or a prescription for blood pressure medication.
In other words, getting one’s HIV medicines from their local pharmacy is a discreet process. Indeed, it’s an area of great concern, with many worried about how their confidentiality will be handled in a community setting.
“Privacy surrounding medical conditions is a big issue for a lot of people, not just people with HIV,” Manning said. “We take that very seriously at Blake’s Pharmacy, and I would think that all pharmacies place a big emphasis on confidentiality.”
Online pharmacies offer an alternative for those wanting to access their HIV medicines with even less interaction. Those not wanting to disclose their status to anyone in person or live in rural or regional areas may choose to have their treatment dispensed and delivered via post.
Warren Turner is a pharmacist with over 15 years in the online pharmacy space. He heads the digital pharmacy service, iCare Pharmacy.
“Our focus really is to get people’s meds to them, without a fuss, in a discreet and confidential manner because success in these matters is about being able to take your medications regularly. And to get the medication, you shouldn’t have to go to a hospital or have to worry about potential issues around confidentiality. We can take care of that in discreet manner by getting medication to people direct to their homes, work or wherever they want it delivered.”
There’s no doubting that changes will deliver benefits for the community over time but for now, people living with HIV are being encouraged to plan and talk to their local pharmacist.
The Pharmacy Guild of Australia said many HIV medicines are not typically stocked by community pharmacies, and some may take some time in getting the appropriate medicines in.
“There may be available in a few areas in Sydney that have already been involved in supply to date, but it will be a matter of communication between patients, prescribers and pharmacists so the pharmacy can be prepared to fill prescriptions,” a Pharmacy Guild spokesperson said. “A patient won’t just be able to walk in off the street with a script and expect it to be filled in 10 minutes, as they might with other medicines.”
Positive Life’s Craig Cooper urged people to consider their options. When once none existed, now there are several and it’s vital that people living with HIV find the right avenue that works for them.
“I would tell people to really think about what their options are in this scenario – whether they want to get their drugs online, through a local chemist, or if they want to maintain their existing arrangement with their local hospital. Really think about what’s going to work best for them,” Cooper says.
“And if they are clear that the local chemist option is their preferred option, then to go in and ask to speak to the pharmacist privately and talk through how that would work for them – when they would drop off their script, when they would then collect their medication, what their privacy and disclosure concerns may be, and other medications that the pharmacist may need to consider.
“A pharmacist is now going to be a care provider in the HIV-positive person’s life and they need to start developing a relationship with their pharmacist, if they deicde to go down that path and get their medications from the local chemist.”
From 1 July 2015, people living with HIV will be able to access HIV medications from chemists.
• Scripts will need to be dated 1 July 2015 or thereafter to be honoured
• Plan ahead to renew your scripts and allow time for the chemist to order stock
• Develop a relationship with a pharmacist
• Call the pharmacist to discuss your needs
• If it’s easier to have postal deliveries, there are online options you can access
IT'S YOUR CHOICE
Positive Life NSW has created an online resource assisting people with changes to access to HIV medicines. Visit itsyourchoice.positivelife.org.au.
The contacts below can provide more information and assistance regarding the changes
POSITIVE LIFE NSW
02 9206 2177
Freecall – 1800 245 677
02 9206 2000
Freecall – 1800 063 060
BOBBY GOLDSMITH FOUNDATION
02 9283 8666
Freecall – 1800 651 011
AUSTRALIAN SOCIETY FOR HIV MEDICINE (ASHM)
02 8204 0700
PHARMACEUTICAL SOCIETY OF AUSTRALIA
02 9431 1100
Freecall – 1300 369 772