Earlier this year the Federal Minister for Health, The Hon. Peter Dutton, announced from 1 July 2015, people living with HIV (PLHIV) will be able to obtain their HIV antiretroviral treatments from community pharmacies. This significant and welcome change will see an end to the former barriers and inconvenience that many PLHIV have faced where HIV treatments have (to date) only been available through specialist hospital pharmacies. The new dispensing arrangements, to commence in July 2015, are an important step that, without a doubt, will increase convenience for PLHIV.
This convenience will mean that picking up HIV medications will share the same convenience as picking up any medications at your local chemist, at a time to suit YOU – especially at weekends that the current system does not allow. It also allows PLHIV who have working commitments to remain more confidential in their workplaces, to chose if they wish to take a break in their work day to pick up medications or wait for a more convenient, and subsequently, private time to do so.
The extent to which HIV medication will be available at all community pharmacies is unknown at this stage, although all community pharmacies will have the system capacity to dispense HIV treatments from July 2015. It is anticipated that some smaller, or remote town, pharmacies may not stock some or all HIV drugs. However, the pharmacy supply system can effectively deliver drugs within one day in most cases (although weekends and public holidays need to be taken into account by customers). Most large, metropolitan, pharmacies are likely to keep stock of HIV treatments, especially those pharmacies close to higher case-load S100 Prescribers (HIV doctors), which are expected to attract a lot of HIV-positive customers and therefore have stock on hand.
HIV medication scripts can be issued at any pharmacy nation-wide, not just within your local state/territory. This is expected to further increase the convenience of travelling as well, and safeguards against running out of meds whilst travelling. However, it will be important to know which pharmacies can dispense HIV medicines readily where-ever you travel, as some remote or small towns may not have medications in stock at all times.
Large pharmacy chains also tend to offer the convenience of medication postage as well, although with additional cost such a system also increases convenience and privacy. Pharmacies (and staff) are bound to confidentiality under Privacy laws just as your existing health provider or service is. However, a number of PLHIV may prefer to stick with their existing hospital pharmacy for familiarity sake, and that is your right and choice as HIV medications will continue to be available from existing hospital pharmacies as well. You can also access both types of pharmacies when your needs or circumstances change.
Of great importance is the community Pharmacist’s expertise in understanding the complexities of the many different HIV medications, especially diverse toxicities (side effects) and drug interactions, as well as support and confidentiality offered to HIV-positive customers. We understand that community Pharmacists will be provided training in their continuing professional education programs under the guidance of HIV experts in the field through the Pharmaceutical Society of Australia (PSA), Society of Hospital Pharmacies Australia (SHPA), in conjunction with the Australasian Society for HIV Medicine (ASHM).
A number of structural pieces of information are still awaited on how this new system will operate and function. For example, whether a community pharmacy must supply HIV treatments if requested by an individual. We presently understand that any community pharmacy can make a commercial decision whether they want to provide the service (opt in) or not. If you live in a remote or small town you can request your local pharmacist dispense your HIV medicines, but we understand they can make a choice as to whether to dispense or not. Although PLHIV will have the right to access medications wherever they are it’s important not to conclude that a pharmacist’s decision not to dispense is necessarily discriminatory and prejudice. As this new system develops and is implemented Queensland Positive People (QPP) will keep watch over these matters and inform you when new information is made available. As always, QPP can offer advocacy support if required in your dealings with your chosen community pharmacist. We presently understand it is up to individual’s to approach their local pharmacist for supply of your HIV medications. If you are unsure about approaching your local pharmacy you could consider making an initial anonymous phone enquiry to that pharmacy (closer to July 2015). You could also ask QPP or your peers. QPP will also continue to offer treatment information (including information about drug interactions and side effects management) throughout the roll-out of this new system, if you wish to seek an independent community information and discussion about your treatments. You have the right to seek patient information booklets and fact sheets from your pharmacist about your medications, and to be treated professionally and supported in for your health-care needs. If you are unsure about the clinical advice provided by your community pharmacist your doctor or clinic is the best source to ask if you have concerns.
Like all new systems they can tend to have their ‘teething’ issues. In preparation for the roll-out of community pharmacy dispensing of HIV medications, Queensland Positive People (QPP) is keen to hear from PLHIV within Queensland about whether you would use a community chemist pharmacy to collect your HIV drugs and if not, what your concerns might be? We would also like to hear from those of you who may prefer to stick with your existing hospital pharmacy, or seek other ways to access your medications such as whether postal options might be preferred. We welcome your enquiries and comments, as this helps guide the evolution of support information we can provide on your behalf. We will also be undertaking more formal surveying about community pharmacies among PLHIV in Queensland in February 2015, as a way to measure and inform your questions in preparation for the rollout in July 2015.
Department of Health Media Release (July 2014): www.health.gov.au/internet/ministers/publishing.nsf/Content/health-mediarel-yr2013-dutton049.htm
The Pharmaceutical Society of Australia (PSA): www.psa.org.au
Society of Hospital Pharmacies of Australia (SHPA): http://www.shpa.org.au/SHPA/ccms.r?Pageid=6008&DispMode=goto%7C10431
ASHM News: Article by Levinia Crooks: http://www.ashm.org.au/Pages/News/New-Study-Shows-Support-for-Early-HIV-Treatment.aspx
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