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Community Dispensing: HIV Medications
The document discusses a forum focused on improving access to HIV medications in Australia, highlighting advocacy efforts and the 7th National HIV Strategy aimed at increasing treatment uptake among people living with HIV (PLHIV). It includes survey findings on demographics and experiences of PLHIV, revealing insights into their access to treatments and preferences for obtaining medications. Additionally, the document addresses training needs for pharmacists and the challenges related to stigma and privacy concerns faced by PLHIV in accessing their medications from local chemists.
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Community Dispensing: HIV Medications
- 1. Community Dispensing HIV Medications AFAOMembers Forum Craig Cooper 16 May 2015
- 2. Today’s Presentation • Advocacyand lobbying – Ministerial Announcement • Improved access to HIV medications – treatment uptake and adherence • Australian Commission on Safety and Quality in Health Care – Partnering with Consumers Standard 2 • PLHIV Survey – PLNSW, NAPWHA and LPV • Survey Findings • PLHIV and Pharmacist training, resourcing and information needs • Implementation challenges
- 3. Ministerial Announcement • Concertedeffort and continuous advocacy – NAPWHA, ASHM, AFAO, PLHIV Special Representatives • Ministerial Announcement • 7th National HIV Strategy and Implementation Plan - Increase treatment uptake by people with HIV to 90% • PLNSW Access to HIV Medications – Advisory Group • Pharmaceutical Society of Australia – Steering Committee
- 5. Australian Commission onSafety and Quality in Health Care – Partnering with Consumers Standard 2 The intention of this Standard is to: create a health service that is responsive to patient, carer and consumer input and needs. Context: This Standard provides the framework for active partnership with consumers by health service organisations. It is expected that this Standard will apply in conjunction with Standard 1, ‘Governance for Safety and Quality in Health Service Organisations’, in the implementation of all other Standards. Criteria to achieve the Partnering with Consumers Standard: - Consumer partnership in service planning - Governance structures are in place to form partnerships with consumers and/or carers - Consumer partnership in designing care - Consumers and/or carers are supported by the health service organisation to actively participate in the improvement of the patient experience and patient health outcomes - Consumer partnership in service measurement and evaluation - Consumers and/or carers receive information on the health service organisation’s performance and contribute to the ongoing monitoring, measurement and evaluation of performance for continuous quality improvement
- 6. People living withHIV Surveys (PLNSW, NAPWHA and LPV) National Feb 15 NSW Oct 14 Victorian April 15 Responses 370 Responses 504 MSH=135, AH=41, Online=37, 212 HIV+ 90.27% (334) HIV+ 79.56% (401) 100 %
- 7. People living withHIV Demographics National Survey Feb 15 NSW Survey Oct 14 Male 89.78% Male 94.52% Female 9.90% Female 5.48% Transgender 0.32% Transgender 0.00% Gay Male, homosexual, queer 81.79% Gay Male or homosexual, queer 86.74% Bisexual 3.19% Bisexual 6.05% Heterosexual 14.7% Heterosexual 6.92% Aboriginal, Torres Strait Islander 3.26% Aboriginal, Torres Strait Islander 2.93% Salaried/waged 52.72% Salaried/waged 47.84% Unemployment Benefit 5.43% Unemployment Benefit 4.90% DSP or Aged Pension 30.99% DSP or Aged Pension 39.77% Supported by partner/spouse 1.92% Supported by partner/spouse 3.75% Other source of income 8.95% Other source of income 3.75% 35-44 22.36% 35-44 14.70%
- 8. People living withHIV location National Survey Feb 2015 NSW Survey Oct 2014 Victorian Survey April 2015 ACT 6.07% Sydney Metro 67.72% Melbourne Sexual Health Centre 53.3% NSW 8.63% Western Sydney 3.75% Alfred Hospital 19.34% NT 1.92% Blue Mountains 1.9% Online 17.45% QLD 42.49% Central Coast and Newcastle 6.34% Other 10% SA 12.14% Hunter New England 1.7% TAS 3.19% Mid North Coast 3.17% VIC 10.86% Northern Rivers 6.92% Illawarra and South Coast 1.95% Southern NSW and ACT 3.75% Western NSW 1.95% Interstate 1.5% 2015 Australia NSW VIC QLD SA WA TAS NT ACT 24803 10867 5858 4454 1211 1687 236 180 309
- 9. HIV Treatment andCare National Survey Feb 2015 NSW Survey Oct 2014 Victorian Survey April 2015 Sexual Health or HIV Specialist 51.44% Sexual Health or HIV Specialist 53.03% Sexual Health or HIV Specialist 52% GP/s100 prescriber 28.12% GP/s100 prescriber 32.85% GP/s100 prescriber Hospital doctor (s100 prescriber) 20.45% Hospital doctor (s100 prescriber) 14.12% Hospital doctor (s100 prescriber) ART – 3 or more years 69.01% ART – 3 or more years 76.66% ART – 3 or more years 72% ART – 1 to 3 years 20.77% ART – 1 to 3 years 15.56% ART – 1 to 3 years ART – less than 12 months 7.35% ART – less than 12 months 6.92% ART – less than 12 months Not on ART 2.88% Not on ART 0.86% Not on ART
- 10. Rates of Peopleliving with HIV collecting cART from chemistsNational Survey Feb 2015 NSW Survey Oct 2014 Yes 78.27% yes 64.84% No 21.73% No 36.16% Reason – ease of access 100.00% Reason – ease of access 100.00% 31% 20% 49% Greater Sydney - Reason for No Collect from doctor Current arrangement works Concern with disclosure 4% 39% 57% Regional NSW - Reason for No Collect from doctor Current arrangement work Concern with disclosure
- 11. National NSW QLDNT WA SA VIC TAS ACT Yes (78%) 63% 84% 50% 74% 84% 71% 70% 84% No (22%) 37% 16% 50% 26% 16% 29% 30% 16% Rates of people living with HIV who would consider collecting HIV medications from chemists
- 12. Reasons for collectingHIV medications from a hospital pharmacy National Survey Feb 2015 NSW Survey Oct 2014 Victorian Survey April 2015 Concern about people knowing HIV status at chemist 69.23% Concern about people knowing HIV status at chemist 54.64% Concern about people knowing HIV status at chemist 40% Current arrangement works (convenience) 18.46% Current arrangement works (convenience) 25.83% Current arrangement works (convenience) 80% (36.88%) Can collect ART when seeing doctor 12.31% Can collect ART when seeing doctor 20.53% Can collect ART when seeing doctor Preferred way to access HIV medications National Survey Feb 2015 NSW Survey Oct 2014 Victorian Survey April 2015 Hospital Pharmacy 23.10% Hospital Pharmacy 30.81% Hospital Pharmacy 37.2% Chemist 71.62% Chemist 61.92% Chemist 27.9% Postal scheme 22.11% Postal scheme 19.77% Postal scheme 23.5%
- 13. • Brochure, tear-offpad, eBanner adverts, shout-outs, news items • Pharmacists resource Booklet – ASHM / PSA Resources Information
- 14. People living withHIV • From 1 July 2015, HIV treatments can be picked up from a hospital pharmacy, a local chemist or delivered via online options • To pick up from a local chemist or arrange delivery via an online options, your scripts will need to be dated 1 July 2015 or thereafter • Plan ahead to renew your scripts and allow time for the chemist to order stock especially if you live in an outer suburban, regional or rural area • Call the pharmacist at your chemist to discuss your needs and think about developing a relationship with a pharmacist
- 15. Pharmacist – LocalChemist • Hospital scripts will be recognised by local pharmacists • Pharmacists at the local chemist will be able to identify all the features of a standard Pharmaceutical Benefits Scheme (PBS) script • The script will need to contain the new streamline authority code which will come into place on 1 July 2015 • The relevant PBS Streamlined Authority codes for each of the HIV-ART pharmaceutical benefit items will be generated closer to 1 July 2015
- 16. Pharmacist Training • Society ofHospital Pharmacists of Australia – PLHIV involvement • Pharmacy Guild of Australia • ASHM / PSA Online Learn
- 17. Implementation Challenges • Surveysreveal the level of interest for people living with HIV in the survey and accessing cART from chemists • What's being done in regions and jurisdictions to address PLHIV concerns (privacy and levels of knowledge) and to meet the need? • How are hospital pharmacists and community pharmacists being worked with to identify local chemists and facilitate pharmacist uptake? • HIV stigma, discrimination and prejudice – how will this be mitigated and complaints mediated or resolved?
- 18.