The role of Community Pharmacy in the dispensing of HIV medications. The implications for pharmacy, and the role of the pharmacist in the Healthcare chain

1. HIV medicine access from community
pharmacy

2. Learning Objectives
• Describe the current status of HIV prevalence, treatment
and how HIV is now considered a chronic, manageable
condition
• Describe the barriers that people living with HIV may
perceive towards the dispensing of HIV medicine from
community pharmacy
• Explain the PBS requirements for valid prescriptions of HIV
medicines
• Discuss the practical issues involved in the provision of HIV
medicines including the ordering, supply and counselling to
enhance access and adherence
• Discuss the dynamics of patient engagement relating to the
psycho-social impact for both the patient and the pharmacist

3. Community pharmacy dispensing
Target
↓ sexual
transmission
by 50% by
2015
Challenges
Low prevalence
High testing
High treatment
Needs
↑ testing by 30%
↑ treatment by 80%

4. HIV treatment

5. Joseph Tesoriero
• Has been a Community Pharmacist for 32 years,
primarily in the Commercial Rd, Prahran area
• Owner of HealthSmart Pharmacy, based at The Alfred
hospital since 2002
• Co-owns a number of HealthSmart pharmacy sites,
delivering Community Pharmacy services to public
hospitals, including Alfred, RMH and St. Vincent’s

6. PBS, Medicare & HIV medications
• Familiarize yourself with the usual HIV medications.
Great chart with categories.
• Familiarize yourself with PBS Medicare dispensing
rules. Valid date (1 July 2015). Check quantities.
• Gauge level of customer needs. Talk to your patients re
their usual medication access ( see Privacy)
• Manage customers expectation of notice required to
supply medication.. Urgency / Cost / Wastage
• Treat prescriptions as per other high priced items .
eg Reporting on high $$ items & ↓ GP % for banks

7. Privacy & Continuing Education
• Privacy & Respect - Review QCPP policies/procedures,
always treat with dignity, as with every medical condition
treated, remove the stigma.
• Look at pharmacy layout. Continuous improvement
• Educate assistant staff with processes involved.
• Professional development of pharmacists, ↑ skillset ,
develop service based model of pharmacy
• Rewarding: utilise drug-drug interaction knowledge,
contribute to better adherence

8. Logistics, Technology & Referring
• Most patients ( initially) on established regimens, but
enquire on wholesaler stock availability.
• Technology to manage managing adherence eg
Healthnotes.
• Webster & Medico packs to reduce resistance
• Timely, convenient, extended trading to ↑ compliance
• When to refer, where to refer – Alfred, MSH, PMC
• http://www.ashm.org.au/
• http://www.hiv-druginteractions.org/

9. Business benefits, patients benefit,
PBS efficiency, Community benefits
• Dispensing fee and/or margin for pharmacy
• Builds customer loyalty
• Aware of co-morbidities and other medications
• No delay to DAA packing ( due to no Rx )
• Reduces potential wastage, reduce excess supply ( eg
changes to drug regime)
• Aim to Improve compliance ( 95%+)
• Aim for Undetectable viral loads
• Aim for Zero transmission.

10. Interactions
www.hiv-druginteractions.org