community dispensing: hiv medications
TRANSCRIPT
Community DispensingHIV Medications
AFAO Members Forum
Craig Cooper
16 May 2015
Today’s Presentation• Advocacy and 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
Ministerial Announcement• Concerted effort 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
Australian Commission on Safety and Quality in Health Care – Partnering with Consumers Standard 2The 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
People living with HIV 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 %
People living with HIV DemographicsNational 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%
People living with HIV locationNational 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
HIV Treatment and CareNational Survey Feb 2015 NSW Survey Oct 2014 Victorian Survey April 2015
Sexual Health or HIV
Specialist
51.44% Sexual Health or HIV
Specialist53.03% 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
Rates of People living 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 arrangementworks
Concern withdisclosure
4%
39%
57%
Regional NSW - Reason for No
Collect from doctor
Current arrangementwork
Concern withdisclosure
National NSW QLD NT 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
Reasons for collecting HIV 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 medicationsNational 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%
• Brochure, tear-off pad, eBanner adverts, shout-outs, news items
• Pharmacists resource Booklet – ASHM / PSA
ResourcesInformation
People living with HIV• 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
Pharmacist – Local Chemist• 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
Pharmacist Training
• Society of Hospital Pharmacists of Australia – PLHIV involvement
• Pharmacy Guild of Australia
• ASHM / PSA Online Learn
Implementation Challenges• Surveys reveal 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?
