Update: Changes to HIV treatment access for people ineligible for Medicare

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NAPWHA, ASHM, AFAO,  May 2022

From 1st July, people with HIV who are ineligible for Medicare, and who previously received HIV medication through compassionate access schemes, will be required to transition to alternative access arrangements in order to receive government-funded treatment*.

Option 1: individuals will need to engage in care with a public hospital-based physician and have their medication dispensed from a hospital pharmacy. The cost of consultations and any required pathology will be covered by the hospital.

Option 2: individuals can continue to see their regular s100 prescriber but will need to have their medication dispensed from a hospital pharmacy. The cost of the consult, and any required pathology will need to be covered by the patient or practice.

Option 3: individuals will need to engage in care with a publicly funded sexual health clinic and have their medication dispensed from a hospital pharmacy. The cost of consultations, and any required pathology will be covered by the sexual health clinic.

Option 4: individuals can still need to access their medication through the self-importation scheme at their own cost.

*any additional care or medication costs associated with side effects from treatment will not be covered by this government-funded scheme.

AFAO and the National Association of People with HIV Australia (NAPWHA) have developed a briefing paper to update the HIV community workforce on a Commonwealth initiative to provide equitable access to HIV treatment for people ineligible for Medicare.

HIV treatment must be available for all who need it, regardless of Medicare eligibility. AFAO and NAPWHA believe greater access to HIV treatment will keep people well and prevent onward transmission through effective and affordable treatment as prevention (TasP), ensuring Australia is on track to meet domestic and global elimination targets.

In 2020, 45% of new HIV notifications among gay and bisexual men were reported in overseas-born men. Providing equitable access to HIV treatment and clinical care, regardless of visa status, is a key priority in the AFAO-led Agenda 2025 consensus statement on ending HIV transmission in Australia. The Commonwealth initiative to provide HIV treatment for all is a vital step forward in the Australian HIV response with borders now open again and increasing numbers of temporary residents arriving in Australia.

By J Pope

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